Saturday, November 20, 2010

May the best Universal Health Care Win.

With health care reform comes...ideas. Loved this progress report from Ezra Klein.

Miami Herald: This week, Sens. Ron Wyden, D-Ore., and Scott Brown, R-Mass., introduced the Empowering States to Innovate Act. The bill would let states develop healthcare reform proposals to preempt the federal government's effort. If a state can come up with a way to comprehensively cover as many people as the federal plan, without adding to the deficit, the state can get the money it would have gotten from Uncle Sam for healthcare reform but be exempt from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else.

Wyden, with the help of Sen. Bernard Sanders, I-Vt., was able to build a version of this exemption into the original healthcare reform law, but for various reasons, was forced to accept a starting date of 2017 … The Wyden-Brown legislation would allow states to propose their alternatives now and start implementing them in 2014, rather than wasting time and money setting up a federal structure that they don't plan to use.

A government-run system like single-payer, of course, is even more objectionable to conservatives than the existing healthcare law. But that's the beauty of this option: It allows liberal states to go their way, conservative states to go their way, and then lets the country judge the results.

Conservatives, however, don't believe that will happen. They think that a consumer-directed system will offer higher-quality healthcare at a lower price, and with more choice. If Tennessee takes that route and outperforms Vermont, it'll be their system that spreads across the land.

The funny thing about the healthcare reform debate is that for all the arguing, everyone says they're in favor of it. The problem is that no one seems able to agree on what real reform is. The beauty of Wyden and Brown's approach is that the country doesn't have to choose. ``Real reform,'' in their world, is whatever works best to cover everyone at the lowest cost. Utah and California can go their separate ways, and the other states can judge the victor based on results, not ideology.

Liberal Democrats may shiver at the thought of conservative reform plans, while conservative Democrats may worry about the possibilities of a public option or single-payer system. Republicans may fear that attempts to reform the healthcare law will read to their base as if they're making peace with it rather than working to repeal it. And the various industries will fear -- and likely fight -- the prospect of reforms they can't anticipate, and may not benefit from.

But those who hide from this proposal are fundamentally signaling a lack of faith in their own ideas. What Wyden and Brown are offering is the chance for the various sides to prove that they're right. If industry players make the system work better, then the states that prize their involvement will prosper.

If conservative solutions are more efficient, that will be clear when their beneficiaries save money. If liberal ideas really work better, it's time we found out. Forget repeal and replace, or even reform and replace. How about compete and succeed?

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