Via Ezra, Steve Pearlstein has some interesting ideas:
Rather than falling back into the political set-piece of defending the status quo and demonizing Republicans for another round heartless budget and tax cuts, Democrats might have used the opportunity to change the terms of the debate. With the governors at their side, they could have pushed Congress to take the next step in transforming Medicaid from an entitlement program for the poor into a means-tested health insurer of last resort for all Americans.Italics mine.
How, exactly, does this represent a good idea for Democrats? Announcing a plan to create a health insurer of last resort isn't a homerun for taking back the senate or getting a president elected. "Last resort" doesn't signify quality; it signifies disaster (i.e. I tried that parking break as a last resort before driving off a cliff). Nor is it something that middle class Americans want to be involved in.
Fortunately, other members of the punditocracy (i.e. Ezra) have a scenario that's much more appealing:
Expand FEHBP, the program that currently insures nine million government employees and uses community rating (which means everyone, no matter their health issues, gets charged the same premiums, so nobody is priced out), by opening it to small businesses and individuals . . . Then, once this quasi-national health system is running parallel to the patchwork of private insurers, let Americans make their own choice on what looks most attractive. Let the new FEHBP and the old system compete and see which consumers prefer.FEHBP, the Federal Employees Health Benefits Program, provides excellent comprehensive coverage at reasonable prices. An extension of high quality insurance is something a wide group of the population would support, without associations of poverty and "last resorts". Not only would they get behind it -- they deserve no less than the quality of insurance we give our elected representatives. The longer we fool around with programs that cover the most marginalized parts of society (we already have one!), the longer until we can fix the problem affecting everyone -- inadequate care, increased cost shifting to patients, and loss of health insurance.
Comments