Sunday, June 21,2009
DIAGNOSIS: Competition is key to creating universal health care, American-style
Chad Selweski, Macomb Daily Columnist
If this nation is about to embark on an overhaul of our
health care system, let's create a wide-open competition to see who is
up to the task.
If Washington wants insurance for all and more choices for most, let's have an all-out fight to see who's best at providing the most basic of human needs.
If we want reduced costs, let's unleash the free enterprise system and see who can deliver. Let's put the consumer at the controls, making the choices and causing the insurance companies to scramble for people's patronage. Health care reform has suddenly emerged as the hot-button issue in the nation's capital. Conservatives are skeptical of change; liberals want a full-bore reform plan that puts the government in charge of the health insurance system.
What I envision is a complete transformation, a system in which each individual or family is empowered to shop around for an adequate health insurance policy. With 1,300 insurance providers chasing 300 million potential customers, imagine the enterprising -- and affordable -- insurance products that could emerge.
While the machinations of auto insurance are far less complex than paying for MRIs or heart surgery, there's a certain simplicity in how the market provides auto coverage.
The government mandates insurance so no one can bleed the system. But the market offers unfettered access, allowing unhappy customers to switch coverage again and again. There's always another company out there desperately seeking your business, and luring you with a good deal.
Anyone who has seen hundreds of TV commercials with the Geico gecko knows what I'm talking about. And Progressive and Allstate are always trying to keep up.
Imagine if we all had the ability to shop for a Chevrolet-type health insurance policy -- not the Cadillac version -- with an eye on a few basic costs: an annual deductible, co-pays for prescriptions and doctor's visits, emergency room care and a hospital stay.
Assuming that the competition is a fair fight, those five numbers would tell us most of what we need to know.
This is not brain surgery. This is creating universal health coverage, American-style.
The insurance providers would face only a few requirements: every policy would have to cover a standard array of medical expenses; policy holders could choose their doctor and hospital; the pricing would be the same for those customers with pre-existing conditions; and a licensing process would weed out unconscionable companies that sell policies which resemble the health care equivalent of a sub-prime mortgage.
For all those insurers who are routinely criticized for excessive profits and bloated overhead costs and cutthroat criteria for denying certain medical procedures, this would be an opportunity for redemption.
After all, this is do-or-die time. If the providers don't come up with innovative ways to hold down costs while improving quality, political momentum will grow in Washington for reforms that will put each insurer in a regulatory straightjacket. Or out of business.
Those on both sides of the partisan aisle must concede that timing, in this debate, is everything.
The economy is flailing, unimaginable budget deficits are mounting and the American people are agitated by the federal government's role in propping up banks and taking control of U.S. auto companies. This is not the time for an expensive government takeover of the $2.2 trillion-a-year health care sector.
At the same time, anxiety across the land grows as people fear losing their job and subsequently losing their health insurance. Many workers are paying hefty payroll deductions for their coverage while some employers have simply stopped offering benefits due to spiraling costs. With health care expenses swallowing up nearly one-fifth of our economy -- and sure to eat away more in short order -- this is no time for an abundance of caution.
Any effort by congressional Republicans to quash reforms will only fuel concerns that Washington can't get anything done. Any attempt by President Obama to slowly grab hold of the health insurance industry will be met with skepticism by some, and fierce opposition by others.
Level playing field
The time is surely not right for a single-payer government insurance system for all. The alternative proposed by liberals, a "public option," a government insurance plan that competes with the private sector, invites all kinds of questions about a level playing field and a slippery slope.
The alternative, as I see it at this time, is a fierce competition among the private insurers to offer basic, affordable health care coverage for each individual American.
If we devise a system that puts American purchasing power to work and frees the business community from its health benefits ball and chain, the result could be an economic boost -- a real stimulus -- at a time when we desperately need one.
Our current system, unique in the modern, industrialized world, created a disjointed regimen in which most Americans rely on their employer to supply health care coverage and make all the choices involved in maintaining or curtailing those benefits.
It's the result of a quirk in the World War II era attempt to limit war profiteering by corporations and to impose wage and price controls. What we were left with, through a perverted tax code, is a system in which fringe benefits were a means to lure new employees, and a means for labor unions to help justify their existence.
