Friday, July 10, 2009

If there was going to be a public health care plan...

I realize a public health care plan is a bad idea, but it did get me thinking: if I were making the bill, and everyone else strongly wanted a public plan, is there a form of the plan which I would be agreeable to? I thought about it, and I think a public plan would be eminently workable, provided it has some simple immutable provisions. Now, I don't think the Democrats are going to put anything like this into their disaster of a plan, much less be capable of adhering to all the requirements, but I would venture to say that if they truly wanted bipartisan support, this would be one way to get it; I strongly suspect most Republicans would back a public plan with my simple provisions.

Without further ado, the provisions:

- All public employees will be covered by the same public plan with the same benefits, from every level of government from janitors to the President. This will ensure that the plan is good, provides reasonable coverage, and Congress has a strong incentive to get it right. It also provides an immediate large base of participants from which to negotiate with health care providers, which should allow savings from scale.

- There must be no coercion, direct (laws forcing, pressure) or indirect (tax breaks, incentives, etc.), to force health care providers to accept the public plan: the government must negotiate fairly and openly like every other insurance provider. There should be an independent commission to investigate claims of coercion, and it should be a federal crime with stiff penalties. This means if the government want more providers and/or services available, it will need to pay for them at market rates.

- The cost of the plan should be entirely paid by the plan participants, and nobody else. That means no tax hikes, no changes for everyone else, no raises for public employees to compensate, no new fees, no nothing. If the pundits are correct and the government can save money by economy of scale and increased efficiency, then the savings should be more than enough to cover the additional people (not government employees) who are allowed to be on the plan. If not, then the plan participants will feel the pain only, and not everyone else. This will also provide incentive to limit the availability to only those people who are worthwhile for the government to insure for free, and incentive to set the cost of participation for people choosing the plan to be as near the actual cost as possible.

That's it; simple provisions, logical, fair, and would make the plan acceptable to me, and I suspect would be enough to gather bipartisan support. Readers, thoughts?

15 comments:

  1. Sounds logical to me, but the lefties don't understand logic; otherwise they wouldn't have passed the 'stimulus bill', bailed out Freddie and Fanny, purchased GM, etc.

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  2. You should lobby your senators and congressman right now. Doing something like this (some kind of Post Office-like plan) is good for the following reason:
    a) If it competes with some employer-captive plans, it will increase labor mobility. Regressive love labor mobility when it means making it easy to fire people, so they should love other forms of labor mobility.
    b) If medical technology gets so good at predicting illness that it makes non-accident health insurance impossible, there will need to be something to take it’s place. It’s better to have something of your choosing than something that liberals craft once the problem becomes apparent.

    My problem with it is how to keep people from abusing it by not carrying insurance until they're sick. It could become the insurer of last resort, like WI’s HIRSP plan. The gov’t would indirectly carry the weight by offering to the plan to its employees. Employees of other organizations could get better insurance b/c they wouldn’t be carrying the weight of everyone who waited till they were sick to get on the gov’t plan.

    [Or you can just keep telling yourselves than liberals don't have logical ideas.]

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  3. Oh, but I disagree, Linda... the Democrats are very logical, calculating in fact. The "Stimulus" waste bill was a power grab and agenda expenditure, of monumental size, capitalizing on the recession fears to appropriate the largest amount of money for partisan policy projects in US history, with the tacit blessing of the idiotic voting populace. The GSE bailout gave them excellent leverage to dictate lending term the effectively all of the housing market, allowing the government to control who can buy a house and who cannot (very much in-line with a Socialist agenda). The banking and auto industry takeovers are well-orchestrated steps to expand government control over private industry, as will be the energy "tax and crap" bill, and the "health care takeover" bill.

    Not only have the Democrats been logical (in my mind), they have been fairly unified in their agenda and pursuit of their goals. One could say they have pursued their agenda with ruthless efficiency to good success. I don't happen to agree with their agenda, goals, or vision for America, but I cannot fault their consistent, logical, and ruthless approach to realizing their designs.

