Health care reform

The phrase “socialized medicine” retains such a negative connotation that Democratic presidential candidates are careful not to use it when discussing their plans for health care reform.

But make no mistake, three of the party’s remaining hopefuls advocate changes that would push us closer to precisely such a system.

For instance, while Hillary Clinton, Barack Obama and John Edwards vary on their specifics, they all agree that the government should essentially expand Medicare to give every American a choice of enrolling in the federal program.

Currently, Medicare is available only to seniors and the disabled, while Medicaid covers the poor.

Defenders of the candidates are quick to point out that their proposals would simply create another choice, that individuals would still be free to buy private insurance, see their own personal physician and pay for their own care.

“The charge that this is socialized medicine is ridiculous,” Austin Goolsbee, an Obama economic adviser, told the Los Angeles Times. “This would remain one choice among many, and you don’t have to pick it.”

Fair enough.

But is it really that far-fetched to see such an approach quickly crowd out competing private plans by offering cheaper, taxpayer-subsidized coverage? Is it really a stretch to imagine fewer private employers offering health insurance to their workers, preferring instead that they enroll in the government system?

Is it so unthinkable that the price of a massive Medicare expansion would far surpass any savings realized by eliminating some costs associated with a large uninsured population? And how long would Democrats tolerate allowing the wealthy — or anybody — to opt out if the federal program becomes the insurer of choice for most Americans?

In fact, these are questions that Sen. Obama, Sen. Clinton and Mr. Edwards should be forced to address when it comes to the real-world ramifications of favoring government-based health care reforms over market-oriented approaches.

“You can call (the government) an option, but if you don’t put any restrictions on who can enroll, and you give the government leverage in terms of ability to negotiate prices, you create a situation that leads to a government-run system,” Lanhee J. Chen, an adviser to GOP candidate Mitt Romney, told the Times.

In other words … shh! … socialized medicine.