Over the last dozen or so years, health care has risen to the top of American conscience. According to the Pew Research Center, health care is one of the fastest growing concerns among independents (the economy traditionally ranks as the most important). There seems to be agreement between the parties concerning the need to address the growing problem of the uninsured, but they obviously seek to address the problem in vastly different ways. Republicans look to the market as a means of addressing the problem and specifically focus their attention on lowering health care costs and increasing efficiency (see Romney, McCain, Huckabee). Democrats have sought (for many years now) to expand health care coverage to each and every American, even if that requires the establishment of a government operated agency to oversee its implementation (see Obama, Clinton, Edwards). In addition to a universal system, some have even advocated for a universal single-payer system, where options are limited and the coverage identical. Some moderate Democrats and Republicans have argued that the solution is the creation of a hybrid system, which would preserve for-profit insurance companies, expand mandated coverage and focus on insuring all children first.
My interest is neither on the Republican nor Democratic dogma, but rather on the hybrid system, or the potential for one to exist and eventually thrive. The one proposal that aligns most comfortably with the hybrid paradigm is that which John Edwards’ has suggested. Edwards program would call for all Americans to purchase a government insurance package similar to Medicare. There is no question that this could eventually evolve into a single-payer system, but, according to the New York Times, Edwards is (surprisingly) not opposed to that. Edwards also seems to acknowledge that the program could take a radically different route – one where insurance companies retain a dominant role in defining coverage and approving procedures - and if that is the preference of the American people, he seems willing to accept that.
“I thought that there was a legitimate and strong argument for it,” he said. “But I also believed that there are an awful lot of Americans who like the health care they have and are nervous about entirely government-controlled health care.”
The program is very much like the system adopted in Massachusetts. Mandatory coverage would be required, but subsidies and tax credits would help the most disadvantaged of Americans pay for it. Those under the poverty line (about 21k) would receive coverage for free. Businesses, with the exception of small businesses, which are exempt, who do not offer insurance would be required to pay 6% of their annual revenue into a regional coverage pool. The program would be paid for with revenue gained from the elimination of the tax cuts for those making over $200k and cost-cutting measures (yes, a Democrat who wants to reduce spending).
Edwards’ proposal has one large gaping hole however, as noted in the Times article: it does not define “affordability,” nor does it address the issue of exemptions (like those in Massachusetts). But, unlike the Obama and Clinton proposals, it still actively seeks to retain a market and was the first detailed plan designed to address the undeniably broken (and porous) system that is presently in place and has left about 50 million Americans (16%) without any coverage whatsoever.
