Friday, January 26, 2007

Healthcare: Two Half Measures Leave a Serious Hole

President Bush, in Missouri hawking his new health insurance gimmick initiative, said (with a straight face), “If people in Washington are serious about dealing with the uninsured, here is a serious idea for them to consider.” That purportedly serious idea, a program of tax subsidies for purchasing private insurance (and penalties for so-called “gold plated” insurance plans), would, Bush promised, decrease the rolls of the uninsured by “up to ten percent.”

[let’s pause for a beat. . . OK]

UP TO TEN PERCENT! You mean like one, two, three, four, five, six, seven, eight, or nine percent, even? Your big insurance initiative will cut the number of people without insurance (currently 47 million) by maybe, if we are really lucky, four-and-a-half million?

Well, first off, of course it won’t. . . most are sure of that (the plan is mostly just another tax break for the well off). . . but even if it did work as best as George W. Bush can possibly imagine, it will only put the tiniest dent in the problem.

Why aren’t more people visibly pointing at him and laughing?

A step up from W’s ten-percenter is the “plan” (talking point?) proposed by newly official exploratory presidential candidate Senator Hillary Rodham Clinton. Speaking earlier this week at the conveniently (but, actually, purely coincidentally) named Chelsea-Clinton Community Health Center, the junior Senator from New York proposed a renewal of a ten-year-old program that tries to provide coverage to those uninsured under 18 whose families earn too much to qualify for Medicare. Clinton, in campaign mode, spoke in broader terms about making sure all of America’s children are insured “as a first step toward making sure that all Americans have health coverage” (that might be the literal quote, but without the link, let’s call it a paraphrase).

Insuring children is not really any kind of first step—it might insure more children, and that’s fine, but insuring children is not a first step toward insuring all Americans. The first step toward insuring all Americans is to insure all Americans. Period.

Gosh, you might say, that is awfully simplistic. To that, I say, it sounds simplistic because it really is that simple. If you want to insure all Americans, then insure all Americans. Anything else—and there are lots of anything elses being floated by several of the 2008 contenders—anything else is just a collection of half measures.

There are many stunningly simple and straightforward plans—making Medicare available to any that want it is one, extending the government employee program is another—that could provide health coverage to almost all Americans that need it. It is when you try to finesse, incrementalize, and compromise that the plan, and the explaining of the plan, gets complicated. And that is also when people get left out, opposition mobilizes, and support fails to galvanize.

Don’t believe me? Get into your time machine, go back about a dozen years, and ask. . . Hillary Clinton.

If it is your intention as a candidate for president, or a senator, or member of the House to cover all Americans, then that is what you should propose. Anything short of that is not a step done for the benefit of those that need the program—the healthcare consumers—it is program designed to appease some other constituency—the insurance industry, big pharma, corporate for-profit hospital chains, “small government” ideologues, and the like.

America is ready for this. America has been ready for this for nearly two decades. Are any of our aspiring leaders ready to represent America?


(Please check out guy2k for more “highlights” from the president’s plan.)

(Cross-posted to Daily Kos.)


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