The Elusive Reasonable Plan

In today’s Washington Post, there was a local opinion piece by John Hewko titled My Health-Care Story: Over 50 and Out of Luck. In it, Mr. Hewko states that he has “…just experienced first-hand our system’s dysfunctional wrath…”. He goes on to describe his situation which, in a nutshell, is this:

  1. Worked as a political appointee.
  2. Left government and became independent consultant.
  3. Insured through COBRA currently.
  4. Applied for individual coverage (nongroup) with CareFirst Blue-Cross BlueShield, which was the carrier that insured him when he was a federal employee.
  5. Denied coverage because of  borderline hypertension (that is controlled with medication) and mild stiffness in his left shoulder and right hip.

Mr. Hewko, who states at the very beginning that he is a Republican, spends some time chastising William Kristol for denying a health-care crisis. And this

No silver bullet will solve all our health-care problems, but four measures would address one of most glaring weaknesses of our system: mandatory insurance for all; subsidies for those who can’t afford the premiums; a prohibition against denying or rescinding coverage for “pre-existing conditions”; and meaningful tort reform. Yet Congress continues to make the ideological perfect the enemy of the desperately needed good. Democratic ideologues reject tort reform and insist on a public option that many suspect is a Trojan horse to a single-payer system, while their Republican counterparts deny that a crisis exists, decry any reasonable attempt at reform as a government takeover and fail to articulate an acceptable alternative.

I agree with Mr. Hewko’s prescription. In fact, it is virtually identical to what I suggested  here. But I think that Mr. Hewko is incorrect in his assessment of Republican views on reform.  Republicans enter the debate not hellbent on radically altering the system as currently experienced by most Americans. I believe that Republicans would like to focus efforts on the uninsured or underinsured, and I think they would like to address escalating costs. Let’s see the Democrats propose a plan similar to Mr. Hewko’s prescription, and then let’s take stock of Republican support before making the charge that Republicans “decry any reasonable attempt at reform”. In other words, let’s actually see a reasonable attempt.

Instead of reasonable attempts, we get unreasonable attempts. In the most recent proposal – the one that garnered a vote from the all-important Olympia Snowe – there are several fascinating assumptions that allow the CBO to declare that the proposal would reduce the budget deficit by $81 billion over 10 years and “continued reductions in federal budget deficits” in the years beyond.

One assumption is that it will be possible to find $500 billion in Medicare savings, presumably from fraud, waste, and abuse. Another is that tax revenues will increase because companies that provide “Cadillac” plans will, in lieu of paying penalties on those plans, reduce the quality of their plans and pay the difference to employees as taxable compensation. And, of course, many of the provisions of the Senate Finance Committee’s proposal do not kick in until after the next Presidential election. Right.

Reasonable Democratic Plans

Reasonable Democratic Plans

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