Jacob Hacker & Roger Hickey on Edwards Health Care Plan

To add to the MyDD discussion already generated by the John Edwards health care plan, I wanted to post new statements from Jacob Hacker of "The Great Risk Shift," and Roger Hickey, co-director of Campaign for America's Future.

The New Republic reports today that a core feature of the plan is "the essential idea behind another health care reform plan that has been quietly generating a great deal of enthusiasm among reformers--a plan composed by Yale University political scientist ... Jacob Hacker."

That plan is Health Care for America, which Campaign for America's Future has been promoting debate around.

Both Hickey and Hacker praised the basic outline of the proposal. Hickey noted this will significantly move the debate, while Hacker laid out areas for Edwards and other candidates to strengthen.

Here's Roger Hickey:

The health care plan put forward by Sen. John Edwards this week moves the debate in a very constructive direction.

We hope other candidates will address as comprehensively as Edwards has the changes necessary to make sure that everyone in America gets good health care coverage -- and what it will take to ensure that new system controls costs as well as Medicare and the VA system now does.

The public wants to hear bold solutions to what they perceive as a health care crisis, and most Americans want to hear health care plans that not only step up to the scale of the problem; they also want to hear solutions that are simple and understandable to be discussed it town halls and barber shops.

On both counts, the Edwards health care plan is a big step forward.

And Jacob Hacker:

Those who believe in health security for all Americans should celebrate John Edwards's new plan.

It includes two key building blocks for affordable universal coverage: a requirement that employers either cover their workers or make a reasonable contribution to the cost of coverage, and the creation of a new publicly overseen insurance pool through which workers without secure workplace coverage can have a choice of guaranteed public or private insurance, including an insurance plan modeled after the popular Medicare program.

To be sure, Edwards's proposal could be less complex and even more effective.

I would prefer, for instance, a single national insurance pool for those without workplace coverage, and I believe the public Medicare-style option should be allowed to offer the broader benefits necessary to attract younger workers and compete on a level playing field with private insurance plans.

If this were done, as Edwards himself has said, the system may evolve over time toward a Medicare-like approach -- the only approach that has been proven to control costs over time without shifting more costs and risks onto patients.

The Edwards proposal should be commended for creating a flexible framework for building on good employment-based coverage and the best elements of public insurance, rather than locking us into an individualized private model, as so many recent proposals have done.

The challenge for those who believe in this basic approach is to press for an even better proposal -- one that more forthrightly expands Medicare-like coverage to those without workplace insurance so as to guarantee broad pooling of risks and better control over costs and quality.

Hopefully that's helpful background as we all size up what the candidates have to offer.

Bill Scher blogs for Campaign for America's Future



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couple of things that should be clarified (3.00 / 4)

1.. there is a big expansion of existing medicaid.

2. insurance companies must except everybody - no cherrypicking patients.

Expand Medicaid and SCHIP: Medicaid and the State Children's Health Insurance Program
(SCHIP) play essential roles in helping low-income Americans getting the health care they need.
Edwards will strengthen the federal partnership with states supporting these programs, committing
the necessary federal resources to allow states to expand Medicaid and SCHIP to serve all adults
under the poverty line and all children and parents under 250 percent of the poverty line (about
$50,000 for a family of four).

* Require Fair Terms for Health Insurance:  Edwards will require insurers to keep plans open to
everyone and charge fair premiums, regardless of preexisting conditions, medical history, age, job,
and other characteristics.  No longer will insurance companies be able to game the system to cover
only healthy people.
Several states - including New Jersey, New York, and Washington - have led
the way on similar community rating and guaranteed issue reforms.  In addition, new national
standards will ensure that all health insurance policies offer preventive and chronic care with
minimal cost-sharing.

also, in every part of the country a publicly run government plan will be competing with private plans for those who do not get healthcare from their employer.

so even the small critiques are not clear are actually true.


Call it "Medicare Option" not public option
by TarHeel on Tue Feb 06, 2007 at 03:47:21 PM EST

another take easy to read (3.00 / 2)

http://www.huffingtonpost.com/rj-eskow/t he-john-edwards-health-p_b_40573.html

Edwards proposes doing something I've been supporting: Allowing individuals to choose between private insurers and a public Medicare/Medicaid program. That would prevent radical disruption of healthcare delivery, while forcing private insurers to become much more efficient than they are today. If they can't, market forces will cause the "withering away of the private sector" and evolution to a single-payer system.

("Withering away of the state" was the old Marxist goal. It's interesting to contemplate government takeover of the health economy happening in reverse - but with a twist. If the private sector can prove it really is more efficient - or can if it become more efficient - it stays in the game and might even gain ground.)

Edwards would require "fair premiums" for insurance, as well as tax credits to help with premium payments, and he would expand Medicaid and SCHIP (for childen). And he wants to "empower patients through transparency" by making provider report cards available to individuals, while promoting evidence-based medicine and better medical information-sharing.

My voucher idea upset some people, as I thought it might, because of its Friedmanesque ring. (Milton, not Tom.) Edwards gives employers the option of either buying health insurance for their employees or paying into the market system.

There's more, but those are the essentials. I think Edwards emphasizes the right issues, shows a strong vision for health reform, and creates a gradualist plan that has a strong chance for success.


Call it "Medicare Option" not public option
by TarHeel on Tue Feb 06, 2007 at 04:17:39 PM EST


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