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Health care and the 2008 election

From NBC's Mark Murray
At the town hall Pennsylvania Arlen Specter (D) held yesterday, one attendee said, "If you guys think that we want health-care reform so bad, do this -- let's have a referendum in 2010. We'll tell you if we like your plan or not. How's that work?"

In a way, however, there already was a referendum: last year's presidential election, which Obama won by seven percentage points (53%-46%) and 192 electoral votes (365-173).

During the two-year presidential campaign, in both the primaries and the general election, Obama wasn't shy about his objectives on health care. He called for universal care; favored a public/government insurance option; talked about lowering costs; and stressed the need to reduce waste and inefficiencies.

"The very first promise I made on this campaign was that as president, I will sign a universal health-care plan into law by the end of my first term in office," then-candidate Obama said on May 29, 2007, when he unveiled his plans on the issue.

What's more, all the top Democrats running for president (Obama, Hillary Clinton, John Edwards) had similar health-care plans. The biggest debate among them, in fact, was whether there would be an individual mandate -- not whether there would be a public option or higher taxes on the wealthy to pay for reform.

Yet what's ironic, especially given the town-hall protests we're seeing, is that Obama's health-care plans weren't something the McCain camp ever really assailed during the general election. McCain's ads whacked Obama over experience, Bill Ayers, taxes, for being liberal, for "sharing the wealth," and even Tony Rezko. But there was nothing aimed squarely at health care (although you could argue that the arguments over taxes and "sharing the wealth" are playing key roles in this current debate).

McCain did address Obama's health-care plans in his convention acceptance speech. "My health-care plan will make it easier for more Americans to find and keep good health care insurance," he said. "His plan will force small businesses to cut jobs, reduce wages, and force families into a government-run health care system where a bureaucrat stands between you and your doctor."

But that was about it.

"It really didn't register during the campaign," a former McCain official told First Read. "And look where we are now."

And if anyone seized on health care, it was the Obama campaign, which blasted McCain's plans to tax employee health benefits. "John McCain talks about a $5,000 tax credit for health care," went one of Obama's TV ads. "But here's what he's not telling you: McCain would make you pay income tax on your health insurance benefits -- taxing health benefits for the first time ever."

"I know they got us good," the McCain official said. "They gut-punched us pretty hard."

But a Republican congressional official makes the point that A LOT has changed in the last few months to make Obama health-care plans more of a target than they were in 2008 -- the bank bailouts, the auto bailout, the $787 billion stimulus, and now the potential for a $1 trillion health-care bill (over 10 years).

"The plan is just flat unacceptable for an American public given the events of the past nine months."

NBC's Ali Weinberg contributed to this article.