How our health care stacks up with Slovenia's.

• Author: Noah, Timothy
• Position: THE STAKES 2008

We don't have a health care crisis in this country," Senator Daniel Patrick Moynihan stated publicly in September 1993, three days before President Bill Clinton was to unveil his health care reform bill. Moynihan's remark, coming from a member of the president's own party, did a lot more than Harry and Louise to kill off Hillarycare. (It didn't help that Moynihan, who was chairman of the Senate Finance Committee, wouldn't hold hearings on the bill.) The good news in 2008 is that no prominent elected official, Democrat or Republican, would dare deny any longer that we have a health care crisis. The bad news is that over the past fifteen years the crisis has gotten much worse.

Since 1993, the number of uninsured Americans has risen from 38 million to 47 million. Per capita health care spending has more than doubled, rising from 12 percent of gross domestic product to 16 percent. Health insurance premiums have increased at an annual rate typically double or triple the rate of salary increases, yet have bought workers steadily less coverage as managed care plans have replaced virtually all traditional health insurance policies. Remember, back in 1993, when you worried that the government would choose your doctor? Today, your insurance company chooses your doctor.

What has this industry-led managed care revolution produced? Well, according to a World Health Organization survey made famous by Michael Moore's film Sicko, the United States--with a GDP three times bigger than anyone else's--now places thirty-seventh out of 191 countries in the overall quality of its health care system. That's just a whisker ahead of Slovenia.

The danger, then, isn't that the next president will fail to pass a health care reform bill. It's that whatever bill he passes will fail to address the current crisis in any meaningful way. That outcome is much likelier if John McCain wins the election.

In discussing their respective health care proposals, both candidates tend to focus on the need to increase regulation of the private health insurance market. I think it's too late for that; the insurers have by now developed many, many more varieties of chicanery to deny claims than any government regulator could hope to keep track of, much less prohibit. The question therefore becomes: Which candidate proposes expanding the government's role in providing health insurance? Only Obama, who would create a new public health insurance program limited to the self-employed, employees...