Tuesday, September 8, 2009

Healthcare Reform to the Max

Sen. Max Baucus(D-MN) finally is circulating his idea for healthcare reform and moderates appear to be gathering around a public option with a trigger that would go into effect if insurance companies fail to meet certain targets.  It now appears that the outlines of a healthcare deal appear to be in place.  After the craziness of August it is hard to believe that we are close to some type of deal but Jonathan Cohn explains how August affected the the political situation and how the odds of a bill being passed are unchanged and perhaps more likely.

Based on my studying of the issue, this is my guess as to what will happen.  A bill with a public option that has a trigger will pass.  The bill will increase Medicaid eligibility and will include an individual mandate.  To help people pay for the mandated insurance there will be subsidies of about 350% of poverty level.  There will also be an employer mandate and some type of insurance exchange that will allow individuals who don't get insurance from their employers, and small businesses, to have access to reasonably priced insurance.

I am not the first to suggest this but President Obama strikes me as someone who uses conservative means to achieve progressive ends.  As The American Prospect pointed out earlier this summer, Obama maintains a strong belief in the ability of American institutions to solve our country's problems.  As far as I can tell this belief includes the medical establishment in the U.S. 

The current reform proposals seek to keep the basics of our the employer based health insurance system but it wants to make the system achieve universal coverage and do it in a more efficient manor.

This is a far from perfect bill and it feels like a colossal disappointment when compared with what seemed possible at the beginning of the debate.  However if a bill like the one described above passes then it will be the most progressive legislation in a generation.  More important a bill that is successful and popular will set the stage for further progression towards public based universal healthcare.

The reality is that not all Democrats are liberal progressives.  Even though the Reagan era looks over, the Democrats are still struggling to posit a positive message about governments role in our society.  The most important thing this bill might do is to reverse the "government is the problem" mentality that marked the last 3 decades of political debate and restore the public's trust in the government's ability to pursue collective action for the public good  If the bill does that then it will be easier to move from this bill to an even more substantial reform of our healthcare system.  

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