The Obama health-care plan

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Sen. Barack Obama, the freshman Democrat from Illinois who had been riding high on "hope" and "optimism," finally offered some substance last week. He issued his health-care plan. During Sunday night's presidential debate in New Hampshire, Mr. Obama declared, "[W]e've got very conservative, credible estimates that say we can save families that do have health insurance about a thousand dollars a year." Alluding to the more than 45 million Americans who do not have health insurance, he added, "And we can also make sure that we provide coverage for everybody else."

Mr. Obama claims he can achieve these goals by reinstating the Clinton-era income-tax rates on those earning more than $250,000; by "driving down the costs, taking on the insurance companies, making sure that they are limited in the ability to extract profits and deny coverage"; and by "mak[ing] sure the drug companies have to do what's right by their patients instead of simply hoarding their profits." A former community organizer in Chicago who admired the radical Saul Alinsky, Mr. Obama still talks like the college sophomore who has taken his second sociology course. This is what passes for presidential timber in the Democratic Party today?

At the end of the debate, Mr. Obama, the best-selling author of "The Audacity of Hope," offered evidence that he is more cynical than audacious. After bringing the troops home from Iraq, he said the "second priority" would be "getting moving on health care because that's something that we can get done, I think, very quickly." This is really cynical because he clearly remembers then-first lady Hillary Rodham Clinton's two-year battle (1993-94) over health-care reform, which ended in political debacles for herself, her husband and their party. Since Mr. Obama's name adorns no important legislation, the notion that he can reform health care "very quickly" is self-serving cynicism. In fact, he cannot even keep his overpromises straight from one week to the next. When he unveiled his health-care proposal last week, his plan repeatedly asserted it "will reduce costs and save a typical American family up to $2,500 each year." On Sunday night, he claimed his plan "can save families that do have health insurance about a thousand dollars a year."

While Mr. Obama understands that health-care costs are exorbitant ("more than $2 trillion" in a $14 trillion economy), his plan does not seem to comprehend that the average annual health-insurance premium for a family now costs more than $12,000, with employers paying about three-quarters of the cost. He would offer people the opportunity to enroll in a "new public plan" with a benefit package "similar to that offered by the Federal Employees Health Benefits Program (FEHBP)." He guarantees "affordable premiums, co-pays and deductibles," which would be "fair" and "minimal."

How does he guarantee "affordability"? His plan provides "income-related federal subsidies." With family premiums costing more than $12,000 and with absolutely no evidence that households without insurance have the kind of loose cash around that could cover a large portion of that premium, the "income-related federal subsidies" would be potentially huge. Fifteen percent of the U.S. population lack health insurance, and the figure is growing. While his plan would "require all employers to contribute toward health coverage for their employees or towards the cost of the public plan," it provides no estimate of the level of employer contribution -- other than it must be "meaningful."

Mr. Obama would also establish a National Health Insurance Exchange, which would "act as a watchdog and help reform the private insurance market." Insurers would have to "charge fair and stable premiums" and make "coverage more affordable and accessible." There will be "rules and standards to ensure fairness." The exchange will force insurers to offer plans "at least as generous" as the public plan, which, remember, is based on the gold-plated FEHBP.

Mr. Obama's plan will "deliver the same quality of care at much lower cost." How? "This is possible because there is considerable waste in our health-care system." Yes, there is waste, but who believes the federal government will eliminate it?

And here's Mr. Obama's answer to the malpractice-insurance crisis: "Barack Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance." In other words, ambulance chasers like John Edwards will continue to be given free rein for their role in sending health costs through the roof, but "President Obama" would put price controls on malpractice-insurance premiums that are a direct result. This is nothing more than a crass political calculation designed to benefit one of the Democrats' most powerful special interests, whose gratitude is expressed in campaign cash. Mr. Obama should consider titling his next book "The Audacity of Cynicism."