Talkin' trash to the garbage around me.

05 February, 2007

C'mon, John! Swing for the fences!

John Edwards released his plan for universal health care [.pdf] today. I do like this little bit of rhetoric (from a campaign e-mail):
We have to stop using words like 'access to health care' when we know with certainty those words mean something less than universal care. Who are you willing to leave behind without the care he needs? Which family? Which child? We need a truly universal solution, and we need it now.

Hear, hear. We do need to be talking about universal care, rather than simple "access," so I'm glad to see Edwards taking the mushiness out of the terminology. But his actual plan, which consists of requiring employers to provide health insurance to their workers, while modestly expanding public insurance systems (like Medicare), providing tax incentives, and creating regional health markets, falls far short of fixing the problem of runaway costs in the health care system. What this looks like, to me, is another hand-off of taxpayer money to private insurers.

Unfortunately, private health insurers are the primary drivers behind rising insurance premiums, and any health care proposal which fails to recognize this simple truth will end up being a massively expensive boondoggle, enriching stockholders in the insurance industry, to be sure, but failing to fulfill the promise of universal quality health care.

I can appreciate the fact that Edwards is trying to thread the needle here, balancing the deep pockets of the insurance lobby with the wishes of starry-eyed leftists like myself, with statements like this:
Choice between Public and Private Insurers: Health Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan [emphasis added].

However, this statement makes it seem as if there's some question as to which sector, public or private, can most efficiently deliver quality health care at a reasonable cost. I think the data is pretty convincing in showing that single-payer systems come out on top. So why put on an expensive (and byzantine) beauty contest when the outcome isn't in doubt?

On balance, the Edwards plan hits a lot of the right notes: public hospitals, good preventative care, and actually promoting universal health care. But any plan which doesn't challenge the profit-driven system of private insurers will ultimately fail.

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