Universal health coverage will lead to reductions in freedom, warns Ronald Brownstein. Actually, that’s not quite right: Brownstein is delighted by the prospect.

Any universal coverage plan will grow unsustainably expensive unless health care inflation slows. Preventing, rather than treating, disease is one key to controlling health care costs. And few diseases present a more obvious target for prevention than the heart and lung ailments and cancers linked to smoking. Rep. Henry Waxman, D-Calif., chairman of the Energy and Commerce Committee, says that as Congress considers universal health care it has “a greater incentive” to deal with tobacco because it is “a leading cause of preventable death and disease.”

States, writes Brownstein, cannot be trusted to do the right thing. The states that most “need” anti-smoking legislation won’t get it because they have too many smokers. So “only Washington can comprehensively confront the intolerable human and financial costs of smoking.” Which is another way of saying that smoking can’t be tolerated.