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A Government Takeover Of Health Care? If Only!

"I want families making decisions about health care, not the federal government."

This, of course, is John McCain's--and every conservative's--favorite line about proposals for universal health care. So in case anybody is visiting this site for the first time, and perhaps hasn't followed this debate, here are the essential points.

1. Obama has not proposed to have the federal government take over health insurance. He would set standards for what private insurance must provide--and how private insurance carriers must sell their policies. That means making sure everybody gets benefits as good as what members of Congress gets and making sure everybody can get coverage. Most Americans think those are good things--and they are right.

2. Obama would create a public health plan, something that looks like Medicare, into which anybody can enroll. One reason for doing this is to provide a safety check on private plans: If private insurers know they must compete with a public plan, they can't play the same games--that is, they can't try to exclude people with serious medical conditions or short-change beneficiaries. Private insurers have been known to do these things. It's possible everybody could end up in the public plan--but, if so, that would only be because everybody wanted to join. (What Obama is proposing looks a lot like this.)

3. For the record, if we did have a government-controlled health care system in this country, we'd probably be better off. The most popular insurance program in America is Medicare, a government-run health care system. Most experts will tell you that the most efficient, high-quality health care in this country comes from the Veterans Administration (thanks mostly to its high-tech patient information system). That's as close to socialized medicine as you'll find in this country. But nothing Obama has proposed would come close to putting everybody into a VA-like system. (Also, for what it's worth,sSome of the best health care systems in the world--namely the systems in France and Taiwan--are truly government-run.)

4. Nobody should know the benefits of govenrment-run health care better than McCain, who over the years has benefitted from eligibility in the VA system, the Federal Employees Health Benefits Plan, and Medicare. 

5. McCain's health plan would not make health insurance more affordable and accessible. More likely, it will lead to people losing good coveage. And the impact will be felt most by those with pre-existing medical conditions--that is, the people who need insurance the most. More on that here and here and here.

--Jonathan Cohn