Thursday, February 25, 2010

A Modest Proposal for Health-Care Reform

As I have pointed out on this blog before, some of the most astute and knowledgeable commentary you can read about the current health care proposals and their progress (or lack thereof) through Congress is over at Keith Hennessey's blog (also linked at the right, in the "Cannon Fodder" section). I took particular note of this remark in a post of his last month, just after he had explained in detail just how the "reconciliation" process could take place (I have added the bold, for emphasis):

The above option [reconciliation, using two bills -- one in each House] has a huge advantage: it requires only 50 Senate Democrats to concur. It therefore avoids the [Scott] Brown problem and the ongoing Nelson/Lieberman risks. This scenario works procedurally if you have a rock-solid unified (218 House + 50 Senate) alliance. This option allows up to 9 Senate Democrats to “walk” and vote no on the reconciliation bill, so the vote counting challenge shifts to the House.

But as one expert said, there are too many potential failure points in this strategy.

As I wrote this weekend, the Democrats’ challenge is not procedural. Their challenge is keeping cohesion within their legislative alliance when it is under massive political strain. Remember that Republicans, who are procedurally almost irrelevant in this strategy, would be pounding away rhetorically as we approach Election Day.
The ongoing "summit conference" at Blair House, taking place as I write, is demonstrating the truth of this observation. The Republicans' ideas and proposals are going nowhere, as far as the Democrats are concerned. But the Democrats are not yet unified behind a single piece of legislation which they could call their own.

Well, I have a modest suggestion to break this logjam. It offers the perfect win-win solution for everyone -- the Democrats get their universal healthcare (public) option, and the Republicans get their private plans, too.

How can this be? you ask. Please pay attention, now:

1. Universal health care at public expense will be provided to all registered Democrats, and only to registered Democrats. If you are not registered to vote as a Democrat, you cannot qualify for the "public option" (whatever they decide that is).

2. All other voters, both registered and unregistered, Republicans, Independents, American People's Party -- whatever -- will have to purchase healthcare in the private market.

3. And now, this is the kicker: while the public option is free to anyone registering as a Democrat, its value must be declared and reported as income. That is, the Government will send every registered Democrat a Form 1099 each year for the actual pro-rata cost of the "public option" plan. (Devices like the Earned Income Credit can be used to keep any undue tax burdens from falling on the lowest income sectors. But George Soros, Bill Gates, Warren Buffett, Steve Jobs and all the other wealthy Democrats will have to pay tax on every dime of benefit they receive.)

4. Meanwhile, all purchasers of private health care plans may deduct that cost from their taxable income. That means that the purchasers of private insurance -- all but registered Democrats -- will subsidize the public plan a little bit, but then the Democrats will also be subsidizing by the same little bit the cost of private healthcare. So it is fair and square all around.

It is simple, and is easily enacted into law. It should pass in a heartbeat, because both parties would get what they most want. And then -- here is the beauty behind it -- the market will take over. There will be plenty of demand for custom private plans (the enacting legislation will also strike down the restrictions by States on what insurance can be sold within their borders). And, since there are plenty of registered Democrats, there will be plenty of demand for the public option as well.

It is true that if you can't afford to buy health insurance, you do have to (maybe hold your nose and) register as a Democrat. But hey -- you get to have a say in what the party decides to offer you, and no one will ever know how you voted inside the voting booth. (And the party leaders should love the resulting increases in registered Democrats in every State.)

And here is another benefit: since all Democrats in Congress are registered with their party, they are automatically enrolled in the same plan they are offering to everyone else in their party. The only members of Congress who will not be able to get free public health insurance will be the Republicans, the Independents, and the Socialists -- they will have to purchase and pay for it themselves, and not out of the public purse. The only "Cadillac" health care plans available for members of Congress will be either (a) the public option, if they are Democrats, or (b) the same private options that are available across the country for non-Democrats, as determined by the market.

And now, one final point behind this proposal. Ask yourself this question: Why would any Democrat turn this proposal down? It gives them everything they want -- for their own kind. They get to design it, and control it from start to finish; they can create as many or as few bureaucracies as they want to administer it. It's their baby.

So if we should see this proposal rejected (for whatever stated reason) by the Democrats, then they will be saying: "It's not enough for us to have what we want -- we want to make you have it, too." And that, in turn, will tell you all you need to know about why they really want "health care reform".

What do you think? Let's spread the word, and get this idea off the ground.


  1. Love it! It reminds me of the following chestnut:

    * You are in a land where there are only two kinds of people. One kind only tells the truth; the other only lies. You can't tell the difference. You do know that they travel in pairs (one truth-teller and one liar).

    * Travelling in this land, you come to a fork in the road. One way leads to certain safety and the other leads to certain death. There are two people at the fork, so you know that one will tell the truth and one will lie - and you can't tell which is which.

    * With only one question to ask, what would it be and who would you ask to get the directions to safety?

    See what I mean? (Now if we only had some more truth-tellers in Congress!)


  2. Too much humour for one day!

    One can only hope the Democrats will weasel word it so thay can pass it and have SCOTUS rule that they must abide by it. :)

  3. Love it ! You are absolutely right IF the Democrats balk on this idea then you will really know what THEY want FOR YOU!!

  4. I think the US rag tag health care system doesn't stack up against other similarly advanced countries. If you are rich or or fortunate enough to have a good health plan paid for through your employment then you have excellent health care. If you are not in that category you have poor or no health care. I ask you; is that what the US is about?r

  5. RC, there is really no such entity as "the US health care system." Like any market in which the government has significantly interfered, it is all over the map. Those who can afford good health care certainly have it; but it is also true that no hospital is allowed to turn away a patient needing care because they lack the means to pay for it.

    The dispute instead is between those who think the grass is always greener on the other side of the fence, and those who know that if you don't tend and water the grass, it will not remain green for long.

    My "modest proposal" is simply intended to let the former group be in charge of tending their own grass, and allow the rest of us to continue to do what we have been doing all along.

  6. Doug Stein, you are right -- there is a single question that can be asked, and it will reveal the truth, no matter who is asked, and no matter which fork leads to safety.

    Assume that the two people are A and B, and that the two forks are L and R (for "left" and "right"). Then I ask A the following question: "If I ask B whether the left fork leads to safety, will he answer me 'Yes' or 'No'?

    This question sorts everything out. Work it out yourself: assume that A is the liar, and see what answer he would give depending on whether the left or the right fork leads to safety. Then assume that A is the truth-teller, and go through the same exercise. You will find that either a "no" or a "yes" answer to your question gives you all the information you need to make the right choice.

    Thanks for the analogy -- it is spot on.

  7. "[B]ut it is also true that no hospital is allowed to turn away a patient needing care because they lack the means to pay for it."

    That may depend on the state where the hospital's located. All federal law requires is that the hospital provide emergency aid until the patient's condition is stabilized.