Health Care Cost and Coverage Reform: the loyal opposition's opinion

As promised, here is the Wall Street Journal's opinion. Before you go on here is a comment from some one from another country:

"I’m not an American (some of those who knows me may add ‘regretfully’… J). Am an Israeli and veteran friend of Laura & Ted (as well as, with other addressees) and as such, I’ve the privilege to be on Ted’s ‘mailing-list’.
Notwithstanding, I’m taking the liberty to share with you guys my feelings.
I feel today that the success of Obama’s Administration (with the House-Speaker’s support…) to pass the Health Reform is an historical event that defined as, no less, than a hilling of the entire ‘Civil Right Legislation’.
By giving a chance to any one to get, at least, a basic Medicare (such as in Israel) we are expressing mercy and humanity.
Yes, the priorities with the budget expenditure might be amended, however, being part of a Society that has a sense of mutual responsibility and brotherhood, seems to be a reasonable price.
To that extent, Ted’s great expression – “The good of everyone equally comes first” is an adequate way to illustrate your achievement for better life.
Happy Passover. Yoav"


CAPITAL JOURNALMARCH 22, 2010
Vast Ambition, Colossal Risk
By GERALD F. SEIB

As a piece of social policy, the health bill passed Sunday night by the House of Representatives ranks up there with the Great Society programs of Lyndon B. Johnson in ambition and scope. But here's one big difference: The Great Society programs were enacted in an era when Americans still tended to trust the government to get things done.

By contrast, a principal reason the health bill was so hard to get to this point, and the reason it's such a political risk, is that this landmark legislation proposes expanding the government's role in the giant health economy at a time when Americans are far less likely to trust the government to do things right.

President Barack Obama will sign the core legislation into law, and it's likely the Senate will also approve a package of changes to that law, which the House passed Sunday night. But how the legislation is perceived by Americans in both the short term and long run may well depend on whether its advocates—Mr. Obama, his Democratic allies in Congress, a variety of labor and health interest groups—can convince Americans that, at least on this giant issue, the government is up to the task.

At a minimum, Democrats will be trying to show citizens that the government can produce outcomes that are at least superior to the status quo in health care, which almost everybody agrees can't be sustained.

Proponents of the health legislation are quick to point out that it doesn't amount to a government takeover of health care, and they are right. The legislation builds on, rather than replaces, the employer-based health-insurance system that has prevailed in this country for decades. It funnels patients getting government subsidies into private insurance policies and pools, not a government-run health plan, and is at best a small step toward the nationalized health-care system some liberals want.

So in that sense, it's a far more modest exercise in social engineering than was the Great Society program of the mid-1960s, which included legislation creating Medicare and Medicaid, the food-stamp program and Head Start, as well as two landmark civil rights acts.

Yet by making the federal government both a much bigger economic player, and a more potent referee, in the private health marketplace, the new health bill represents a similar turn to government action to confront gnawing domestic concerns. What has changed are attitudes toward that government

When President Johnson led the drive to create Medicare and Medicaid, Americans saw before them a government that had won World War II, built the interstate highway system and launched an almost universally admired space program that was headed toward putting a man on the moon. The New Deal was widely considered the reason the Great Depression finally was vanquished. "Liberal" was such a coveted label for a politician that one of President Johnson's deep worries when he took over after President John Kennedy's assassination was that he might be seen in Kennedy circles as too conservative.

Since then, attitudes have soured. The Vietnam War went from nuisance to debacle, tarnishing for a long while the notion that the nation's best and brightest minds were at work in Washington dealing brilliantly with difficult problems.

Later, President Ronald Reagan told us government was the problem rather than the solution, President Bill Clinton declared the era of big government was over and President George W. Bush told us the other big piece of the social safety net, Social Security, was better taken out of the government's hands entirely and turned over to the private sector.

More recently, government experts assured the nation that Iraq had weapons of mass destruction, a mistaken conclusion with calamitous consequences. Now deficits further sow doubts about Washington.

The result has been an erosion over time in confidence in government's competence. One of the best barometers of that shifting attitude is found in polling done by the Gallup organization, which for four decades has been testing Americans' trust in government. When Gallup asked in 1972 how much Americans trusted the federal government to handle domestic problems, 70% said they had a "great deal" or "fair amount" of trust. By last year, that had fallen to 51%—almost even with the 48% who said "not very much" trust, or "none at all."

Here's an even starker reading: In a Wall Street Journal/NBC News poll last fall, Americans were asked how much of the time they trusted the government to do the right thing; 65% said "only some of the time," and a stunning 11% said "never."

Can confidence in government be turned around? Perhaps; it seemed to rise briefly in those feel-good moments after President Obama's 2008 election victory.

That's why the Obama administration's ability to competently put health legislation into practice, assuming it becomes law, is so crucial.

On that front Democrats can console themselves with some other history: Medicare itself was viewed as a nearly impossible undertaking, but was implemented smoothly, as was a Medicare prescription-drug benefit signed into law by President George W. Bush.

Maybe, advocates might argue, that shows the government can get some things right after all.

Write to Gerald F. Seib at jerry.seib@wsj.com