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An Aborted Obama Health Care Postmortem

Former Bush administration health official Tevi Troy has a long article in Commentary that seems to have been intended as a postmortem of President Obama's health care plan but was perhaps edited to account for its continued existence to date. The article begins with the election of Scott Brown, and uses that as a pivot to its thesis -- "the Brown election can be seen as the closing of the door on a two-decade era in which Democrats, Republicans, and most of the political class came to believe that the Democrats possessed an inherent electoral advantage on the health-care issue" -- even though Brown's election has only changed the procedural mechanics of trying to pass health care reform.

Troy's article is a familiar restatement of the conservative view of the health care debate, with the slight twist of glorifying Bush's role -- incremental reform, financed 100% with deficit spending -- rather than condemning it. I thought this line was especially amusing:

Since Medicare’s passage in 1965, there has been an understanding—among the American people if not always its leaders—that the government would help seniors, poor people, and those with disabilities attain health-care coverage, but that the rest of the country would secure private health insurance.

That, of course, is the problem: 46 million members of the rest of the country have not secured private health insurance, or any health insurance. If Troy wrote what he is actually trying to say, he would have phrased it like so: "the rest of the country would have to rely on its own means to obtain private health insurance, though tens of millions would be unable to do so." I can see why phrasing matters more frankly didn't appeal to him.

I'd also note that the arrangement that Troy claims currently exists -- seniors, the poor and disabled get government sponsored insurance, the rest of the country secures private insurance -- is what Obama's plan would actually do.