Thursday, January 20, 2011

David Frum on the Politics of Health Care

David Frum explains the Republican problem with health care:

If I were working for a 2012 Republican presidential aspirant, I’d be preparing now for this debate question: “Governor/Senator: Do you believe that the federal government should ensure that all Americans can buy an affordable health-insurance policy?”

It’s a tough question. If you answer “no” — well you are putting yourself pretty clearly on the wrong side of public opinion.

Americans may be divided on the Democrats’ recent health reform. . . but on the specific question I just asked, the American public expresses itself more than 70 percent in favor, according to the Kaiser Family Foundation. In a survey conducted during the George W. Bush years, The New York Times tested Americans’ generosity. What if helping the less advantaged increased the cost of your own health insurance? Forty-eight percent were still in favor of a government plan; only 38 percent said they were not. What if the plan added $500 to your tax bill? Forty-nine percent were in favor, 44 percent said “no,” with independents polling slightly higher in the direction of “yes.”

In other words, candidly shrugging off the uninsured will rub many voting Americans very much the wrong way. On the other hand, answering affirmatively carries other risks for a Republican.

Once you commit to covering everyone, you have taken a big step toward something that looks very like the plan Mitt Romney signed into law in Massachusetts.

There are infinite possible variations on that program, but it gets kind of hard to avoid its basic shape: regulation to define what insurers must cover, a mandate on individuals to buy insurance, subsidies for those who cannot afford insurance. It’s hard to escape the Romney-care destination — a destination mistrusted and disliked by the Republican Party’s voting base.

All the health care rhetoric being put out by the current Republican leaders, about making health care work better and not putting the government between you and your doctor, is just a smokescreen designed to distract moderate voters from the grim truth: they don't care if poor people can get health care.

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