One of my lingering concerns about Obama’s campaign is the question of what health care proposal he’ll introduce. I worried for a while that he would come up with something too cautious (like Edwards’ and Clarks’ plans from 2004). Well, those fears are up in smoke now (via Ezra):
Obama explains that his campaign is just eight weeks old, but that there will be a plan in the coming months. The basic principles of his plan are that “everyone’s in”; that there needs to be new efficiencies (from prevention, dealing with chronic treatment more intelligently, new medical technology, decreasing administrative costs, etc.) that can be put towards covering those now without coverage; creating a new pool for coverage, perhaps like the one in which Senators are enrolled; and finding lower costs, such as through the use of generic drugs, not only name brand ones. Following up, Tumulty asks whether where funding should come from, what type of mandates there should be, whether we should continue basically with this system or to come up with a new system, etc. Obama again notes that he is developing his plan, but that he also wants input from Americans through roundtable discussions around the country. That said, Obama favors pooling to increase access but that it will take some time to transition away from the employer-based system but that, for now, employers will either need to pay or play (give their employees healthcare or pay into a system).
Emphases mine. The “everyone’s in” detail is important, because it means that he’s going to be doing something far more ambitious than Lieberman, Clark, Kerry, or even Dean tried in 2004. No more tax credits, SCHIP expansions, and patients’ bil of rights. He’s already gone beyond the candidate I supported in ’04 (Dean), which is great.
The reference to FEHBP is interesting; Kerry proposed opening up it up to non-government employees, while the CAP used it as a basis for a universal program. It passes the Ezra Klein Test of Health Plan Goodliness; he doesn’t just gush about it, he views it as the most likely way to universal coverage. I’d prefer something more along the lines of Medicare Plus, but FEHBP expansion is the best possible option if one is to preserve private insurers.
That said, the “pay or play” reference takes an important aspect of the Hacker proposal: a strong, specific employer mandate. While the reference to Senate coverage suggests that the “system” into which employers would have to pay if they didn’t cover employees themselves will be more similar to FEHBP than to Medicare, this plan is still very good, and stronger than any proposal from 2004 not originating from the crazy three (Kucinich, Moseley-Braun, Sharpton). I’m impressed. Then again, I often am by Obama.