Russ McBee

I've posted previously about the health care proposals put forth by Barack Obama and Hillary Clinton. This time, I'm going to look at what John Edwards is saying.

In brief, his plan consists of the following factors:

• Require businesses and other employers to either cover their employees or help finance their health insurance.
• Make insurance affordable by creating new tax credits, expanding Medicaid and SCHIP, reforming insurance laws, and taking innovative steps to contain health care costs.
• Create regional Health Markets purchasing pools to give every American the bargaining power to purchase an affordable, high-quality health plan, increase choices among insurance plans, and cut costs for businesses offering insurance.
• Once these steps have been taken, require all American residents to get insurance.

Later, he restates these four bullets as "Business Responsibility, Government Responsibility, New Health Markets, and Individual Responsibility." He doesn't call the third one "Market Responsibility," which would have been a nice acknowledgment of the fundamental market failure so evident in our current health care system.

But I digress.

His plan would require employers to provide health insurance for their employees, either through private plans or through regional "Health Markets" which would pool individuals and small companies together to bargain collectively for lower premiums. He states that, among the plans these Health Markets would consider, at least one would be a publicly funded plan based on an expansion of Medicare. Participation in the Health Market would be optional, but ultimately coverage of all employees will be mandatory. Individuals will also be required to carry health insurance, either through their employer or through private participation in a Health Market. The net result will be a requirement on both employers and individuals to keep their health insurance current.

He's proposing a refundable tax credit to help pay for premiums in low- and middle-income households.

Medicaid and SCHIP would be expanded, and discrimination based on pre-existing conditions would be banned.

He also seeks to improve the dissemination of information within the field, much like Clinton's proposed Best Practices Institute. And, like Clinton's and Obama's plans, Edwards proposes a streamlining of IT-related infrastructure in the industry.

 So far, I don't see a whole lot of daylight between the three plans. I intend to study them in more depth (along with the proposals put forth by the other candidates), but at this point, they seem pretty similar to each other. All three are proposing collective bargaining, the promulgation of best practices, IT improvements, and some kind of expansion of public providers like Medicaid, Medicare, and SCHIP.

I like Edwards's emphasis on transparency, Obama's dynamic between a new Medicare-like program and an expansion of the federal employee's private plans, and Clinton's deeper understanding of the IT efficiency issues (she proposed the idea of improving medical record keeping alongside Newt Gingrich two years ago). But overall, the three don't seem fundamentally different from one another. Edwards does admit that "over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan." So, at least there's that.

I intend to do a side-by-side comparison of all the health care proposals put forth by all the candidates (not just these three). I'll even see what the Republicans have to say on the subject, just for giggles. But for right now, I'm not that impressed with any of the proposals from the Big Three Dems. All of them seem to be relying on downward pressure on insurance premiums, coupled with universal coverage, in order to put downward pressure on spiraling medical costs. None of them are talking about serious reform of the medical services part of the industry, with the exception of drug imports.

That's a disappointment.