Fantasy

Shorter John McCain: big publically-run nonprofit healthcare is bad; big privately-run for-profit healthcare is good:

"I've made it very clear that what I want is for families to make decisions about their health care, not government, and that's the fundamental difference between myself and Sen. Obama and Sen. Clinton," McCain told reporters in Miami, Florida, referring to the two remaining Democratic presidential candidates, Sens. Hillary Clinton and Barack Obama.

"They want the government to make the decisions, I want the families to make decisions," he said.

Well, bullshit.  Under our current system--and under McCain's tepid plan for health care reform--"families" do NOT get to make health care decisions.  Decisions are made for them by health insurance companies financially self-interested in minimizing payouts and maximizing premiums.  Decisions are not being made by "families," they're being made by health care industry bureaucrats who are rewarded with bonuses and promotions not on the basis of how healthy their policyholders are but on the basis of how little money they authorize their employers to pay out.

Of course, McCain gets Tricare, the excellent government-run health plan for military retirees.  Tricare doesn't make any decisions about healthcare; it trusts people to make those decisions, and Tricare pays the bills without fuss, paperwork or delay.

McCain's fantasy of "families" sitting around the kitchen table and rationally choosing which doctors, which procedures, which tests, and which specialists they will avail themselves of is part and parcel of the laissez-faire delusion that individual consumers and giant health insurance companies are bargainers of equal power in a vast marketplace.  In fact, most people take whatever health insurance their employer offers and grit their teeth.