I supported Part D -- the largest expansion of Medicare in a lifetime -- while most Democrats who supported the same approach in 1999 did not. I did because I thought that adding drug benefits would reduce health care spending overall and that giving people choice would create competition and lower costs. I have always opposed SCHIP because it addressed a problem that did not exist with a solution that made matters worse. We have 4 -5 million kids eligible for Medicaid in 2006 and that was about the same number in 1997. Meanwhile the single payer approach if you will has made it hard for people to enroll in SCHIP. All the while, we have ignored the issue of coverage for illegal workers who make up a huge chunk of the uninsured and the fact that lots of people are just to cheap and irresponsible to buy their own insurance.
But that's the heart of the debate. I think everyone should have access to health care coverage and decent care. I don't think we can guarantee results or equal outcomes and I don't think government does a great job delivering health care coverage. Cohn does. This debate is not over. SCHIP will get refunded but not expanded. And then we can have a debate about whether we want Hillary to run health care (setting up a false set of choices that lead to a single payer system) or let people decide for themselves through insurance deregulation, HSAs, tax credits and retail clinics.
I think conservative ideas on health care will win the day. Why? Because we value freedom as an essential ingredient for excellence in medical science and sustaining dignity in the doctor patient relationship. Without freedom, the freedom to innovate, to prescribe, to choose, to err, medicine suffers.
My thanks again to Mr. Cohn for reshaping the debate around what matters. Here's a link to his post and to his book about the health care system.