What we don't have is a real choice for consumers. Most employees have no idea how much their health insurance policy costs or how their employer managed to select their provider. What I'm proposing is a plan, referred to immodestly, for purposes of this column, as the Selweski Solution. I propose this:
* Ending all employer-provided health care. Eliminating those outdated, 1940s-era tax deductions for health benefits could generate more than $300 billion a year to pay for health care reforms. Of course, each employer would have the option of maintaining benefits for their most-prized employees. That would be a perk, not protocol.
* Creating a system in which each individual is required to have health insurance, much like the mandate that we must all have auto insurance. This is a provision that seems to already have gained considerable bipartisan support in Washington. It's a self-evident means of addressing head-on the problem of having 47 million uninsured people in this nation.
* Allowing consumers to switch their insurance on an annual basis, much like the Medicare prescription drug program. This would further fuel competition.
* Encouraging each state to establish an alternative -- a massive pool of residents seeking coverage, with the state's insurance business collectively put out for bids. Each household or individual who does not want to engage in the shopping process would sign up to be a part of the pool and receive coverage from the insurance carrier that's chosen by the state.
* Offering a federal tax credit that refunds to each taxpayer the amount they pay for health insurance premiums over 5 percent of their income -- a reasonable place to start. This would not be a deduction, it would be a dollar-for-dollar credit awarded in their annual income tax refund. A family with a household income of $60,000 would, in effect, pay no more than $3,000 a year for health insurance.
* Devising a federal catastrophic coverage plan that would relieve insurers from paying for medical cases in which expenses go off the charts. This would amount to a tax-funded program that would, for example, pay 75 percent reimbursement for all costs above $50,000 in any one year for any one medical patient.
The reason why the tax credit is ideal is because it sets a moral measuring stick that says no American family should have to pay more than 5 percent of their income on a basic service like health care.
The reason why state insurance pools are essential to this mix is that they would supply huge bargaining power to the average consumer who now has no leverage, especially for the unsophisticated consumer who is currently told that prices for an individual health policy begin in the five-figure range.
The reason why the employer-based system must end is fairly obvious. With all the layoffs and corporate downsizing we've witnessed in recent months, millions of Americans are losing their health care coverage. Millions more are staying put at failing companies, declining to pursue opportunities to join a firm on the rise -- or to create their own business -- simply because they cannot afford to join the ranks of the uninsured.
The reason why catastrophic coverage is integral is that it substantially revises the risk assessments facing insurance company bean counters. Take away the prospect of a patient piling up $500,000 worth of medical bills, and the cost of all insurance policies should drop significantly. The reality is that a substantial share of the nation's health care bill is generated by a tiny portion of patients with massive medical needs.
At General Motors, company executives estimated in 2005 that a national catastrophic health plan would reduce the price tag on the automaker's health benefits by 23 percent.
In Michigan, a unique provision mandating catastrophic coverage for auto insurance policies offers unlimited medical coverage in the event of an injury-accident
-- at a cost of about $100 a year. A national catastrophic coverage program could be financed through FICA tax withholdings, requiring a payroll tax that would be barely noticeable if it's levied equally on all income earners.
Perhaps the biggest benefit of this plan would be the economic impact. Imagine the boost employers would realize if they were no longer saddled with administering a fringe benefits program for medical care. Less paperwork. Less HR headaches. And no more attempts to create in-house wellness programs or smoking cessation classes. Isn't that the job of an insurance company?
The bottom line is that this system would provide a financial boost for a company's bottom line. This would, in effect, provide a supply-side tax cut.
In addition, with health care costs off the books, employers would have a significant incentive to hire more workers.
What's more, many workers will realize a weekly pay increase as their weekly health care deduction disappears. And at tax time, most would receive a healthy IRS refund. Some will spend it; some will use it to pay their health insurance premiums.
Even state and local governments struggling to avoid budget deficits would enjoy a large fiscal boost from a ledger that's free of rising health care costs for employees.
U.S. firms, especially manufacturers, would suddenly emerge far more cost-competitive in the
global marketplace, where they currently struggle to keep up with foreign companies from countries that have government-run health care.
In terms of logistics, the key is flexibility.
Many states may favor awarding two bids for their pool of customers, to allow companies to compete with each other rather than giving all the participants to one firm. Each pool member would choose one or the other insurance carrier, and if states rebid every couple of years, no one would be locked in.
Some states may want their chosen insurer to offer two plans - one with a low deductible and one with a fairly high deductible that features low monthly premiums. A few states may choose to levy a small assessment on each premium paid to finance a transition to comprehensive computerized medical records and billing. The move toward an IT system pays big dividends.
