I thought the Obama campaign was avoiding talking about health care because the issue was too complicated to explain in a campaign. But I was wrong (or the financial news lately changed their mind): they saved it for last because it's one of their most powerful issues. Obama gave a speech on health care yesterday (text here, via Ezra). He frames the issue as part of the larger economic crisis:

Now I know that at this moment, when we stand in the midst of a serious economic crisis, some might ask how we can afford to focus on health care. Well, let’s be clear: the rescue package we just passed in Congress isn’t the end of what we need to do to fix our economy – it’s just the beginning. ... In other words, the question isn’t how we can afford to focus on health care – but how we can afford not to. Because in order to fix our economic crisis, and rebuild our middle class, we need to fix our health care system too. Let’s not forget, it’s not just small businesses and families who are struggling. Some of the largest corporations in America – including major American auto manufacturers – are struggling to compete in the global marketplace because of high health care costs. They’re watching their foreign competitors prosper – unburdened by these costs – as they struggle to create the good jobs we need to get our economy back on track.

Obama is in the unique position now of going up against a Republican whose health care plan is more radical than his own!

You see, Senator McCain would pay for his plan, in part, by taxing your health care benefits for the first time in history. And this tax would come out of your paycheck. But the new tax credit he’s proposing? That wouldn’t go to you. It would go directly to your insurance company – not your bank account.

So when you read the fine print, it’s clear that John McCain is pulling an old Washington bait and switch. It’s a shell game. He gives you a tax credit with one hand – but raises your taxes with the other. And recently, after some forceful questioning on TV, he finally admitted that for some Americans – those with the very best plans – his tax increase will be higher than his tax credit, and they’ll come out behind.

John McCain calls these plans “Cadillac plans.” In some cases, it may be that a corporate CEO is getting too good a deal. But what if you’re a line worker making a good American car like Cadillac who’s given up wage increases in exchange for better health care? Well, Senator McCain believes you should pay higher taxes too. The bottom line: the better your health care plan – the harder you’ve fought for good benefits – the higher the taxes you’ll pay under John McCain’s plan.

And here’s something else Senator McCain won’t tell you. When he taxes people’s benefits, many younger, healthier workers will decide that it’s a better deal to opt out of the insurance they get at work – and instead, go out into the individual market, where they can buy a cheaper plan. Many employers will be left with an older, sicker pool of workers who they can’t afford to cover. As a result, many employers will drop their health care plans altogether. And study after study has shown, that under the McCain plan, at least 20 million Americans will lose the insurance they rely on from their workplace.
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A $5,000 tax credit. That sounds pretty good. But what Senator McCain doesn’t tell you is that the average cost of a family health care plan these days is more than twice that much – $12,680. So where would that leave you?
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Here’s another thing Senator McCain doesn’t tell you – his plan won’t do a thing to stop insurance companies from discriminating against you if you have a pre-existing condition like hypertension, asthma, diabetes or cancer…the kind of conditions that 65 million working age Americans suffer from – people from all backgrounds and walks of life all across this country. Employers don’t charge you higher premiums for these conditions, but insurers do – much higher. So the sicker you’ve been, the more you’ll have to pay, and the harder it’ll be to get the care you need.

The bottom line:

So here’s John McCain’s radical plan in a nutshell: he taxes health care benefits for the first time in history; millions lose the health care they have; millions pay more for the health care they get; drug and insurance companies continue to profit; and middle class families watch the system they rely on begin to unravel before their eyes. Well, I don’t think that’s right. I don’t think we should settle for health care that works better for drug and insurance companies than it does for hard working Americans. I don’t think that’s the change we need. We can do better than that.

Health care policy is one of the reasons I moved to the left in recent years. Finally the desperately needed overhaul has a real chance of happening.