In the Arena

More on the Edwards Health Care Plan

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Here’s what I like about the Edwards health care plan:
–it’s universal and mandatory.
–it imposes needed reforms on the insurance industry, like community rating (which means that everyone has to be covered at similar rates, regardless of pre-existing conditions).
–it opens the door to a fascinating competition: private insurers would have to compete against a Medicare-style government plan. It reminds me of a similar competition in a weirdly different venue: sanitation in Phoenix, Arizona. I think it was David Osborne who told the story in his book, Reinventing Government. Phoenix divided itself into sanitation sectors and allowed private carters to compete against the Dept. of Public Works. At first, the private carters submitted bids that were significantly below those offered by the bloated public bureacracy…but then the DPW got its act together and won back 3 of the 4 sectors…In any case, Edwards has proposed a plan that could answer some eternal questions about the need for market incentives in the health care sector. A terrific idea.

Here’s what I don’t like about the Edwards plan:

–it still puts the burden on employers, including small employers, to provide health insurance or pay for it. This places an unfair competitive burden on U.S. employers in a global economy.
–it keeps Medicaid (health care for the poor) separate. I think the poor would be better served by being included in the same system as the rest of us, as Senator Ron Wyden does in his plan.
–Edwards, admirably, pays for it by raising taxes on the wealthy. I prefer to pay for it as Wyden does, by eliminating the deductibility of health benefits and giving tax credits to everyone. I’d still raise taxes back to the Clinton levels, but use that money for other things.

All in all, though, this is a good, honest, courageous effort. Looking forward to seeing what the other candidates come up with.