My erstwhile Bloggingheads.tv counterpart, Ezra Klein, has an interesting piece in The American Prospect arguing that John Edwards’ strong early support for an aggressive overhaul of the health care system is forcing other Democrats, notably frontrunner Hillary Clinton,to do the same.
He starts with an analogy, arguing that Edwards is playing the role of Harris Wofford, the Pennsylvania Democrat appointed to fill John Heinz’ seat after he was killed in a plane crash and then went on to win in a stunning upset when he had to stand for election.
The secret of his remarkable victory? A 34-word catchphrase that pithily expressed the agonizing injustices of our health care system. “The Constitution says that if you are charged with a crime, you have a right to a lawyer,” Wofford kept telling the voters. “But it’s even more fundamental that if you’re sick, you should have the right to a doctor.”
Two things immediately strike me about this example. First, Wofford didn’t actually get his plan enacted into law. Second, the slogan may have been effective in garnering votes but it has to rank very high on the list of the dumbest things ever uttered by a politician.
Despite a strong predisposition toward laissez faire economics and the power of incentive, I’m sympathetic to the argument that a society as wealthy as ours ought to be able to provide basic health coverage to the downtrodden. The reason the Constitution guarantees free lawyers to criminal defendants* but not free doctors to the sick is not because we think the former provide a more worthwhile service but as a check on the power of the state. With rare exceptions, the state doesn’t make us sick; in all cases, however, criminal defendants are there because of state action. Ensuring that those at risk of life, liberty, and property because of state action have adequate legal representation is, therefore, fundamental.
That said, I agree that debating the government’s role in the health care system is worthwhile. Ezra summarizes HillaryCare 2.0 thusly:
Her plan includes an individual mandate to ensure universal coverage, offers all Americans access to the same menu of regulated private insurance options that members of Congress use, creates a new public insurer based off of Medicare that anyone can buy into, bars the insurance companies from price discriminating based on preexisting conditions, and uses refundable tax credits to limit the percentage of a family’s income that health costs can consume (a more detailed summary of the plan can be read here, the full plan can be downloaded here.).
Kevin Drum has some wonkish disagreements with the plan but figures he can only chose from among the plans proffered by the three leading Democratic presidential candidates and finds Hillary’s “not just substantively as good as any of them (and better in some ways), but also the politically savviest and most practical of the lot.”
Gabriel Malor is much more skeptical of the details, wondering “whether Clinton plans to criminalize failure to purchase health insurance in similar manner to auto insurance.” Certainly, as with Edwards’ plan, the implementation details are tremendously important.
None of these plans will get passed anytime soon. While I understand the appeal of a universal pool, forcing people to buy health insurance is a non-starter. And it’s simply idiotic to deny insurance companies the right to charge people different rates based on their existing health; the entire business is one of calculating risks.
Ultimately, these plans are solutions searching for a problem. Simply expanding Medicare so as to cover those who fall through the cracks of the current system makes loads more sense than trying to overhaul the entire system. Most of us, after all, are reasonably happy with our current coverage.
*It’s actually a lot more complicated than this but it works as a shorthand. See FindLaw for a more nuanced discussion.