In the Arena

A Very Belated Question About Health Care

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The release of the Baucus plan raises all sorts of policy questions, but it also raises a significant political issue that I keep forgetting to address here: Why on earth is the implementation of universal health insurance delayed until 2013?

It seems to me this is political idiocy. It will guarantee that Barack Obama’s reelection campaign will be overwhelmed by the same sort of demagoguery on this issue that defiled the month of August. The Republican candidate will be able to campaign on a one-issue platform: Stop Government Health Care Before It’s Too Late!

I know, I know–budget and logistical consideration demand a slow ramp-up to universal care. But it sure is inconvenient politically.  Mandates are never popular anywhere, but especially not in America–even though, in this case, they are morally and economically imperative. Given that as much as a third of the uninsured are young people who can afford insurance but don’t feel the need to buy in, I can easily see the Republican candidate running ads on MTV: “Barack Obama Wants to Force You to Pay $X000 per year for health insurance. That’s just not American!” And, no doubt, the campaign to scare the bejeezus out of senior citizens would ramp up another couple of notches.

Again, I know–no one ever said this was going to be easy. But, in politics, timing is essential. And the timing of this bill is not good for Barack Obama’s chances to win a second term.

Update: Paul Starr addressed this issue in the American Prospect last week:

Under the current proposals, most of the uninsured wouldn’t get coverage until the new insurance exchanges are set up in 2013. The law would move more quickly in improving prescription-drug coverage for the elderly and curbing some of the worst insurance abuses. But before the non-elderly would see results firsthand from the new system for buying, subsidizing, and regulating insurance, Republicans would have two elections to arouse public anxiety and overturn reform.

Obama said that it would indeed take four years to set up the exchanges in order to “do it right.” But then he added, “In the meantime, for those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.”

Making catastrophic health insurance “immediately” available would provide a bridge to more substantial reforms in 2013.