Each state would become a laboratory for health care innovations and efficiencies. Arizona may want to copy the best practices at work in Tennessee. New York may learn from the mistakes made in Illinois.
Obviously, each would want to emphasize preventive care, wellness programs and disease management when writing their bid specifications. As the process plays out, state officials could work in concert with the chosen insurer, doctors, hospitals and medical experts to find ways to improve outcomes and reduce cost.
The Selweski Solution is all about choices and competition. However, one federal mandate I would favor is a requirement that every American receive a full physical examination annually. Other than that, Washington would mostly take a hands-off approach.
One way to give consumers a guide to judge how well their plan is serving them would be a simple yearly report card. The Mayo Clinic in Minnesota is the gold standard for quality, affordable health care due its top-notch doctors and collaborative approach to medicine. The federal government could establish federal guidelines that would allow each state to compare their pool plan's efforts with Mayo Clinic successes.
The report card would become a selling point for providers, a seal of approval.
In addition, many Americans don't appreciate that health care costs vary widely from region to region across the nation. A pool plan would put a white-hot spotlight on costs in states where bids come back substantially higher than in other states.
In sharp contrast to the current system, with employers quietly making the decisions, the pool price would become a major public issue.
Critics of the Selweski Solution may argue that only the sickest people will enter the pool process, causing the bids to come in too high. But the elimination of pre-existing conditions as a price factor will provide some protections, along with the parameters established for catastrophic coverage.
Word of mouth
Yet, the pool must remain an option only. Allowing individuals to pursue their own health insurance plan can provide a powerful, free-market incentive that leads to healthy lifestyles.
Those unhappy with their pool price may look to their neighbor, let's say a 40-year-old man who exercises regularly and eats healthy foods, and recognize that he gets a good deal on his insurance. That disappointed pool participant then has a financial incentive to achieve the same low rate as the neighbor. Capitalism and cost-containment by word of mouth.
Critics may also say that my plan puts far too much faith in the free market system and the average consumer's ability to make smart choices.
But the Medicare Part D program, which provides prescription drug coverage for seniors, demonstrates that the power of the consumer, plus a competitive atmosphere with dozens of companies fighting for customers, can produce surprising results. The program's cost is projected at hundreds of billions of dollars less than originally anticipated.
While the system I propose would not offer insurance policies with wide-ranging coverage, individuals and families could certainly purchase supplemental coverage for things such as in vitro fertilization or chiropractic services.
And it's obvious that the Selweski Solution requires a health care overhaul of unprecedented magnitude that would involve logistical problems and unforeseen start-up costs. Labor contracts with fringe benefits would also complicate the transition.
I leave the fine points to others with far more expertise.
But I think this overall plan provides a platform that addresses some of the basic issues that Congress has been wrangling with for many years.
No more uninsured. No more ties between losing a job and losing health care. No more concerns about providing "portability" of health coverage.
The price tag
Yet, every discussion of health care inevitably comes down to this: How do we pay for it?
Well, in this case the end of the health care tax deduction for employers would generate an estimated $300 billion a year. The economic jolt from this transformation away from employer-provided coverage could generate hundreds of billions of dollars in more revenue. And, of course, Congress and the White House are tinkering with ideas to raise tens of billions of dollars for the forthcoming health reform plans that are emerging on Capitol Hill.
Once again -- the catastrophic coverage, with an estimated price tag of just $30 billion to $40 billion a year, would be self-sustaining. What's more, a slight expansion of Medicaid coverage could provide insurance for more moderate-income families and for the desperately unemployed.
The bottom line is that the 5 percent income tax credit, even if it's staggered to reflect a household's number of dependents, would cost the government perhaps $400 billion to $500 billion a year. But it's worth it.
Those Americans who have worked hard for years and expected little in return from their government should not have to shovel out 8 or 10 or 12 percent of their income in order to avoid chronic illness or premature death.
Frankly, given the eye-popping deficits we now face under Obama or, for that matter, the buckets of red ink we experienced under conservative George Bush, can anyone assert that an investment of this magnitude should be cast aside if it's not fully paid for?
Some will say this plan is simplistic. Conservatives will find fault. Liberals may hate it. Unions would try to destroy it. Many insurance companies would attempt to undermine it out of fear of losing the cozy business relationships they now enjoy.
But if such a wide array of Washington insiders have doubts, maybe the winners would be all of us who have nothing to gain -- except a fair deal.
Let's give it a try.
