Obama for America

Austan Goolsbee is a senior policy advisor to Senator Barack Obama.

The key words are universal and affordable.

There are some who say we can simply mandate coverage and everything will be right with the world and we won't have to do the hard work of making health care affordable.

Common sense tells us that this is just wrong. As does the experience in the few places that have tried mandates.

There is no sense in mandating something that people can't afford. In Massachusetts and California (the only places that have tried mandates), they had to leave a large fraction of the uninsured out because they knew the costs were too high for them. At the national level, a mandate would leave 15 to 20 million people uncovered until the costs came down.

In order to reach universal health care coverage in our country, we must start with making coverage more affordable. That has to happen before we require people to buy it, not after.

Anything less just won't cut it.

The Obama plan reduces costs for the average family by $2,500 and commits to delivering universal coverage. It is the gold standard.

No matter which Democratic candidate for president you support, though, you probably agree with the majority of experts, like Henry Aaron at the Brookings Institute and Robert Reich, the former Secretary of Labor under President Clinton, who have said that all the major candidates' plans are ambitious, similar and any of them would finally at least put us on the path to universal health care in this country.

I agree with them, too. And I also believe, as the health experts do, that the key to solving our country's health care crisis is finding the person that can bring people together and actually get it done once elected.

The failure of health care in 1993 burned that lesson into our minds. The defeat of the Clinton plan set the cause of universal health care back by 15 years.

At the time, Democrats controlled both the presidency and the Congress - universal health care should have been doable.

But a secretive process, systematic attacks on alternative plans put forward by people who should have been allies, and an unwillingness to compromise with the major players in the industry played into the hands of the opponents of universal health care.

So it shocked me recently to hear some people attacking the Obama premise - of bringing people together to solve the problem - as "naive" and arguing that it should be abandoned in favor of outright partisan, polarized warfare: kick the other side out of the negotiations and then ram it down their throats.

Wow. After the 15 years of policy paralysis inflicted by that approach in 1993, I never expected to hear it again - especially from our Democratic friends.

The problem is, it just doesn't work.

Jonathan Alter of Newsweek, a great journalist as well as a historian of American politics, just wrote an article laying out the evidence proving that very thing.

He wrote that the really big changes in America - Social Security, Medicare, agriculture policy, labor rights - did not come about from a polarized, burn-them-at-the-stake style of warfare but rather through presidential leadership and building coalitions for change.

Let me be clear: Senator Obama's health care plan is as tough as any out there on the destructive practices of big drug and insurance companies that must to be ended - insurance companies refusing coverage because people are sick, drug companies charging Americans three times more than they charge Canadians and Europeans for the exact same medicine, and paying the makers of generics not to produce so they can maintain their profit margins.

Senator Obama's plan would fix these problems.

But does anyone really think that you could completely transform the health care system in America and reach universal health care without even talking to the companies currently working in the industry, the Republicans in Congress or any independent or Democrat that holds a slightly different view?

We tried that once. It didn't work. Let's learn from our mistakes, rather than doing the same old thing over and over again. Let's do it right.

Barack Obama will lead the way.

Sound off in the comments about what you think is the best approach to achieving universal health care. And check out Barack Obama's plan here: