Obviously, something needs to be done about health care. Too many Americans are uninsured; and the employer based health care 'program' that currently exists has - to be frank - turned to shit. Surprisingly (or unsurprisingly, to some of us), most Americans think this program is 'normal' in some sense - that it is the job of one's job to provide health care coverage. In fact, the only reason employers provide health care in America is because , as a consequence of WWII wage controls, companies began offering non wage extras to entice workers, the most significant of which was a health care plan. But this system - which is no system at all, but rather a short term creative solution for a very particular situation - has stuck with us. And it has failed us - is failing 40 some million Americans (and killing American industry) of every day.
What to do...
Basically, there are three options (four if, as Washington habits have taught us, we include innaction). Option 1 - A state run single payer plan on the European social democrat model; Option 2 - Something akin to the Clinton 1994 plan, which essentially amounts to universal coverage based on a continuation of the current employer provided model; Option 3 - A plan which removes the onus from employers and provides tax credits and subsidies to ensure universal coverage.
In my opinion, only the last option amounts to a true solution. My support regarding the particulars of that option is firmly behind the plan offered by Oregon's Democratic Senator, Ron Wyden, which is both radical and simple (and perfectly fitting for a republic, to boot): 'Every American citizen should have the same health benefits available to members of Congress.' Moreover, 'according to an independent assessment by the Lewin Group, a nonpartisan health-care consulting firm, it would save $1.48 trillion over the next ten years.'
Joe Klein (in the afterward to his terrific book, Politics Lost) summed up the plan and its implications best, i think:
What to do...
Basically, there are three options (four if, as Washington habits have taught us, we include innaction). Option 1 - A state run single payer plan on the European social democrat model; Option 2 - Something akin to the Clinton 1994 plan, which essentially amounts to universal coverage based on a continuation of the current employer provided model; Option 3 - A plan which removes the onus from employers and provides tax credits and subsidies to ensure universal coverage.
In my opinion, only the last option amounts to a true solution. My support regarding the particulars of that option is firmly behind the plan offered by Oregon's Democratic Senator, Ron Wyden, which is both radical and simple (and perfectly fitting for a republic, to boot): 'Every American citizen should have the same health benefits available to members of Congress.' Moreover, 'according to an independent assessment by the Lewin Group, a nonpartisan health-care consulting firm, it would save $1.48 trillion over the next ten years.'
Joe Klein (in the afterward to his terrific book, Politics Lost) summed up the plan and its implications best, i think:
Wyden's plan would eliminate the current employer-based system [and] employers would 'cash-out' the money they currently pay for health benefits and distribute it as wages; individuals would then pay an annual health care premium to the federal government, as part of their annual taxes, and choose their own private plans from a system very much like the one currently offered federal employees. There would be two mandates - one for individuals and one for insurance companies. The individual mandate would require everyone to participate, especially those who can aford health insurance and currently choose not to buy it... The destitute - those who currently receive Medicaid - would join the same system as the rest of the public, and their health-care premiums would be subsidized on a sliding scale up to 400 percent of the federal poverty level. The second mandate would require insurance companies to cover everyone who applies at the same rate, regardless of preexisting conditions (this is called 'community rating' in the trade). So where's the pain [in such a plan]? Up the income scale. Health care would no longer be tax deductible. Those with incomes of more than 400 percent of poverty would have to pay for their health-insurance premiums themselves.Why is this plan best? Five reasons: 1 - it simplifies the system; 2 - it disentangles coverage from work, a move for which portability is only the best upshot; 3 - it gets rid of Medicaid; 4 - it provides real choice instead of imposing a one-size-fits-all coverage plan, which imposition would be thoroughly unAmerican in its utter disregard for freedom of association (and to associate freely), that most basic of American traits - and the basis, as Tocqueville understood, of American society, economy, and polity; and 5 - it is eminently fair, democratic, and republican (in the particular sense understood by Plato and Cicero, Hamilton and Madison, and Montesquieu and Mill - and which is the most basic of my political sensibilities)!
No comments:
Post a Comment