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Wednesday, November 12, 2008

Universal Healthcare Inches Closer To Reality?

   This version of healthcare would have a few mandates, but it's a start.
by TomP @ DKos Wed Nov 12, 2008

Just a quick diary here. Senator Max Baucus (D. Mont.), chairman of the Senate Finance Committee, which is the committte with jurisidiction over a universal health care plan, says we need mandated health insurance.  While I prefer single payer, so long as the eventual plan has a means to migrate to single payer, I think this is progress.  And this plan has a government option.

Paul Krugman indicates that Barack Obama may not oppose a plan with mandates:

This is very big news.

But now Max Baucus — Max Baucus! — is leading the charge on a health care plan that, at least at first read, is more like Hillary Clinton’s than Barack Obama’s; that is, it looks like an attempt at full universality

(The word I hear, by the way, is that Obama’s opposition to mandates was tactical politics, not conviction — so he may well be prepared to do the right thing now that the election is won.)

Paul Krugman, Hopeful signs on health care

More, after the poll. (Obama spokesman update at end of diary)

It looks like the Democrats are not going to settle for baby steps:

Baucus of Montana, chairman of the Senate Finance Committee, said in a health-care blueprint released today that only a mandate could ensure people didn't wait until they were ill to buy health insurance, forcing up the price for everyone.

The 89-page proposal revives a debate from the Democratic presidential primaries about how to overhaul the U.S. health- care system. Obama supported requiring coverage only for children, saying adults would buy coverage voluntarily if it were affordable. Senator Hillary Clinton of New York said insurance must be mandated for everyone.

``Requiring all Americans to have health coverage will help end the shifting of costs of the uninsured to the insured,'' Baucus said today in his plan. The requirement ``would be enforced possibly through the U.S. tax system or some other point of contact between individuals and the government,'' he said, without spelling out possible penalties.

Senate Finance Chief Calls for Making Health Coverage Mandatory

The Baucus plan has a government option:

Echoing Obama's campaign proposals, Baucus said the exchange should include a new government plan, similar to Medicare, that would compete with private insurance, as well as subsidies to make coverage more affordable. Except for small businesses, employers that don't offer insurance to their workers would have to contribute to a fund to help cover others.

``Once affordable, high-quality, and meaningful health insurance options are available to all Americans through their employees or through the Exchange, individuals would have a responsibility to have health coverage,'' he wrote in his plan.

Senate Finance Chief Calls for Making Health Coverage Mandatory

I hope Krugman is right that Obama's anti-mandate proposal was more tactical than deep conviction.  At one time, Obama favored single payer.  I suspect he will sign a bill with mandates or without mandates, so long as it has a government plan that will compete with private insurance and could migrate to single payer.

Other big players in the Senate will be Teddy Kennedy and Hillary Clinton.  Baucus says this 89-page proposal is a ``vision for health-care reform,'' not a legislative proposal.  And Teddy Kennedy wants Democrats to agree on a single bill first and then work together to pass it. 

The big news is that universal health care is on the agenda.  If we cannot get single payer, this is a real step forward.

(Just a note: the Clinton universal health care plan (on which the Baucus plan is somewhat based) was extremely similar to the plan announced by John Edwards in early 2007, months prior to the Clinton plan:

Feb 5, 2007

Chapel Hill, North Carolina – Senator John Edwards today released a bold plan to transform America's health care system and provide universal health care for every man, woman and child in America. Under Edwards' plan, families without insurance will get coverage at an affordable price, families with insurance will pay less and get more security and choice, it will be cheaper and easier for businesses and employers to insure their workers.

"The American health care system today is broken for far too many of our families," said Edwards. "To fix this crisis, we don't need an incremental shift, we need a fundamental change. We need universal health care in this country—not only access to insurance as some politicians say—so every American is insured and we bring down costs for middle and working-class families."

Edwards Announces Plan for Universal Health Care

John Edwards had some personal failings, but he placed universal health care on the agenda last year, leading to the announcement of universal health care plans by Obama and Clinton months later.  At the time Edwards made the announcement of his plan in February 2007, and said he was willing to pay for it by repealing Bush's tax cuts for those who make over $200,000, most Democrats thought that universal health care was years away.  The failure of the Clinton administration in 1994 to get its plan passed took universal health care off the table for years.  Dr. Dean supported it in 2003 and 2004, but incrementalism was the policy.  Many Democrats were afraid of being called "socialists" or being accused of favoring "socialized medicince." Hillary Clinton spoke of doing it at the end of her second term, and Barack Obama had no plan for months in 2007.  Edwards, as he did with many issues, pushed the agenda leftward, and that was a good thing. (I'm glad Obama won the nomination and he was clearly the right choice, but I'm also glad Edwards ran and pushed these issues.  It was a win/win for all of us.)

Hillary and Bill Clinton also tried to reform health care in 1993 and 1994. Many have fought for this, but I wanted to thank John Edwards here). 

Update I:  The Office of Barack Obama provides a non-committal comment:

"President-elect Obama applauds Chairman Baucus’s work to draw attention to the challenges of the health system and looks forward to working closely with the Chairman and other Congressional leaders, as well as the American public, to make quality, affordable health care a reality for all Americans."

Ben Smith, quoting Obama spokesman spokesman Tommy Vietor:

Whether you agree or disagree with mandates or even an insurance plan, this is good because it keeps health care as a priority.  

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