March 24, 2005

Health Care Verdict

Okay, okay, so I've finished reading through the CAP's "Plan for a Healthy America." See my preliminary comments in the two posts below. Basically, this is a Frankenstein approach—trying to patch together Medicaid, employer-based coverage, and expand the FEHB—that has a lot of serious flaws. That said, the system we have right now has a lot of serious flaws. Worse flaws, in fact. So if the CAP's plan passed into law, and if it could be implemented for a mere $100-$160 billion a year, then the United States would have a much, much better health care system than the one we currently have. Monumentally better. Astronomically better. Et cetera. (And for those gulping hard at the costs, don't be delusional: any plan that involves covering America's 50 million uninsured is going to cost at least $100 billion, minimum. There's no way around that, no matter what the president has told you.)

Now, that may seem like a good thing. Who doesn't love better health care than what we have now? And indeed, the CAP's plan is more likely to pass than any single-payer proposal, since it's less radical. So, the argument might go, even if the single-payer approach might be better overall—just assume this for the sake of argument—liberals should prefer to get something enacted than to dream big and get nothing, right? Well, maybe. On the other hand, if the CAP plan ever passed, that would effectively kill any hope of ever enacting a truly radical and comprehensive health care reform plan. From here on out, the U.S. health care system would be based on Medicaid, Medicare, employer-based coverage, and individual tax credits. In other words, a mess. So it might be better to "dream big" rather than "go realistic." But if you wait for perfection, in the meantime 50 million people suffer without health insurance. 50 million...

Then there are the politics of simply proposing this sort of thing. Should the Democrats start touting this approach as "their" plan for health care? Can they win elections this way? Better yet, are they more likely to win elections by flogging the CAP plan, or by flogging a big, starry-eyed truly radical reform? That I can't answer, though I'd love to hear someone try.
-- Brad Plumer 3:25 AM || ||