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John Edwards, at my mum's request. (Health care edition)
blaisepascal
As I write this, I've only had a cursory glance at John Edwards issues page. I can tell this will be more difficult than Ron Paul. Whereas Paul had a dozen or so issues which he had a page of rhetoric about, John Edwards has divided his list into three groups with overviews, and about a dozen or so issues in each group. And I expect Edwards is likely to be a bit more....sane than Paul, which will also make it more difficult. It's easy to point out that someone is a raving loon. It's harder to judge someones positions when you have to evaluate then closely to see if they make sense. I haven't read in depth, so I don't know if I like him or not, yet.

Update Did you know <strike> tags are not properly terminated with <\a>? I must have forgotten that bit. Fixed now.


His Issues Page is called "John Edwards' Plan To Build One America", and appears to work off the premise that there are currently "two Americas" and he plans to unite them into One America, but the page doesn't state what the two Americas are: black/white, rich/poor, red/black, men/women, etc. My guess is that he means rich/poor, but that's just a guess. He doesn't define it on this page. There is a link to an 80-page PDF, but I'm not going to read it right now.

First issue... Health Care: Here's the good, the bad, and the ugly. The good thing is he has a plan. The bad thing is in my opinion it's a sucky plan. The ugly thing is it's probably more feasible than anything I'd consider a good plan, which probably makes it a better plan all told. The problem, as he sees it, is 47million Americans are uninsured, the only insurance available is either through your employer (in which case it really sucks to change jobs) or is prohibitively expensive, and the costs are going up and up and up. His solution is to add another layer of bureaucracy require employers to pay for insurance, set minimum standards for what insurance has to cover, create "Health Care Markets" to provide low-cost public and private insurance plans, and give partially-refundable tax credits to help offset the cost of these insurance programs to families. Oh, and then, once that's all in place, require all US residents to have health insurance. He also wants to expand Medicaid, Medicare, and SCHIP.

In my mind, this ignores the primary issue (health care costs) and tries to fix the currently broken health insurance system by treating that as the necessary evil. Health insurance companies exist to solve the problem of disastrous health care costs when something goes wrong. If another way to pay for health care exists, then health insurance companies don't have to exist. Treating health insurance companies as if they are an important and necessary part of the health care issue is probably pragmatic, but not a necessity.

There are many suppliers of health care in town. There are many insurance companies that serve this town. That means each doctor has to have a contract with many different insurance companies to accept payment from them. There are many businesses in this town as well. Each one that provides health care has to choose which insurance carrier to buy it from -- or rather, to offer to their employees, since each of us gets a a choice as to whether or not to accept our employers carrier (I might, for instance, get a better deal signing on as part of my spouse's family on her employer's plan, or vice versa, or we might be better off signing on individually). As a consumer of health care, my choices for insurance coverage are limited essentially to the one plan my, or my spouse's, employer signed on to. I pay indirectly, as I'm sure that my employer takes into account one way or another the cost of my benefits when deciding my compensation.

As a practical matter Edwards' plan would effectively add more insurance carriers (including Government-run ones) to the above mix, and might expand my choices from just my or my spouse's employer's plan to include potentially third party (or Government-run) plans available through the "Health Care Markets" his plan would create. And then require everyone join a plan.

That's not much of an improvement. The one improvement I see is that he plans to force insurance carriers to keep their plans open and not excluding those with medical conditions which insurance carriers wish to keep out now. Since these are, by definition, expensive patients I don't quite see how he can do that and still lower costs without some other radical shift.

I've a friend who is seriously obese, diabetic, and has crippling arthritis. Under Edwards' plan, she'd be required to buy health insurance. I doubt that the tax credits and low-cost plans would be enough for her to be able to afford one, as her health situation makes it hard for her to find work that would pay for insurance. As it is, she can't work because when she does she gets kicked off of Medicaid. It's a major catch-22 for her. Hopefully Edwards' expanded Medicaid plans would allow her to go back to work without losing health-care.

What sort of plan would I like? As I mentioned in my discussion of Ron Paul, I support a Government-run, single-payer system. Health insurance isn't the problem. Health insurance is a not-very-well-working solution to the problem. Businesses got into the providing health care for their workers by accident; they don't have a moral responsibility to do so beyond not harming them in the first place. The purpose of insurance is to distribute risk so that we all pay a little so no one person has to pay a lot. For health insurance, that means we all pay a little so we all have access. That is also precisely one of the jobs of government, to collectively pay for things which have a collective benefit.

I would consider getting there by expanding Medicaid -- first by making its pay to health care practitioners competitive so there is a wider choice of doctors to go to. Second, by making the eligibility income limits rise, and rise fast, say to the median income level in 10 years, and 100% coverage 10 years after that. Third, I'd seriously re-examine what it takes to prove you qualify. Right now, applying for Medicaid is intrusive, difficult, and somewhat degrading, as you have to prove you are poor. During my 3-year period of unemployment I'd joke that Medicaid was the best health insurance plan I've ever had, but the qualifications were a bitch. I'd love to see that same sort of ease of use expanded so everyone could use it.

And, yes, that would mean higher taxes. But it would also mean no health insurance premiums. I just ran a quote for myself via US Insurance Online and got a quote that basically amounts to 20% of my monthly take-home pay for a monthly premium. I'm sure the added tax burden would be less (as its spread over more people).

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(Deleted comment)
take a look at what Dennis Kucinich proposes for health care (warning: PDF file).


I just did. Short form: I've a couple of concerns. Long form: see my next entry (after the "ooh! kittens!" one already up) to be posted when I have time.

when i do that "which candidate matches your opinions?" meme, Kucinich comes out on top for me. unfortunately, i don't think he has a snowball's chance in hell.

as far as i can tell, both Clinton's and Obama's proposals for health coverage are very similar to Edwards'.



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