The Democratic-led Congress has passed bills to provide health insurance for 4 million uninsured children. In the Senate, nine Republicans joined all Democrats in the bill. That leaves 32 Republicans who opposed it. And here’s why:

But Mr. McCain said, “Some of us who look at this bill may view it as another effort to eliminate, over time, private insurance in America, and I am concerned about that.”

And Senator Roger Wicker, Republican of Mississippi, asked, “Is the real intent of this legislation to replace the private health care system with a government-run health care system?”

And from The Wall Street Journal’s Kimberley Strassel, who fears that Democrats in Congress are using “stealth” tactics to nationalize health care:

The bill even takes a whack at the private market. Under the guise of money for “health technology,” the legislation makes the government the national coordinator for electronic health records, able to certify what platforms are acceptable. This is an attempt to squelch a growing private market that is competing to improve transparency and let consumers compare providers and costs. In liberal-world, only government should be publishing (and setting) health-care prices.

Dude, if only! I would love to see the day when health insurance rips off only stupid rich people and the rest of the country enjoys a single payer health care system, freeing both businesses and workers alike from the burdens of rising health insurance costs and providing quality health care to everyone, regardless of class.

Oh, but that would be “socialism,” so screw that. If we look at how the Democratic candidates debated health care only a year ago, I think we’ll recall that the consensus favored a hodgepodge of various programs that hopefully achieved near-universal health care insurance coverage. The main bone of contention among the candidates was whether or not the government should impose an “individual mandate” that would somehow force everyone to seek some form of insurance — from an employer, from a government program, or from a private company. (I tended to agree with Obama that such a mandate could penalize poor people yet seemed rather unenforceable anyway.) There is also the Massachusetts program:

Yet Massachusetts has taken a very different route than Senators Clinton and Obama envision. Massachusetts basically adopted an individual-market model: People without coverage from their employer need to actively seek it out. The cornerstone of both candidates’ plans, by contrast, is the play-or-pay requirement: employers cover their workers, or their workers are automatically enrolled in a single insurance pool to which employers are required to make contributions. (Both candidates have said they would exempt small businesses from this requirement, which could pose a big hurdle to universal coverage, since most of the uninsured work for small firms.)

Done correctly — with businesses reporting whether they cover their workers to the federal government, which then enrolls uninsured employees and their dependents — a play-or-pay requirement makes covering people much less complicated. The more than 90 percent of non-elderly Americans (and more than 80 percent of the uninsured) who live in a family in which someone works would be enrolled automatically through the workforce. Many of those missed are already covered through public programs, and aggressive outreach could reach those who still remain without coverage. Thus, Mr. Obama’s plan could well cover almost everyone even without the individual mandate.

That leaves about 10-15 million people without health care coverage. For its part, the Democratic Party agenda advocates “quality, affordable health care for every single American” — and it’s the “affordable” part that sticks in my eye. Republicans lie that Democratic-led government will destroy the health insurance industry. I wish it were true, but I have more faith in corporate influence on congressional Democrats than that of well-placed single payer advocates. However, in the spirit of the times, I’ll hold out some hope that Rep. John Conyers succeeds in bringing “Medicare for all.”

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