If Washington wants insurance for all and more choices for most, let's have an all-out fight to see who's best at providing the most basic of human needs.
If we want reduced costs, let's unleash the free enterprise system and see who can deliver. Let's put the consumer at the controls, making the choices and causing the insurance companies to scramble for people's patronage. Health care reform has suddenly emerged as the hot-button issue in the nation's capital. Conservatives are skeptical of change; liberals want a full-bore reform plan that puts the government in charge of the health insurance system.
What I envision is a complete transformation, a system in which each individual or family is empowered to shop around for an adequate health insurance policy. With 1,300 insurance providers chasing 300 million potential customers, imagine the enterprising -- and affordable -- insurance products that could emerge.
While the machinations of auto insurance are far less complex than paying for MRIs or heart surgery, there's a certain simplicity in how the market provides auto coverage.
The government mandates insurance so no one can bleed the system. But the market offers unfettered access, allowing unhappy customers to switch coverage again and again. There's always another company out there desperately seeking your business, and luring you with a good deal.
Anyone who has seen hundreds of TV commercials with the Geico gecko knows what I'm talking about. And Progressive and Allstate are always trying to keep up.
Imagine if we all had the ability to shop for a Chevrolet-type health insurance policy -- not the Cadillac version -- with an eye on a few basic costs: an annual deductible, co-pays for prescriptions and doctor's visits, emergency room care and a hospital stay.
Assuming that the competition is a fair fight, those five numbers would tell us most of what we need to know.
This is not brain surgery. This is creating universal health coverage, American-style.
The insurance providers would face only a few requirements: every policy would have to cover a standard array of medical expenses; policy holders could choose their doctor and hospital; the pricing would be the same for those customers with pre-existing conditions; and a licensing process would weed out unconscionable companies that sell policies which resemble the health care equivalent of a sub-prime mortgage.
For all those insurers who are routinely criticized for excessive profits and bloated overhead costs and cutthroat criteria for denying certain medical procedures, this would be an opportunity for redemption.
After all, this is do-or-die time. If the providers don't come up with innovative ways to hold down costs while improving quality, political momentum will grow in Washington for reforms that will put each insurer in a regulatory straightjacket. Or out of business.
Those on both sides of the partisan aisle must concede that timing, in this debate, is everything.
The economy is flailing, unimaginable budget deficits are mounting and the American people are agitated by the federal government's role in propping up banks and taking control of U.S. auto companies. This is not the time for an expensive government takeover of the $2.2 trillion-a-year health care sector.
At the same time, anxiety across the land grows as people fear losing their job and subsequently losing their health insurance. Many workers are paying hefty payroll deductions for their coverage while some employers have simply stopped offering benefits due to spiraling costs. With health care expenses swallowing up nearly one-fifth of our economy -- and sure to eat away more in short order -- this is no time for an abundance of caution.
Any effort by congressional Republicans to quash reforms will only fuel concerns that Washington can't get anything done. Any attempt by President Obama to slowly grab hold of the health insurance industry will be met with skepticism by some, and fierce opposition by others.
Level playing field
The time is surely not right for a single-payer government insurance system for all. The alternative proposed by liberals, a "public option," a government insurance plan that competes with the private sector, invites all kinds of questions about a level playing field and a slippery slope.
The alternative, as I see it at this time, is a fierce competition among the private insurers to offer basic, affordable health care coverage for each individual American.
If we devise a system that puts American purchasing power to work and frees the business community from its health benefits ball and chain, the result could be an economic boost -- a real stimulus -- at a time when we desperately need one.
Our current system, unique in the modern, industrialized world, created a disjointed regimen in which most Americans rely on their employer to supply health care coverage and make all the choices involved in maintaining or curtailing those benefits.
It's the result of a quirk in the World War II era attempt to limit war profiteering by corporations and to impose wage and price controls. What we were left with, through a perverted tax code, is a system in which fringe benefits were a means to lure new employees, and a means for labor unions to help justify their existence.
What we don't have is a real choice for consumers. Most employees have no idea how much their health insurance policy costs or how their employer managed to select their provider. What I'm proposing is a plan, referred to immodestly, for purposes of this column, as the Selweski Solution. I propose this:
* Ending all employer-provided health care. Eliminating those outdated, 1940s-era tax deductions for health benefits could generate more than $300 billion a year to pay for health care reforms. Of course, each employer would have the option of maintaining benefits for their most-prized employees. That would be a perk, not protocol.
