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The Texas Blue
Advancing Progressive Ideas

A Health Care Plan for the Two Americas

By 2016, one out of every five dollars Americans spend will be on health care. This alarming estimate was published online recently by the Centers for Medicare and Medicaid Services, a governmental agency. The U.S. already leads the world in per capita health spending, which will double in the next 10 years to $4.1 trillion. The biggest problem indicated by these staggering figures is the inefficiency of the system.

Even though we’re spending more than every other country on Earth for health care, many Americans remain uninsured. Almost 1 in 5 non-elderly Americans are uninsured; last year, 18,000 people died because they couldn’t afford to pay for health insurance. Even those who are covered aren’t significantly improving their health compared to those countries that pay a fraction of Americans’ costs. We all know there are problems — the numbers associated with the uninsured and the costs associated with the insured are staggering, and until recently, no one had stepped up to the plate to propose a legitimate, real, achievable solution.

While the other two leading Democratic candidates engage in a back and forth about what Hollywood mogul or southern bigot said what about whom, John Edwards is stealing the “issue spotlight” with his Edwards Plan for Universal Health Care. The Plan is a complete one — not just one to “start the debate,” but one that can be successfully implemented and effective. He addresses the major failures of the current system: from uninsured Americans, to spiraling health care costs and the inefficiencies of private insurance, to the inconsistent quality of health care provided to Americans. And the Plan provides a solution to all of these.

The Plan shares some commonalities with past and current plans for universal health care, like a requirement for businesses to insure their employees (as Massachusetts now requires), or an expansion of Medicaid and the State Children’s Health Insurance Program (SCHIP). To pay for the Plan, Senator Edwards wants to eliminate certain tax breaks for households earning over $200,000 annually. He’s not shy about needing to “raise taxes” on the wealthy to pay for universal health care.

The cornerstone of the Plan is the requirement that all Americans have health insurance. To ease the financial burden on average families, the Plan offers a sliding-scale tax credit to offset families’ health care costs. Furthermore, Edwards’ Plan proposes cost-cutting technological improvements such as electronic medical records and automated prescription filling. These innovations will cut down on medical errors and reduce excessive administrative spending — currently $1,000 per American (or over 30% of the total costs of private health care) — making the logistics of health care more efficient.

But the Edwards Plan goes even further — it introduces the idea of “Health Markets,” non-profit purchasing pools of competing insurance plans. Health Markets will be set up regionally, by states and groups of states, and each will include at least one public health care plan based upon a Medicare model. All plans offered in the Health Market will be required to offer full benefits, including mental health coverage, at current Medicare prices.

Health Markets act as a natural price stabilizer. Private insurers spend a large percentage of premiums on administrative costs; because these same insurers will now be competing with Health Markets with dramatically lower administrative costs, private insurers will be forced to lower their prices (to compete against members of the Health Markets) or be put out of business. Also, because the Plan requires insurance companies to offer coverage to all Americans, not just healthy ones, public and private insurance companies will evenly share the cost of insuring those with more expensive health problems, creating a more equitable system.

The Health Market proposal suggests that Edwards is looking to a real solution, not just a plan filled with magic phrases like “tax incentives.” He doesn’t mind saying his Plan is going to cost money and require a tax increase, because the overall social benefit (and real benefit to every American and American business) far outweighs the tax increase. Health Markets will require private insurance plans to compete with public plans, which will automatically lower prices. Over time, the single-payer approach may prove itself more effective, because private insurers may not be able to compete with the public system, but that will be a choice made by the market rather than the legislature.

It’s time for politicians to offer real solutions to the health care crisis in America. It’s an embarrassment that this country, with all its medical resources, ranks near the bottom in healthy life expectancy and infant mortality rates when compared to other industrialized nations. We should be ashamed that a country as affluent as the U.S. can allow its citizens to die for want of access to quality care. The health care crisis is a perfect example of John Edwards’ description of “the two Americas,” and his Plan will help eliminate the stark contrast between the Americans who can afford insurance coverage and those who die trying.

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