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  4. But, Nick, why would they want to ruin our wonderful country? Why do they want to give it all away? Why does 'he' always apologize for what we have done? Why was 'he' elected? Where are the sensible, reasonable, smart, prudent citizens of America? How long can we last?

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  5. To: 19%ers (White, rural, right-wing fringe idiots from "real" America)

    From: 58%ers (Smart, educated, urban and urbane REAL Americans who are effectively working to create a more civilized, European-style world.)

    Ha Ha Ha! You hear us? He He He Hee Hee Hooooo....

    We love it! We love that you guys have your underwear in a bunch, that you are brimming with anger, that you can barely see because of your apoplexy. We will enjoy it for the next eight years. Oh the world is changing, and it is sweet. Universal health care is on the way, and nothing you can do will stop it. You will spend the next 50 years trying to dismantle it to no avail, just like you've been trying to dismantle Social Security since the 1930s. The energy bill will change the planet and the US for the better, and there's nothing you can do about it. You hear us? NOTHING!!!!

    HA HA HA HA HA!!!

    We love it that you love Sarah Palin. Please please please nominate her for President in 2012. Nothing will ensure another four years of progress than that. Oh sure, at some point, another Republican will get elected (2020?). No majority lasts forever (Mr. Rove). But that person will not be able to undo the progress that the Obama administration will have set in stone. Social Security and Civil Rights are now a fait accompli, and though idiots still try to attack them at the fringes, they aren't going anywhere. The same will happen with all the Obama programs.

    And by the way, your numbers will keep dwindling. You are 19% of the population right now, but demographics are not on your side. Soon, white people will be a minority. Our increasingly numerous Black and Hispanic brethren and our growing urban centers will ensure your voices will continue to be marginalized until some day in the not-so-distant future they will be extinguished, just as backward, reactionary, pseudo-christian redneck zealotry always is.

    Enjoy it while you can, suckers!!!! BWAAAAA-HAAAAAA-HAAAAAAA!

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  6. Do you wonder why those that think we are 'all wet' won't sign their names? Hmmmmmm?

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  7. What's also amusing is that although I certainly can't speak for most of the readers/commenters, I'm certainly in the smart, educated, urban demographic, despite the fact that I'm not at all in favor of a socialized European-style America.

    He does have some good points (interspersed with racial and cultural bigotry), though. Nominating Palin would almost certainly ensure another Democratic president in 2012, and there might be a schism in the Republican party over it. There will also be lasting damage done by the Obama administration (as there was lasting damage done by FDR) which will be difficult, if not impossible, to repair. He/she is also correct that demographically speaking, "minorities" are becoming the majority in the country, primarily though illegal immigration and birth rates, and if that trend is not reversed we could see bigots like this poster having the desire and the means to extinguish dissenting voices, Hitler-style.

    It's a very legitimate warning about the future of America, albeit in gloating hate-speech form.

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  8. I seriously think Nick's idea is great if he can solve the freerider problem I described in my comment. The Democrats' plan has the same flaw, so it's nothing ideological.

    I also think regardless of ideology, new medical technologies will increase public support for some kind of gov't health plan. I do not want a gov't plan for the middle class, but I think we will get one b/c of trends in technology. Democrats will probably keep the upper hand on this issue b/c they were for a gov't plan before new technologies make policy more popular.

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  9. I have a real public health care plan that will work: The public will pay for it's own health care. Then the free market will step in and doctors, medicine producers, etc. will be forced to charge market values for their services and health care will be affordable again. There will be a $5K tax refund/rebate all American Citizens to help them pay for health care, and this will adjust as average health care prices change. If Americans choose not to use this money for other things, that is their responsibility.

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  10. Andrew: Your plan will not be wildly regarded as "working" if my prediction comes true. My prediction says at birth technology will be able to determine if someone will have huge medical needs and at what point in their lives the needs will present. Private insurance won’t be able to insure against this, unless perhaps the parents buy the policy at a point before the tests can predict their child’s medical needs. Such a solution will be untenable to all but free market purist. People will want some kind of a plan to spread the risk of being born with a detectable genetic predisposition to disease. I would rather see some kind of plan that does that now so we don’t get a plan aimed at babysitting the middle class in their healthcare purchasing.

