In the Arena

Hillary Care, Bush Care, Wyden Care

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I’m going to have a lot more to say in a few weeks about the importance of proposing a universal health insurance plan if you’re running for President. But if you are going to make a health care proposal, certain minimal parameters seem obvious, especially The Two Mandatorys:
–an individual mandate, which requires everyone to buy into the system, even those young people who can afford health insurance and choose not to buy any because they think they’re going to live forever and never have a motorcycle accident that requires emergency room care (which the rest of us pay for). Obviously, such a system would also have to provide refundable tax credits–that is, money–to the working poor, so they can afford to buy in, too (sort of like the earned income tax credit).
–an insurance company mandate, which requires insurers to cover everyone who applies at the same rate, regardless of pre-existing conditions (this is called “community rating” in the trade).

Several readers have commented that Hillary Clinton is just getting started on health care, and shouldn’t be judged only on today’s universal coverage for children proposal, mentioned two posts below. I suspect they’re right, but we’ll see..
George Bush’s State of the Union health care “plan” apparently includes neither of the two mandatorys, but it does include a significant step forward–trumpet clarion here–higher taxes for those who receive more than $15,000 per family (and $7500 per individual) in health benefits per year from their employers. I am tempted to write GEORGE BUSH SUPPORTS HIGHER TAXES 500 times and add nyah, nyah, nyah, but hey, I’m a serious policy pundit so let me pose the following conflicting points:
–his plan probably won’t raise taxes on very many people, since $15,000 per year is in the upper range of health expenditures.
–his plan opens the door for a real negotiation on changing the current tax code in a more progressive way, which is to say: all benefits received from employers should be included in salary totals.

To my mind, the best health care proposal out there is Senator Ron Wyden’s plan, which would scrap the current employer-based system and create a universal tax credit (refundable to the working poor). Wyden’s plan abides by The Two Mandatorys and has a lot of other thoughtful features. I’ll have more to say about it anon.
UPDATE: Ezra Klein, no relation, who follows health care policy carefully, has this to say about Bush’s proposal.