Incremental Health Care reform is the correct approach - proponents just use the wrong start date
There is debate on the left about how to obtain health care reform. The arguments usually go like this - We don’t have the votes in Congress to get what we want so we have to settle for what we can get. Therefore, let’s start with a small “practical “approach and then someday we will get what we want.
These same folks, in the same breath, usually acknowledge that a single payer option is best. Barack Obama for example. Even local activists I’ve had conversations with.
Inevitably the word “increment” pops up as in “we need incremental change”.
Here is where they are both right and wrong.
Baby Steps -
I’m all for baby steps - walking before you run and all that -but when they talk about incremental steps - they are ignoring the steps we have already taken.
Here is the deal. We are already poised to implement reform. It is called Medicare for all.
Medicare was passed in 1965 and, as we approach the 44th anniversary, we have had a generation to work out the kinks, hone the payment processes and all that. Medicare recipients already choose their doctor and Medicare is a wonderful program according to the folks I’ve spoken to. With its low overhead - why not EXTEND IT TO EVERYONE?
Got that? The incremental step happened 44 years ago. Why do some people believe we have to start over?
Let Medicare become the Public Option. Let people opt into medicare. Heck, beef up the coverage some too - that whole health care is a human right thing that follows from “life, liberty and the pursuit of happiness” but give everyone a choice between their current coverage or Medicare.
Oh, that is what the 37 page, HR-676 does. Expands Medicare coverage and gives it to everyone.
It isn’t complicated and that is why it can be written in 37 pages as opposed to 600 odd for the Kennedy/Dodd bill.
It isn’t complicated at all.
Oh one more thing. That video of Barack Obama he talks about designing a system from scratch - we don’t have to - we already have a single payer system it is called Medicare.
baby steps people means counting the steps we have already taken.
Related posts:
- Health Care reform - Just pass it - it is a start point not a destination
- The D&C covers our local Reps approach to communicating about Health Care reform
- Dr Scheiner blasts President Obama’s approach to Health Care reform
- 100 years of Health Care Reform efforts in 8 minutes
- Robert Reich weighs in on health care reform
i have to tell you as a member of Progressive Democrats of America, and as a public policy analyst, that when you are talking about a major crisis such as health care, a major systems change is necessary.
In that sense, incrementalism does not work. The failure of President clinton’s health care proposal, and the election of a “Contract with America,” Republican Congress, proved that. President Clinton then decided that the best he could do on health care reform was HIPAA.
HIPAA is the Health Insurance Portability and Accountability Act. For the first time, that permitted people to take their health insurance with them, when they went to another job. It also helped guarantee the protection of medical records. That was incremental change. Incrementalism is used when a President wants to improve a system, without threatening any of the major powers that be.
There is the so-called Medicare Part D, prescription drug coverage. people were overwhelmed with confusing plans, and formularies, such that you had to choose prescription drug coverage based on the medications you took. Some people have approached a ‘donut hole.’ I think that is where they purchased as much medi8cation as their plan would allow foir the year, but still had to purchase more.But the problem since then has gotten worse. Millions more joined the medically uninsured. The research shows that incrementalism does not work when you have to overhaul a whole system.
An excellent example is President Obama’s overhaul of the financial system. There was nothing incremental there.
I hear you -
I think the point here was that one of the arguments against single payer is that the change is “too big” as if we are starting from scratch and those making that argument some how conveniently forget that 44 years ago we set up a single payer system called Medicare.
Now it is simply a matter of expanding it.