To the Democrats in Congress who don’t quite get it: I want to offer a personal pledge. I – and a lot of other people – have every intention of removing you from Congress in the next election if you stand in the way of health care legislation that the people want[.]

One has to always be careful with and wary of the use of phrases like, “the people”, of course. Moore can’t possibly think (or at least certainly shouldn’t think) that every single Democratic voter, let alone the moniker of all Americans to which a catch-all like, “the people” might point, are supportive of a public option in the way that he and those who agree with him are. But it remains true that for all the controversy and haggling, there is reasonable base of support for the public option amongst Americans.

Given that support, the kind of galling concern-trollery one hears coming from the lips of Max Baucus sort of begs to be met with war cries. To the point I made last Friday, there is a troublesome disingenuous in the studied ballet of Baucus’ political pirouettes that has left many wondering what the real intentions at play here are. Politics as the art of the possible notwithstanding, do we really know what is possible before even trying or in the facing of hedging against possible outcomes from the outset of the debate? [Read more →]

I believe there is a way to work with the present employer-based system to guarantee that all Americans have choices, and I am proposing it in an amendment to the latest Senate health care bill. My amendment, called Free Choice, would let everyone choose his health insurance plan.

It would impose only one requirement on employers — that they offer their employees a choice of at least two insurance plans, one of them a low-cost, high-value plan. Employers could meet this requirement by offering their own choices. Or they could let their employees choose either the company plan or a voucher that could be used to buy a plan on the exchange. They could also simply insure all of their employees though the exchange, at a discounted rate.

All payments that employers would make, whether in the form of premiums or vouchers, would remain tax-deductible as a business expense. Reinsurance and risk adjustment mechanisms already in the bill would balance the costs of employers who end up with disproportionately sick pools of workers, and this would avoid any disruption to existing employer coverage. Any employers that did not offer either their own choices or insurance through the exchange would be required to pay a “fair share” fee to help support the system.

My plan would actually strengthen the employer-based system by making it possible for even more employers to afford coverage than can today. Employers who offer high-quality health insurance to attract first-rate employees could continue to do so. And employees who like the coverage they have could keep it. Those who don’t, however, would be able to shop elsewhere.

According to one estimate, injecting this kind of competition into the employer-based system would save people and businesses more than $360 billion over 10 years. At the same time, it would improve the quality of health care.

Americans could take advantage of this change, or ignore it if they like; it would not be forced on them by government mandate. Ultimately, by empowering people to select the health insurance that makes the most sense for them and their family, we could end up with a system that works better for everyone.

Turns out, also, that the President has recently met with Senator Rockefeller and with Senators Bennett and Wyden at the Whitehouse, which may be a good sign that the President is taking seriously – if not their bill – then at least Wyden’s Free Choice Proposal which he’d like to add to the  Senate bill.  This is a good idea, even though the CBO has given the current Baucus proposal a pass, and Stan Collender thinks it’s fiscally sound.  Wyden’s proposal would help make it even more fiscally sound, not just for the government, but for consumers of health care. [Read more →]

Imagine you’re the head of a family of four, with two adults, making an income of $70,000. And since you don’t get insurance from your employer, you have to buy it on your own. If Baucus had his way, you could buy coverage through the exchange. And you’d have to spend no more than 13 percent of your gross income–or around $9,000–on your insurance premiums. But your insurance wouldn’t cover everything. There’d be deductibles, co-payments, and so on. If you bought the minimum level plan, you’d be on the hook for as much as $12,000 in out-of-pocket expenses–a level you could hit pretty easily if you had a seirous illness or injury. Add it all up, and you could be paying as much as $21,000–a third of your income–on medical expenses.  I believe the appropriate reaction is “oy.”

Ezra Klein meanwhile, first summarizes and then tepidly endorses the proposed framework:

The early reaction to Baucus’s bill has been overly negative. It’s an imperfect improvement to the current system, but an improvement nevertheless. Where it really falls short — even in comparison to the rudimentary framework released by HELP and especially when compared to the more complete package offered by the House — is in imagining a system that is different and better and fairer than our own, and working to make it a reality. Baucus talks often of building a “uniquely American” system, but this proposal largely plugs some holes in the one we already have. As such, the failure is not so much in the bill as in its unwillingness to lay the groundwork for the bills that may need to succeed it.

I have only skimmed the Baucus proposal, so I’ll go off of Klein’s summary for now.  From what I can tell it offers up a few good reforms that really will help cover more of the uninsured, but does very little to contain costs or to make insurance more portable or costs more transparent.  It does almost nothing to untangle us from the status quo (one of the main reasons I like Wyden-Bennett as an alternative).  It doesn’t do enough to make health insurance national – not nationalized, but part of a national market – and while in 2015 insurance companies would be allowed to sell across state lines, they would only need to follow the regulations of the state where the “compact” is formed, something many people have worried will look similar to the credit card industry.  Even the exchanges set up under this plan would be state-by-state, which makes almost no sense at all. [Read more →]

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