* Creating a system in which each individual is required to have health insurance, much like the mandate that we must all have auto insurance. This is a provision that seems to already have gained considerable bipartisan support in Washington. It's a self-evident means of addressing head-on the problem of having 47 million uninsured people in this nation.
* Allowing consumers to switch their insurance on an annual basis, much like the Medicare prescription drug program. This would further fuel competition.
* Encouraging each state to establish an alternative -- a massive pool of residents seeking coverage, with the state's insurance business collectively put out for bids. Each household or individual who does not want to engage in the shopping process would sign up to be a part of the pool and receive coverage from the insurance carrier that's chosen by the state.
* Offering a federal tax credit that refunds to each taxpayer the amount they pay for health insurance premiums over 5 percent of their income -- a reasonable place to start. This would not be a deduction, it would be a dollar-for-dollar credit awarded in their annual income tax refund. A family with a household income of $60,000 would, in effect, pay no more than $3,000 a year for health insurance.
* Devising a federal catastrophic coverage plan that would relieve insurers from paying for medical cases in which expenses go off the charts. This would amount to a tax-funded program that would, for example, pay 75 percent reimbursement for all costs above $50,000 in any one year for any one medical patient.
The reason why the tax credit is ideal is because it sets a moral measuring stick that says no American family should have to pay more than 5 percent of their income on a basic service like health care.
The reason why state insurance pools are essential to this mix is that they would supply huge bargaining power to the average consumer who now has no leverage, especially for the unsophisticated consumer who is currently told that prices for an individual health policy begin in the five-figure range.
The reason why the employer-based system must end is fairly obvious. With all the layoffs and corporate downsizing we've witnessed in recent months, millions of Americans are losing their health care coverage. Millions more are staying put at failing companies, declining to pursue opportunities to join a firm on the rise -- or to create their own business -- simply because they cannot afford to join the ranks of the uninsured.
The reason why catastrophic coverage is integral is that it substantially revises the risk assessments facing insurance company bean counters. Take away the prospect of a patient piling up $500,000 worth of medical bills, and the cost of all insurance policies should drop significantly. The reality is that a substantial share of the nation's health care bill is generated by a tiny portion of patients with massive medical needs.
At General Motors, company executives estimated in 2005 that a national catastrophic health plan would reduce the price tag on the automaker's health benefits by 23 percent.
In Michigan, a unique provision mandating catastrophic coverage for auto insurance policies offers unlimited medical coverage in the event of an injury-accident
-- at a cost of about $100 a year. A national catastrophic coverage program could be financed through FICA tax withholdings, requiring a payroll tax that would be barely noticeable if it's levied equally on all income earners.
Perhaps the biggest benefit of this plan would be the economic impact. Imagine the boost employers would realize if they were no longer saddled with administering a fringe benefits program for medical care. Less paperwork. Less HR headaches. And no more attempts to create in-house wellness programs or smoking cessation classes. Isn't that the job of an insurance company?
The bottom line is that this system would provide a financial boost for a company's bottom line. This would, in effect, provide a supply-side tax cut.
In addition, with health care costs off the books, employers would have a significant incentive to hire more workers.
What's more, many workers will realize a weekly pay increase as their weekly health care deduction disappears. And at tax time, most would receive a healthy IRS refund. Some will spend it; some will use it to pay their health insurance premiums.
Even state and local governments struggling to avoid budget deficits would enjoy a large fiscal boost from a ledger that's free of rising health care costs for employees.
U.S. firms, especially manufacturers, would suddenly emerge far more cost-competitive in the
global marketplace, where they currently struggle to keep up with foreign companies from countries that have government-run health care.
In terms of logistics, the key is flexibility.
Many states may favor awarding two bids for their pool of customers, to allow companies to compete with each other rather than giving all the participants to one firm. Each pool member would choose one or the other insurance carrier, and if states rebid every couple of years, no one would be locked in.
Some states may want their chosen insurer to offer two plans - one with a low deductible and one with a fairly high deductible that features low monthly premiums. A few states may choose to levy a small assessment on each premium paid to finance a transition to comprehensive computerized medical records and billing. The move toward an IT system pays big dividends.
Each state would become a laboratory for health care innovations and efficiencies. Arizona may want to copy the best practices at work in Tennessee. New York may learn from the mistakes made in Illinois.
