Obama began his response with a simple declarative sentence: "I believe that health care is a right for every American." ...... "That is a fundamental difference that I have with Senator McCain. He believes in deregulation in every circumstance. That's what we've been going through for the last eight years. It hasn't worked, and we need fundamental change."
Obama was right. The health-care issue illustrates not only the philosophical differences between the two candidates but also the political difficulties McCain has been having in this election. Obama's gamble is that the public — worried at the beginning of the campaign, terrified now — is ready for greater government support and regulation of the health-insurance system. That assumption has always been a sure loser in American politics. Republicans have perpetually and successfully waved the bloody flag of "socialized medicine." But the employer-provided-health-care system is fraying, costs to average families are rising, and almost everyone has a friend with a horror story. McCain's plan is a half-baked vestige of Reagan-era ideology: it tilts the incentives away from employer-provided health insurance and assumes that people will act in their enlightened self-interest if they are thrust out into a free market. That's absolutely true when it comes to buying refrigerators. But health insurance is complicated and scary; most people don't have the time or expertise necessary to make wise choices. They rely on their employers to make sure they're getting a good deal — and to fight for them if the insurance companies try to cheat them. And with many employers slouching away from that responsibility, the public seems ready to turn to the government for protection. In a collapsing economy, government regulation — forcing insurers to cover everyone at reasonable rates — sounds more comforting than stultifying.
The desire for more government activism is true across the board. All of a sudden, government-provided infrastructure programs — and that's what most of McCain's despised "earmarks" are — don't sound like such a waste of money, especially if they are married to alternative energy sources and conservation (which is why Obama talks constantly about "retrofitting" buildings to conserve energy). All of a sudden, boring bureaucracies like the Securities and Exchange Commission, which have been undermined and underfunded by Republicans, become a crucial bulwark against the rampaging free-market anarchists on Wall Street. This is, as Obama says, a fundamental change — but not a radical one. It is a modulation, a move to preserve the free market by controlling its excesses.