Are you confused about the health care debate?
Are you a bit dizzy from trying to distinguish among the Clintonplan, the Cooper plan, the Senate Finance Committee plan, the HouseWays and Means Committee plan, the Mitchell plan, the Gephardt planand the Dole plan?
Of course you are. That's because we're confused as a peopleabout what we want, and how we think it should be paid for.
Here's one example, provided by Hillary Rodham Clinton. Thereports of her comments focused on the 'personal attack' shesupposedly made on Texas Sen. Phil Gramm. But the substantive pointshe made deserves examination.
How does Gramm feel, she asked, about government-mandatedpayroll deductions in order to support health care for an entireclass of Americans regardless of their economic need?
In fact, we have such a program. It's called Medicare. Itcovers every American over the age of 65. And it's almost impossibleto find a senator who will stand up and say this program should berepealed or drastically curtailed.
Medicare is one of the most costly 'entitlement' programs run bythe federal government. In hospital insurance alone, Medicare cost$67 billion in 1990; when the program was passed in 1965, costprojections for 1990 were estimated at $9 billion.
Could we cut the cost of Medicare? Sure - provided we werewilling to tell senior citizens: 'You can spend this amount of moneyfor health insurance, and no more.'
It's called 'rationing.' And given the clout of the seniorcitizens' lobby, the odds on enacting some form of rationing areabout the same as the chance that we will cede Oregon and Idaho toCanada.
At the same time, the specter of the government somehow gainingany more control over the nation's health care system is frighteningto millions of Americans.
In part, this is a product of the multimillion-dollaradvertising campaign; Harry and Louise have done their jobs.
In part, this fear is rooted in a belief that the governmentwill louse up anything it gets its hands on. This is exemplified bythe argument that a government-run health care system will combine'the efficiency of the Postal Service with the compassion of theInternal Revenue Service.'
What all this adds up to is a citizenry whose politicalschizophrenia was dramatically demonstrated by a recent NBC poll.
When asked if they favored cuts in 'entitlements' to cut federalspending, 61 percent of those polled said 'yes.'
But when asked if they favored cuts in 'government programs suchas Social Security, Medicare and Medicaid' - the three biggestentitlements - 66 percent of those polled said 'no.'
It is in this atmosphere, then, that the Senate health caredebate will take place: with the public favoring a health care planthat covers everyone, provides all the health care that we desire,preserves all the choice that most Americans have, and costs lessthan what we now pay.
Meanwhile, the rest of the industrialized world, which has hadsome form of government-supplied health care for decades, looks on inconfusion.
Of course, that's because they don't understand the subtletiesof America's political philosophy.
