Republicans are warming up to the possibility of winning back Congress in this year’s elections. The advice from nearly every pundit and political leader is that it is not enough to just be anti-Obama. To win, all say, Republicans must put forth a plan to solve the country’s problems. This wisdom ignores the success of Democrats in the last election, who ran entirely on blaming Bush for everything and offering very little beyond amorphous “hope and change.” Elections are indeed won based upon little more than not being the last guy. The problem arises when it is time to govern.

Advocates of increased government involvement in health care frequently cite the profits of private health care providers as a major part of the costs of health care. The numbers, however, show that health insurance and managed care industry profits are 0.36% of the national bill for health care. If the compensation of industry executives is added as part of the alleged problem, then the industry accounts for 0.37% of total costs. The notion that industry profits are responsible for rising health care costs is a fraud.

I think it is possible for government to compete fairly with private enterprise, although I cannot think of an instance where it has happened. When the question is posed, what first comes to mind are subsidies by taxpayers to the government operation. That’s true, but there are also issues of access to and the cost of capital, costs of building market share, equatable rules of competition, and the risk of failure. All of these factors must be taken into account when considering if there is level playing field. I’m here to help.

President Obama made the point in his speech this week that H.R. 3200, the leading health care bill in the House, specifically excludes coverage of non-citizens. That brought the infamous outburst, “You lie!” from South Carolina Republican Jim Wilson. Wilson’s outburst was inexcusable, and he rightly apologized. But what is the planned coverage for illegals, and what should it be?

Nancy Pelosi has stated in explicitly: any bill that does not include a government option cannot pass the House. Howard Dean says that true reform of health care requires a government option. The question is why a larger role by government is deemed essential by ideological liberals. the main reason is fear that the compromise might work, and that would upset their larger agenda for government control.

There is a difference between a lie and a mistake and also between hypocrisy and just playing the cards you are dealt. These conceptual differences arise regularly in political debate, and now in in the health care debate. Let’s start with hypocrisy.

The current debate on health care is confusing. I focus on five central issues. The debate would be improved if these specifics were in the forefront. My points are, (1) heath in the US is more a product of lifestyle than the care system, (2) insurance company profits are a trivial part of health care costs, (3) justified changes in insurance regulations do not require the much large health care package, (4) a person will not be able to keep their present health insurance if employers drop the option, and (5) critical details of the new system are not disclosed.

It’s a straightforward observation: when government is presented with a problem, there is a strong tendency to use some form of rationing as a major part of the solution. We see this in health care, water supplies, electricity, and many other aspects of government regulated or government-run operations. It’s is a reasonable to unexpected emergencies, like World War II shortages or hurricane interruptions, But it is an unreasonable response to chronic problems. So why is it the preferred tool? I think it is because it does not require long term planning, it enhances government authority, and it perpetuates an illusion of fairness.

Today President Obama spoke before the American Medical Association, explaining his plans to “reform” the medical care system in the United States. You can tell I’m skeptical, because I put “reform” in quotes. I hold open the possibility that not all plans to spend huge sums of taxpayer money are actually reforms. If the health care plan actually saves money, then it should be funded entirely from the savings achieved. I’ll grant some startup costs, but after a few years money should be flowing into either the Treasury or into the pockets of taxpayers. That, however, is not a part of the plan.

Costs may always be reduced by limiting the amount of health care that is provided, and every nationalized health system established uses some form of rationing to minimize costs. The paradigm for government systems is that is appears cheap, but you can’t get much of it. Here we are talking about the unit cost of delivered health care. If you manage to receive X amount of care, how much can we expect that to cost under a government system as opposed to a free market system. We give a dozen reasons.