Squeeze play

Ezra Klein created a buzz in the blogosphere recently by observing that the main roadblock to universal healthcare is that people fear change.

the central reality of health care politics, which is that most Americans are basically happy with what they have, but worried about keeping it. Policies that guarantee their futures are quite popular. Policies that radically change their presents are not.

The forces that don’t want change exploit that fear to maintain the status quo. Only a sense of crisis will allow radical change—but most people don’t sense a crisis in their personal situation, therefore proposals to mandate individual insurance, or eliminate employer coverage and establish “regional plans”, look like big change—-and create fear.

Given that, why not, asks Kevin Drum,

“expand Medicare (or create a similar program) to cover every person in America under the age of 21. And then let them keep it as they grow older. In ten years everyone under 31 would be covered. By 2050 at the latest the whole country would be covered — and probably earlier than that once the program reaches a critical mass.”

Exactly. The problem is how to expand Medicare. Proposals have been around for years to expand it to children, but go nowhere in Congress. But if we are going to get to universal healthcare, expanding Medicare to children is a much more likely route than a radical revamping of our current institutions. I think Bush senses this too. That’s why he vetoes any expansion of SCHIP. He sees it as a political squeeze play: first cover the elderly (Medicare) then the children (SCHIP)—then squeeze them together to cover everyone.

It also seems like the easiest political sell because a) it demands the least change, and b) I would really love to hear Republicans argue against it: Tell me again Mr. GOP. You say you really like Medicare and recently fought hard to expand it to include prescription drugs–but you don’t want Medicare for children? How does that work?

Update: speaking of healthcare for children here’s Paul Krugman on the subject:

…if universal education didn’t exist in this country, people on the right would denounce it as un-American, and it’s only because it’s already in place that they can’t quite do that… The case for every child having access to healthcare is absolutely the same as the case for every child having access to elementary school.


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Filed under healthcare finance, social insurance

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