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June 10, 2006


I once read that former Senator Dole ruled that the Republicans would have to kill Hillary's health-care plan, that they could not let it happen. If this is true, and I suspect it is, why isn't this included now and then in the media coverage denigrating her health-care plan?

It's time for a new series of harry and Louise commercials talking about how they are ok now, they have Medicare, but they are worried about their kids--Fred just lost his job and the family has no health care, and Franny's just been diagnosed with cancer, and the medication will be more than her health insurance covers. They could reminisce about how it would have been different for their kids and grandkids if some form of universal health care had been enacted in 1993--"We didn't understand then. We thought the private health plans would take care of us. We thought government-funded care meant rationing, but the private plans all do it too, and the ultimate rationing is no health insurance at all."

There has to be a phased in plan, and starting with kids and then allowing people over 55 to buy into Medicare would help.

But every time I hear someone say that we need "universal health INSURANCE" I know they don't get what the problem is--too much paperwork and rationing by armies of insurance workers, and misallocation of resources among specialties and geographical locations.

The real progress on this is likely to come from the states. The states regulate the insurance industry, and as some states move to Universal programs, they are going to find it in their self interest to use their ability to regulate insurance costs, and place other economies into the delivery systems. I suspect that once you reach about ten states engaged in a state program -- the feds will be put under pressure to accomodate. It is the same pattern we know historically regarding other matters -- old age pensions began in the states, as did regulation of child labor, and because both insurance and medical licenseing is done by the states -- I expect this matter -- Universal access -- to also bubble up through the states and not down from the fed level.

that makes the MA experiment very interesting, indeed.

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