Wednesday, January 30, 2008

California's "Universal" Health Coverage Dies on the Table: WSJ Does a Post-Mortem

Arnold Schwarzenegger's "universal" health-care plan died in the California legislature on Monday, in what can only be called a mercy killing. So let's conduct a political autopsy, because there are important lessons here for the national health-care debate...

So much for that. The California legislature is probably the most liberal this side of Vermont, and even Democrats refused to become shock troops for this latest liberal experiment. Mr. Schwarzenegger and Democrats in the State Assembly did agree on a compromise plan in December. But on Monday, only a single member of the Senate Health Committee voted to report the bill to the full chamber -- and thus it joined a graveyard full of state "universal" health-care failures.

Like collapses in Illinois, Wisconsin and Pennsylvania, this one crumpled because of the costs, which are always much higher than anticipated. The truth teller was state Senate President Pro Tem Don Perata, who thought to ask about the price tag of a major new entitlement amid what's already a $14.5 billion budget shortfall.

An independent analysis confirmed the plan would be far more expensive than proponents admitted. Even under the most favorable assumptions, spending would outpace revenue by $354 million after two years, and likely $3.9 billion or more. "A situation that I thought was bad," Mr. Perata noted, "in fact was worse."

This reveals that liberal health-care politics is increasingly the art of the impossible: You can't make coverage "universal" while at the same time keeping costs in check -- at least without prohibitive tax increases. Lowering cost and increasing access, in other words, are separate and irreconcilable issues...

All of which is to say that while the plan was opposed by nearly all Republicans, it died at the hands of Democrats. Mr. Schwarzenegger was a collaborator in that he went out of his way to assail and thus alienate fellow Republicans for opposing tax increases to pay for the plan. But if Mrs. Clinton or Barack Obama want to push a major health-care reform through Congress, they will have to find a way to appease their own left-wing while not alienating business and taxpayers...

What the California collapse should discredit in particular is the individual mandate as a policy tool for Republican reformers. This was Mr. Romney's enthusiasm for a time, helped along by the Heritage Foundation. But in order to be enforceable, such a mandate inevitably becomes a government mandate, and a very expensive one at that.

Voters are rightly concerned about health care, but they also don't want to pay higher taxes to finance coverage for everyone. Mr. Schwarzenegger's spectacular failure shows that there's an opening for Republicans to make the case for health-care reform based on choice and tax-equity, not mandates and tax hikes.