"What’s easy about guaranteed health care for all? For one thing, we know that it’s economically feasible: every wealthy country except the
The politics of guaranteed care are also easy, at least in one sense: if the Democrats do manage to establish a system of universal coverage, the nation will love it.
I know that’s not what everyone says; some pundits claim that the
There’s every reason to believe that a program that extends universal coverage to the non-elderly would soon become equally popular. Consider the case of
Yet recent polls show overwhelming support for the plan — support that has grown stronger since it went into effect, despite the new system’s teething troubles. Once a system of universal health coverage exists, it seems, people want to keep it.
So why be nervous about the prospects for reform? Because it’s hard to get universal care established in the first place. There are, I’d argue, three big hurdles.
First, the Democrats have to win the election — and win it by enough to face down Republicans, who are still, 42 years after Medicare went into operation, denouncing “socialized medicine.”
Second, they have to overcome the public’s fear of change.
Some health care reformers wanted the Democrats to endorse a single-payer, Medicare-type system for all. On the sheer economic merits, they’re right: single-payer would be more efficient than a system that preserves a role for private insurance companies.
But it’s better to have an imperfect universal health care plan than none at all — and the only way to get a universal health care plan passed soon is to inoculate it against Harry-and-Louise-type claims that people will be forced into plans “designed by government bureaucrats.” So the Democratic platform emphasizes choice, declaring that Americans “should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan.” We’ll see if that’s enough.
The final hurdle facing health care reform is the risk that the next president and Congress will lose focus. There will be many problems crying out for solutions, from a weak economy to foreign policy crises. It will be easy and tempting to put health care on the back burner for a bit — and then forget about it."