President Barack Obama says his Republican foes have no plan for health care. In fact, they do. They just don’t want to bring it up right now.

And one can hardly blame them.

The core of the conservative idea on health care is taxing health benefits. John McCain offered a version in 2008 that included a $5,000-per-family tax credit to offset the switch.

Obama brutalized McCain for his suggestion.

It was the ugliest phase of the Obama campaign, featuring a lot of scaremongering about how McCain’s plan amounted to a “trillion-dollar” tax on the middle class based on a “radical” idea that could have a “catastrophic” effect on health care.

The worst of it was a television ad warning seniors that they would lose Medicare coverage under the McCain plan, which called for savings through eliminating fraud, using electronic health records and paying doctors for good outcomes instead of procedures.

Those Medicare reforms may sound familiar because they’re essentially the same ones the president has proposed to help offset the costs of his trillion-dollar-plus health plan.

In fact, McCain’s reform weren’t that different from the ones Obama had proposed as a candidate. Obama tried to terrify little old ladies about the McCain plan while his own Web site was suggesting pretty much the same thing.

The irony now is that Obama, who once warned that McCain would cut $882 billion from Medicare and Medicaid, is trying unsuccessfully to squeeze a comparable cost estimate out of the Congressional Budget Office.

While the president accepts the McCain position on Medicare and Medicaid, taxing benefits is another matter.

Under the Republican plan, health insurance subsidies from employers would be treated as taxable income. Instead of looking at medical services as something that comes with a job, people would return to the common practice before benefits were exempted from taxes during World War II. The old model was for families to carry policies to protect against catastrophic costs from serious illness or injury and pay for the rest out of pocket.

Instead of recipients of care, Americans would return to be being consumers of health services. Imagine what would happen to the courts if every full-time worker in the land had unlimited access to legal services after paying a small deductible. Add a Byzantine set of regulations for payments and coverage, and you see why America’s hybrid health system has problems.

The disconnection between paying for and using regular medical care causes huge inefficiencies that will result in rationing. Liberals want the government to do it. Conservatives want individuals to do it by making their own decisions about what health care they need.

Aside from any ideological objections, Obama can’t accept the idea of taxing benefits because it would fall heavily on two groups with near veto power over his plan: labor unions and insurance companies.

In the current debate, the idea of taxing benefits popped up in the Senate Finance Committee. Sen. Max Baucus entertained a limited version of the plan in an effort to get some Republican support, but the White House and most of Baucus’ Democratic brethren batted it down.

The president is now coming around on the idea of taxing health benefits ... kind of.

Obama is entertaining an excise tax on insurance companies for issuing deluxe policies. If companies had to pay a 1 percent excise on each policy worth more than $40,000, it would raise an estimated $100 million to pay for some of the cost of expanding government coverage.

It’s pretty convoluted, but it recognizes that taxing benefits affects consumer behavior. Democrats argue that such a plan would help reduce overall costs by discouraging the issuance of “gold-plated” plans, which they say encourage overcharging and overspending.

The proposal is so thin that it won’t allow for a bipartisan solution, especially when coupled with a government-run insurance option.

That leaves the president little choice but to try to ram through a plan with parliamentary tricks.

But it didn’t have to be this way.

What if Obama had swallowed his pride, conceded the wisdom of McCain’s approach and asked the self-styled maverick for his help in taxing benefits? Odds are, McCain would have called for a bipartisan plan on health care and covered Obama’s back on the Hill.

In exchange for getting a market-based solution, Republicans might have accepted using the revenues to expand coverage for the uninsured.

Instead, Obama opted for the same kind of old-fashioned politics he once decried: demonize your opponent and then blame him for refusing to cooperate.

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