In health-care fight, Americans are rightly suspicious of politicians' egos

WASHINGTON — What's driving the great health debate of 2009 is not a popular clamor for universal insurance. "Many Americans are balking again at the prospect of health-care reform," writes pollster Andrew Kohut of the Pew Research Center. A new Wall Street Journal poll found 41 percent of respondents opposed to President Barack Obama's proposals and 39 percent in favor (the rest were undecided). The underlying driver is politicians' psychological quest for glory.

"My colleagues, this is our opportunity to make history," implored Chairman Max Baucus as the Senate Finance Committee last week opened consideration of his bill. Politicians, in their most self-important moments, see themselves as instruments of national destiny. They yearn to be remembered as the architects and agents of great social and economic transformations. They want to be at the signing ceremony; they want a pen.

Ordinary Americans are rightly suspicious of this exercise in collective ego gratification, which has gripped Obama and many of his congressional allies. Even when the goals are worthy — as they are here — the temptation to exaggerate, simplify and sugarcoat often proves irresistible. Baucus' promotion of his handiwork is a case in point.

One study "found that every year in America, lack of health coverage leads to 45,000 deaths," he told the committee. "No one should die because they cannot afford health care. This bill would fix that."

There was more. "These reforms would give Americans real savings," Baucus said. The Congressional Budget Office "tells us that the (insurance) rating reforms and exchanges in our proposal would significantly lower premiums in the individual market." As well, the bill wouldn't increase the budget deficit and "starts reducing the deficit within 10 years."

If only all this were irrefutable. But Baucus' claims are shaky. It's questionable whether more insurance would save 45,000 lives a year. Unfortunately, just having insurance doesn't automatically improve people's health. Sometimes more medical care doesn't really help. Sometimes people don't go to doctors when they should or follow instructions (take medicine, alter lifestyles). Indeed, many people don't even sign up for insurance to which they're entitled. An Urban Institute study estimated that 10.9 million people eligible for Medicaid or CHIP in 2007 didn't enroll.