Obviously, each would want to emphasize preventive care, wellness programs and disease management when writing their bid specifications. As the process plays out, state officials could work in concert with the chosen insurer, doctors, hospitals and medical experts to find ways to improve outcomes and reduce cost.
The Selweski Solution is all about choices and competition. However, one federal mandate I would favor is a requirement that every American receive a full physical examination annually. Other than that, Washington would mostly take a hands-off approach.
One way to give consumers a guide to judge how well their plan is serving them would be a simple yearly report card. The Mayo Clinic in Minnesota is the gold standard for quality, affordable health care due its top-notch doctors and collaborative approach to medicine. The federal government could establish federal guidelines that would allow each state to compare their pool plan's efforts with Mayo Clinic successes.
The report card would become a selling point for providers, a seal of approval.
In addition, many Americans don't appreciate that health care costs vary widely from region to region across the nation. A pool plan would put a white-hot spotlight on costs in states where bids come back substantially higher than in other states.
In sharp contrast to the current system, with employers quietly making the decisions, the pool price would become a major public issue.
Critics of the Selweski Solution may argue that only the sickest people will enter the pool process, causing the bids to come in too high. But the elimination of pre-existing conditions as a price factor will provide some protections, along with the parameters established for catastrophic coverage.
Word of mouth
Yet, the pool must remain an option only. Allowing individuals to pursue their own health insurance plan can provide a powerful, free-market incentive that leads to healthy lifestyles.
Those unhappy with their pool price may look to their neighbor, let's say a 40-year-old man who exercises regularly and eats healthy foods, and recognize that he gets a good deal on his insurance. That disappointed pool participant then has a financial incentive to achieve the same low rate as the neighbor. Capitalism and cost-containment by word of mouth.
Critics may also say that my plan puts far too much faith in the free market system and the average consumer's ability to make smart choices.
But the Medicare Part D program, which provides prescription drug coverage for seniors, demonstrates that the power of the consumer, plus a competitive atmosphere with dozens of companies fighting for customers, can produce surprising results. The program's cost is projected at hundreds of billions of dollars less than originally anticipated.
While the system I propose would not offer insurance policies with wide-ranging coverage, individuals and families could certainly purchase supplemental coverage for things such as in vitro fertilization or chiropractic services.
And it's obvious that the Selweski Solution requires a health care overhaul of unprecedented magnitude that would involve logistical problems and unforeseen start-up costs. Labor contracts with fringe benefits would also complicate the transition.
I leave the fine points to others with far more expertise.
But I think this overall plan provides a platform that addresses some of the basic issues that Congress has been wrangling with for many years.
No more uninsured. No more ties between losing a job and losing health care. No more concerns about providing "portability" of health coverage.
The price tag
Yet, every discussion of health care inevitably comes down to this: How do we pay for it?
Well, in this case the end of the health care tax deduction for employers would generate an estimated $300 billion a year. The economic jolt from this transformation away from employer-provided coverage could generate hundreds of billions of dollars in more revenue. And, of course, Congress and the White House are tinkering with ideas to raise tens of billions of dollars for the forthcoming health reform plans that are emerging on Capitol Hill.
Once again -- the catastrophic coverage, with an estimated price tag of just $30 billion to $40 billion a year, would be self-sustaining. What's more, a slight expansion of Medicaid coverage could provide insurance for more moderate-income families and for the desperately unemployed.
The bottom line is that the 5 percent income tax credit, even if it's staggered to reflect a household's number of dependents, would cost the government perhaps $400 billion to $500 billion a year. But it's worth it.
Those Americans who have worked hard for years and expected little in return from their government should not have to shovel out 8 or 10 or 12 percent of their income in order to avoid chronic illness or premature death.
Frankly, given the eye-popping deficits we now face under Obama or, for that matter, the buckets of red ink we experienced under conservative George Bush, can anyone assert that an investment of this magnitude should be cast aside if it's not fully paid for?
Some will say this plan is simplistic. Conservatives will find fault. Liberals may hate it. Unions would try to destroy it. Many insurance companies would attempt to undermine it out of fear of losing the cozy business relationships they now enjoy.
But if such a wide array of Washington insiders have doubts, maybe the winners would be all of us who have nothing to gain -- except a fair deal.
Let's give it a try.
Individuals already have the choice to shop around for their own health insurance - and as a freelancer with no options for employer group coverage, I didn't have any companies knocking down my door for my business. All I got after shopping around for my own policy was a heaping dose of discouragement since every plan I encountered was far too expensive for my budget.
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