    Also, I would like a plan that is provides some money and hand-holding for the poor. That's the main reason I'm still a Democrat even though I disagree with a large gov't health plan. I suspect if there were an alternate plan that spread genetic risk and helped the poor, Democrats would lose enough support to make them a minority. I don't know if that's politically possible, though, b/c any Republican proposal at this point will look like a me-too plan, no matter how good it is.

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  11. And do you think the government will do as good a job with that as it does with the DMV? Or even better, look at what really goes on at the Fed and then tell me you want those morons in charge of your health care. (see my blog for financial post)

    Dude, you never know when you will have such needs. Mine hit me when I fell off a ladder with a chainsaw trimming a tree, and fell 11 feet and landed head first on concrete. What genetic test preps you for that? Before that I never had health problems. Now, my brain is damaged to the point that it doesn't regulate my body temp, and the doctors are basically intensionally overmedicating me so that my brain will work. With out the meds, I am a veggie. Eventually my brain will simply overload and shut down but there's no telling when that will be. I don't know for sure but you seem rather young, and when I was young, I didn't think my health would ever be a problem. Now, I know it always will. There is this thing called "personal responsibility". That means that if you want to keep the freedoms you have now, keep the government out of as much as possible.
    Genetic "risk" does not mean you will get the "risk" trait. My Asian Leopard being that it is 75% wild and the wild gene is a superdominant gene she should be reclusive and at times aggressive. She should also be spotted. She is neither except around strangers, she becomes reclusive, but a purely wild Asian L cannot even be kept as a "house pet".
    With health care, when the problem now is too many hands in the cookie jar causing price increases, what do we do? We put more hands in the cookie jar and hope it is o.k. That is like those who say well, Bush spent way too much so it's okay for Obama to triple 2 terms of Bush spending in 6 months. Little things like runaway debt and the impending crash of the dollar aren't anything to worry about. And so now we throw more of our monopoly money (because that is what it is, only the American people don't know it yet...see my blog) into ruining health care too.
    By the way, this post kinda seems like I am angry, and I want to clarify that I am not. I am just making my point. I am a free market purist by the way and Republicans are me too Democrats. That's why everybody quit voting for them.

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  12. BWAAAAA-HAAAAAA-HAAAAAAA!....the financial ruin both Democrats and Republicans have inflicted is sooooooo accelerated by Obama's wreckonomics that in two years $100,000 will buy you either a Ferarri OR a TV dinner! WOOO HOO.... (Don't take this seriously, I am just kidding about all the wooo-hoo stuff)

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  13. NIck, I just wanted to say that while we do not always agree, your ideas are always well thought out and well said. I always enjoy reading your posts as they lack a certain bitterness that infects many others on the extremes of both sides. Thank you for giving me an opposing point of view that is a pleasure to read. I understand you are a Democrat. That's okay, I am an independent and have voted for Dems before when I thought the Dem was the better candidate. I have no party alliances. I care more about right and wrong than right and left. If the Democrat party were all people like you, I would probably support them far more often.

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  14. SCREW WHAT THAT OTHER ANONYMOUS "N" LOVER SAID!!! THAT'S WHAT'S REALLY WRONG WITH THIS GREAT COUNTRY, IT'S PEOPLE LIKE YOU! YOU MAKE ME WANT TO THROW-UP.

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  15. To the anonymous poster that was spewing BS..
    You are what is wrong with this country. You want health care??? Maybe you should get off your ass and get a job. I'm a full time student and also work a full time job. Do you want to know why I do this? I do this because I need to provide myself with health insurance and I need to be able to financially support myself. I'm a white girl from a middle class area, so unlike other people I am not being handed discounted housing, free health care, or food stamps by the government. You are too ignorant to know what is actually at stake, you're too hung up on the fact that the president is 'black', and you're right he is black, and that's a great accomplishment. What people seem to overlook is that he is a moron that is slowly destroying all of the foundations that this country was built on, and soon we'll be living in a socialist society. It will be you and your 58% of brain dead morons that will be to blame.

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