Poll-Driven Policy
What happened to Obama's old promises about health-care reform?


Revolutionary. There’s no word that more aptly describes the health reform that was just enacted. It will affect everyone. Every employee. Everyone on Medicare. Everyone on Medicaid. It will even affect those who choose to remain uninsured. It will give the federal government enormous control over a sector in which one out of every six dollars in our economy is spent. Once fully phased in, the ten-year costs will approach $2.5 trillion — and maybe more.

Given all that, does anyone find the way the president talks about health care these days a bit strange? Consider these fairly routine stump-speech phrases:

“Insurers will not be able to drop your coverage after you get sick.” True enough. But this practice has been illegal for the last decade and a half under a federal law called HIPAA.

“If you have a 26-year-old dependent child who can’t get health insurance elsewhere, you will be able to cover him on your own health plan.” Well, okay. But how many 26-year-olds can’t find insurance, and need to enroll in their parents’ plan? Not many, I gather. When the White House finds one, I’m sure they will trot him out for the television cameras.

“There will be no more lifetime caps on health-insurance benefits.” Good news, no doubt, for the one-hundredth of a percent of the population that bumps up against them.

“If you have a child or adopt a child, your insurer will not be able to exclude him because of a pre-existing condition.” Most states already require this. And it’s standard practice anyway.

“In four years, no insurer will be able to discriminate against anyone because of a pre-existing condition.” True enough. But more than 90 percent of everyone in the United States with health insurance already can’t be excluded because of pre-existing conditions (again, HIPAA requires employers to take everyone with minimal waiting periods). And of the other 10 percent, only a small fraction faces serious problems.