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The Healthcare Primary -- Why this issue will be big

Slate magazine has an article this week about Barack Obama's health care plan. Obama and all the other candidate will come to the table with health care plans of some sort.

Yet this Slate article -- apparently the first in a series -- is useful because it tells us why healthcare will be a big deal.

The issue of greatest immediacy is the Iraq war, but none of the candidates has a brilliant idea about what to do. Even if he (or she) did have an effective plan, it would still be a crapshoot as to whether he (or she) would implement it if elected...Immigration is the hot issue of the moment, but I presume that by Election Day either it will be resolved or the warring parties will have resolved not to resolve it.That leaves health care.

And the timing for healthcare -- the environment for real change seems right:

The American health-care system is in an advanced state of collapse owing to the failure of an 80-year experiment in market economics. Politically, the problem has grown more urgent because rising health-care premiums and diminishing coverage are starting to cause serious problems for the middle class. Health insurance costs more and more and covers less and less. Per capita health-care costs are about twice what they were when Hillary Clinton tried unsuccessfully to reform the system in 1994, and the ranks of the uninsured have increased by 13 percent. Universal health insurance, which has eluded the political system at least as far back as 1912, when former president Teddy Roosevelt endorsed it in his failed Bull Moose bid, is starting to look inevitable. Even insurance companies think so, according to a May 30 article by Jackie Calmes in the Wall Street Journal. According to the Journal, the insurers have given up blocking universal health care, "Harry and Louise"-style, and are now redirecting their energies toward co-opting it.

So what is Obama proposing -- required health insurance on the individual level coupled with a number of much needed reforms in the vein signed by Mitt Romney. That said, the best part would be a public health insurance program with comprehensive benefits, limits on premiums, co-payments and other protections.

The bad news about Obamacare's (shhh!) socialized-medicine component is that it would be offered only to the self-employed, to employees of small businesses, and to people whose employers didn't give them health insurance. But this last group is growing larger every day, and the mere existence of a public health-insurance program would likely cause businesses to drop out of their private health-insurance plans in droves. That would be fine by me, provided the public health-insurance plan were a decent one. Eventually, all the other parts of Obama's plan might well wither away, leaving only this one.

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