The contenders for the 2020 Democratic presidential nomination are coming out of the woodwork, along with their policies — although we still can't take that for granted.  Indiana mayor Pete Buttigieg, chief among them, has voiced his opinion on Obama's Affordable Care Act. 

This contentious piece of legislation is depicted by Buttigieg as "a conservative proposal."  It was, after all, conceived at The Heritage Foundation, a conservative think-tank.  The mayor is filled with respect; the way Obama came through with enough votes for it was nothing short of a masterwork of policy chops.  It was a wonderfully constructed compromise that allowed for private doctors along with a public payer.  The right has been playing with the goalposts a bit too much, writing the ACA off as a left-wing brainchild.

The idea that the monster Obamacare became was reared by conservatives is laughable.  Stuart M. Butler, Ph.D., distinguished fellow at The Heritage Foundation, balks:

Is the individual mandate at the heart of 'Obama Care' a conservative idea?  Is it constitutional?  And was it invented at The Heritage Foundation?  In a word, no.

Heritage and I actively oppose the individual mandate, including in an amicus brief filed in the 11th Circuit Court of Appeals to the Supreme Court.

Additionally, the meaning of the individual mandate we are said to have "invented" has changed over time.  Today it means the government makes people buy comprehensive benefits for their own good, rather than our original emphasis on protecting society from the heavy medical costs of free riders.

Moreover, I agree with my legal colleagues at Heritage that today's version of a mandate exceeds the constitutional powers granted to the federal government. Forcing those Americans not in the insurance market to purchase comprehensive insurance for themselves goes beyond even the most expansive precedents of the courts.

Still, Buttigieg will accuse conservatives of crying wolf if they dare condemn a program now tainted by socialist ideals.  No honest Republicans would reject a health care plan they helped draft.

Besides, the word "socialist" is overused.  "It's lost all power I think, especially for my generation of voters.  Folks just want to know whether an idea is a good idea or not and slapping a label on it, especially in a careless way that doesn't make any sense, I don't think it moves the debate."

So let's debate.  Where do his hopes for health care lie?  And where would they lead the country?

For starters, Mr. Buttigieg would have us believe that the famous Obama line of deceit — "If you like your doctor, you can keep your doctor" — held true.  This suggestion couldn't be farther from the truth.  In fact, many unfortunate souls lost their private plans due to noncompliance with ACA standards.  Between 3 and 5 million people said goodbye to their company-provided plans.  Paying the penalty was more economical for employers than doling out the health insurance benefits.  Obamacare was one of the most progressive, unconstitutional enactments in the history of Congress.

And yet, Buttigieg laments to the New Yorker that it wasn't enough:

You know, Democratic Presidents in my lifetime, Clinton and Obama both, I think, have been operating in a fundamentally conservative framework, and it's something we should remember when we think about the shortcomings of the things that didn't happen that we wish would.

I mean, for example, if you want to — if you wish, as I do, that there had been at least a public option as part of the A.C.A.

Here comes the requisite rallying cry of "Medicare for all who want it."  The adult-in-the-room pragmatist, hell-bent on pursuing ideas that will work, calls for yet another step toward the abyss.  He dreams of the sort of nationalized health care currently imploding in the U.K. and Canada. 

The way Mr. Buttigieg described it, "you take some flavor of Medicare, you make it available on the exchange as a kind of public option, and you invite people to buy into it."

Surely, a spoonful of universal helps the health care go down.

He'd implement an all-payer rate for health care before going single-payer, a system he is "all for."  This should frighten voters who came to the realization that a nation's call for health care is first and foremost a call for quality care.  With thousands of Brits dying while waiting for treatment and millions on surgery waiting lists, a simple fact of reality has become increasingly clear: the government's hand wreaks havoc on whatever and whomever it touches.

Not so for the man of the hour.  This sort of "crazy, conspiratorial talk" about the horrible goings on as private plans slipped through the cracks "[doesn't] actually come to pass in the real world."  You see, he's studied how it works in the U.K.  Apparently, "there is a role for the private sector."

In the real world (where he'll claim to be operating), nationalized health care has not only bound, but gagged the private sector:

In 2017, Canadians were on waiting lists for an estimated 1,040,791 total procedures.  Often, wait times are lengthy.  For example, the median wait time for arthroplastic surgery (hip, knee, ankle, shoulder) ranges from 20 weeks to 52 weeks.

In the British National Health Service, cancellations are common.  Last year, the National Health Service canceled 84,827 elective operations in England for nonclinical reasons on the day the patient was due to arrive.  The same year, it canceled 4,076 urgent operations in England, including 154 urgent operations canceled two or more times.  Times of high illness are a key driver in this problem.  For instance, in flu season, the National Health Service canceled 50,000 "non-urgent" surgeries.

When questioned by George Stephanopoulos about the pitfalls, Pete smugly replied that he doesn't believe that "leaving Americans to the tender mercies of corporations is the best way to organize the health sector in this country."

As if the National Health Service doctors who decided to pull the plug and let little Alfie Evans die, ignoring his parents' right to make the life-and-death decision for their own child, were the prime example of righteousness in action.

As if the faceless bureaucrats over at the Veterans' Administration busy covering up the lengthy wait times patients were forced to endure were the epitome of merciful individuals.  As a proud veteran of Afghanistan, Buttigieg ought to have learned from the disaster that was the V.A.

Alas, the cry for "Medicare for All" is too powerful to resist.  Pete remains insistent that the ACA was the winning issue for Democrats in 2018.

Prayerfully, that won't be the case in 2020.  Along with Kamala Harris and Bernie Sanders, Buttigieg will champion a one-size-fits-all health care policy, much to the delight of misinformed, mindless lemmings.  With the popularity of the issue at hand as his only yardstick, Pete is content to lead the masses farther toward the medical mirage. 

And if Obama's opportunity for concrete action was too constrained, his being stuck between a "conservative framework" and a hard place — as Pete continually grumbles — a Buttigiegian structure would best be avoided, to say the very least. 

Image: Marc Nozell via Flickr.