John Edwards’ Healthcare Plan

JOHN EDWARDS’ HEALTHCARE PLAN….John Edwards’ new healthcare proposal is, basically, an individual mandate (everyone is required to get health insurance coverage somehow) combined with community rating (private insurers have to take all comers, regardless of medical condition) and government subsidies (the feds will pay for insurance if you’re too poor to afford it). Private insurance would be available through a mechanism Edwards calls “Health Markets.” Jon Cohn explains what makes this new:

But that’s not the plan’s most intriguing — and potentially radical — feature. That distinction…is for what’s known as a Medicare buy-in. When people go to buy insurance through the Health Markets, they’ll have the option to buy into a public program modeled on Medicare. This would, in theory, set up a competition between the public and private insurance plans. And, if the public program ends up winning in the long run — by attracting most or all of the subscribers — then eventually you’d have what is basically a single-payer system, in which the government provides insurance directly to most people through something like Medicare.

Upside: Edwards’ plan has the potential to evolve into a rational single-payer model in the future. Downside: It might not, and in the meantime it combines the additional cost of universal coverage without the offsetting benefits of the administrative savings from a single-payer system.

Overall, though, it’s a decent plan. So is Mark Schmitt right to say that it’s still a political loser? “Let me go public with the one sure thing I learned from my own miserable six months working on a presidential campaign — Do Not Put Out A Health Care Plan….There will be particular problems with any health care proposal….And the people who are most likely to vote based on health care are also people likely to be fearful of losing what they have. It will always be for political opponents to push that fear button. And when they do, the cause of universal health care is set back.”

I don’t think I agree, because at some point you really do have to run a campaign and win despite the fear button. Otherwise you’ll get the feel-good vote during the election but then lose later on when you try to fulfill your campaign promise and run smack into….the fear button. Best to take it on in broad daylight and wrestle it to the ground. Eventually someone will have to.