Editore"s Note
Tilting at Windmills

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June 18, 2003
By: Kevin Drum

UNIVERSAL HEALTHCARE....Commie symp lefty blogger Max Sawicky takes a look at Howard Dean's platform and says, basically, it looks OK to him. However, he also makes this specific comment about Dean's healthcare plan:

I'm not sufficiently expert to evaluate the Dean plan. I note that it has multiple parts and runs the risk of Hillarification. In this business, simplicity is important. I also note that there seems no treatment of cost containment, the giant sleeper issue in health care that no politician talks about.

I agree with all of that. Whether universal healthcare is a winning issue for Democrats in 2004 is something I'm not sure about, but a simple plan is certainly the only kind that has a chance. By way of comparison, I would say that Al Gore lost the 2000 election not because his tax cut proposal was too small, but because it was too complex. George Bush was able to paint it as a typical piece of idealistic liberal social engineering, and that description stuck.

(And yes, I know that whenever an election is as close as 2000 was, pretty much anything can be plausibly trotted out as the straw that broke the camel's back. I happen to think that this is the one that both (a) made a big difference and (b) was entirely under his control.)

I suppose the problem is that a simple plan is almost inevitably a very wide ranging and costly plan as well, and no one thinks that's politically feasible. Still, I can't help but think that candidates would be better off just skipping the issue entirely than they are offering a competing set of watered-down plans that are hard to understand and don't appeal to a very wide segment of the population.

And as Max says, cost containment is key. Unfortunately, only one of those simple, broad-based (but politically risky) plans has even a prayer of keeping costs down. Still, if there's any way to sell simple universal healthcare to the American public (and Congress), this is the soft underbelly to attack. Americans spend far more on healthcare than any other country, but we don't seem to get appreciably better service for all the extra money that we pay.

Of course, cost containment inevitably means rationing of some kind, regardless of what you call it, and that's a political loser.

On the fourth hand....well, you get the idea. The whole thing is just a mess and it's hard to see what kind of plan actually has a chance of getting widespread support. Overall, I'm just not convinced that the healthcare sweepstakes currently in play in the Democratic primaries has much chance of helping our cause. Maybe in 2008.

Kevin Drum 3:33 PM Permalink | Trackbacks

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