The Democratic candidates’ health plans: getting it right
What the candidates and their weighty staffs need to get straight is that there is one, single, first, healthcare issue. It is the threshold issue, the one problem that is the truly corrosive one that will continue tearing the country down until it is solved, It is the one single healthcare issue that unites virtually every adult American, at least those over 35 or so or anyone with kids. That is the insurance issue, period. Not better care, not more universal care per se, not less costly medical care, not more insured people, not insuring kids, not cutting the uninsured down from 43 million to “only” 10 million, not getting the proper balance between employer-sponsored plans and government insurance, and not sticking it to the nasty insurance companies or getting even.
The fact is, right now there may be 43 million uninsured, but there are 150 million or so – that is, including every American employee who is insured now as well as all the Americans who would like to work and even some that would prefer not to work – who know they someday could join the ranks of the uninsured if they are not there already. Considering the horrendous cost of COBRA plans I’ve seen, it could happen in an instant with a pink slip following a cutback, a merger, a spin-off, an obnoxious new boss, whatever. Anyone approaching the perceived threshold of never being considered as a new hire somewhere – age 50, that is – is, to put it bluntly, scared shitless of losing health insurance. Crappy or unsuitable jobs are held onto, at the cost of collective productivity, for fear of losing health insurance and having everything worked for over a working lifetime wiped out completely. Temp jobs without benefits are all the rage, and the first question anyone asks about it is, “What about health insurance?” Two-worker households become a critical necessity, with the chance that at least one of the spouses will have at least a minimal plan.
Before any of the other problems can be solved, we must first guarantee every single American absolute universality, absolute portability, that he or she and his or her family will be covered at least enough to prevent a devastating financial loss from a major health event. The Democratic candidates must address this, must recognize that this is the first healthcare issue for most voters. Lower cost obviously is critical in the long run, but it is a good-government issue, not a devastating issue to the average voter. Better care for everyone, sure. Taking care of the uninsured is nice, too, but if it’s approached as a welfare matter, it will not grab the average voter – that is, probably about 98-99% of voters, the ones not rich enough to absorb a health catastrophe financially, as a deeply personal issue.
Democrats can totally kick butt with all the centrist voters they could possibly imagine (and take a huge monkey off the backs of American businesses and open them up to non-temp employment again) if they boil it down and show beyond doubt they are absolutely committed to solving this one single problem first. Republicans have done utterly nothing, and have demonstrated they do not and never will have a clue. But the issue needs to be sharply defined. That single problem is the fear of losing a life’s savings to a major health event. The candidate who articulates crisply at the right moment that this is the first healthcare issue that needs to be solved, clearly identifying the need for complete universality and absolute lifetime portability, and presenting a simple, broadly understandable vision of a plan that will obviously solve it and that has a prayer of building the powerful political support that will make opposition extremely difficult – like “Medicare for all,” or “Federal Major Medical Insurance,” or “Federal -- will win.
Walldon in his post yesterday is dead-on ("http://scatablog.blogspot.com/2007/05/making-simple-complicated.html"). I did one in the same vein a few months ago. ("Healthcare: are we making it more difficult than it needs to be?")
What I would like to see from all the Democratic candidates is a de-coupling of the issues from their healthcare plans because they each have somewhat different constituencies. The cost-containment issue is very important, yes, but it’s an issue for policy wonks and budget balancers. Not losing your life savings is an issue for everyone. The first just makes the second sound too complicated and unattainable once again. One giant step for mankind at a time, please.
The fact is, right now there may be 43 million uninsured, but there are 150 million or so – that is, including every American employee who is insured now as well as all the Americans who would like to work and even some that would prefer not to work – who know they someday could join the ranks of the uninsured if they are not there already. Considering the horrendous cost of COBRA plans I’ve seen, it could happen in an instant with a pink slip following a cutback, a merger, a spin-off, an obnoxious new boss, whatever. Anyone approaching the perceived threshold of never being considered as a new hire somewhere – age 50, that is – is, to put it bluntly, scared shitless of losing health insurance. Crappy or unsuitable jobs are held onto, at the cost of collective productivity, for fear of losing health insurance and having everything worked for over a working lifetime wiped out completely. Temp jobs without benefits are all the rage, and the first question anyone asks about it is, “What about health insurance?” Two-worker households become a critical necessity, with the chance that at least one of the spouses will have at least a minimal plan.
Before any of the other problems can be solved, we must first guarantee every single American absolute universality, absolute portability, that he or she and his or her family will be covered at least enough to prevent a devastating financial loss from a major health event. The Democratic candidates must address this, must recognize that this is the first healthcare issue for most voters. Lower cost obviously is critical in the long run, but it is a good-government issue, not a devastating issue to the average voter. Better care for everyone, sure. Taking care of the uninsured is nice, too, but if it’s approached as a welfare matter, it will not grab the average voter – that is, probably about 98-99% of voters, the ones not rich enough to absorb a health catastrophe financially, as a deeply personal issue.
Democrats can totally kick butt with all the centrist voters they could possibly imagine (and take a huge monkey off the backs of American businesses and open them up to non-temp employment again) if they boil it down and show beyond doubt they are absolutely committed to solving this one single problem first. Republicans have done utterly nothing, and have demonstrated they do not and never will have a clue. But the issue needs to be sharply defined. That single problem is the fear of losing a life’s savings to a major health event. The candidate who articulates crisply at the right moment that this is the first healthcare issue that needs to be solved, clearly identifying the need for complete universality and absolute lifetime portability, and presenting a simple, broadly understandable vision of a plan that will obviously solve it and that has a prayer of building the powerful political support that will make opposition extremely difficult – like “Medicare for all,” or “Federal Major Medical Insurance,” or “Federal -- will win.
Walldon in his post yesterday is dead-on ("http://scatablog.blogspot.com/2007/05/making-simple-complicated.html"). I did one in the same vein a few months ago. ("Healthcare: are we making it more difficult than it needs to be?")
What I would like to see from all the Democratic candidates is a de-coupling of the issues from their healthcare plans because they each have somewhat different constituencies. The cost-containment issue is very important, yes, but it’s an issue for policy wonks and budget balancers. Not losing your life savings is an issue for everyone. The first just makes the second sound too complicated and unattainable once again. One giant step for mankind at a time, please.
posted by KISSWeb | 4:18 PM
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