Saturday, December 27, 2008

Suggestion #14: Insure the kids.

These are “unusual suggestions” and everybody else is already talking about health care.  So why would I weigh in?  Three words. Start with kids.

The greatest mistake Hillary Clinton made, way back in 1993 -- the calamitous opening she gave the neocons, who then came roaring into power -- was to try fixing the health mess all at once, in a sweeping act of policy-wonkdom.  It only gave her foes an opening to ridicule the complexity and centralized, federal hubris of her plan.

Moreover, it ignored some basics of American psychology. Our inherited frontier ethos idolizes a type of individualist self-reliance that -- even when it is mostly illusory -- we often cling to at all costs.  One result: an attitude that adults ought to find their own way, sink or swim.  Or, at least, enough Americans felt that way to reject any thought of an overall federal system.

(Part of a 12/08 series of “unusual suggestions for America and the Obama Administration.”)

But Americans are a lot less callous, and effectively more socialistic, when it comes to kids!  An overwhelming majority support public education and (more narrowly) backed affirmative action in schools.  Because it is far easier to persuade us that all young people should be helped to the same starting line than it is to suggest fixing the final results of the race.

Let’s chew on that distinction, for a moment.  “All men are created equal.”  That isn’t the same as ensuring equality of outcomes.  (Bill O’Reilly’s relentless false accusation is that liberals aim at leveling outcomes -- an out-and-out, bald-faced lie that is supremely laughable, especially since a capitalism and competitive markets always do better under Democrats.)

Nevertheless,  “All men are created equal” does suggest that... well... no child should be crippled before the starting gun is fired.

Face it.  If Hillary in 1993 had said: “Let’s just concentrate now on taking care of all the kids,” she would have won, easily.  Newt never would have had his killer issue.  And by now, after 14 years, the Child Health Care system would have had enough kinks ironed out and would be covering the elderly, too.

And the grownups who were left with private insurance? They would be pushing theit policy companies against a wall, demanding they improve or face their bitter end.

Key point:  President Obama has plenty on his plate already and very little spending money.  Yet, people expect something to be done about health care.  Hence, I suggest that he at least consider this option of starting with the kids.

This approach has several advantages:

1) It can be done swiftly.  No complicated insurance company illusions.  Simply go to Canadian-style single payer just for those under 18.  Perhaps bill all parents on their income tax for a basic, FICA-like premium.  We’ll all love it, especially if the cost is lower than the kid-premiums in our present policies.

2) Conservatives wouldn’t dare say no.  They’ll scream about “slippery slopes.”  But the American psyche would be on Obama’s side this time.  So would a hundred million worried parents.

3)  It will terrify the insurance companies into cooperating on some next step.

4)  All kids would get uniform preventive care, at relatively low cost, attacking the crisis at its most basic level. Moreover, there would not be an issue of European style age-based care rationing, since children get maximum care, no matter what.  That quagmire can be put off for a while.

All right, that’s my unusual suggestion about health care.  I don’t expect either side to like it at all!

But that’s what I do.

--Continue to Suggestion #15: Truth and reconciliation...

THIS IS PART OF AN ONGOING SERIES: Suggestions to the new administration

Part 1: Unusual Suggestions for an American Undergoing Change
Part 2: The Horn of Africa
Part 3: Radical Transparency
Part 4: Watch out for a supra-national Aristocracy
Part 5: Avoid a crisis caused by "just-in-time"
Part 6: Repair the U.S. Civil Service
Part 7: Free the Inspectors General!
Part 8: Micro-Suggestions about the Economic Crisis
Part 9: Restore the Army, the Reserves and the National Guard
Part 10: Enhance our nation's (and civilization's) overall resilience
Part 11: Control the borders
Part 12: Investigate Wartime Contracts
Part 13: Restore Independent Advisory Agencies for Science and Technology
Part 14: Insure the kids
Part 15: Truth and Reconciliation 
Part 16: More Truth and Reconciliation: bring crooks to justice
   Part 16b: Truth and Reconciliation Addendum
Part 17: Political Matters
Part 18: Time to do something about Gerrymandering

David Brin
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Anonymous said...

very interesting blog here and I've yet to go through it all. I think you would be very interested in taking The Crash Course and weighing into the conversation at the Chris Martensen website.


rewinn said...

"Kids First" is an excellent example of framing the problem so that your idea wins.

Let conservatives rail against kids, PLEASE! They will be smacking their noses against the plan's fist over and over.

Charging the premium on the 1040 is an interesting idea, but however it is paid for, I don't want to hear economic conservatives complain about the price tag. Health care for children is a classically wise investment for the family OR for the nation; quite apart from the moral value of healing the sick, it pays for itself in economic terms. Any individual, organization or nation that won't invest in itself is stupid indeed.

I do question the use of the word "insure". That moves the discussion away from health and onto money. The insurance model is essentially a gambling model, which is a poor way to fund capital improvements such as a healthy cohort of children. More importantly, if you move the argument away from children onto money, you're getting away from your strongest argument.

C. Keith Ray said...

Kids first is a good tactic.

Every now and then, I hear about kids who are income-qualified for free meals at school, but who don't take advantage of that because of shame.

Why are public schools charging for school lunches at all? Health Insurance is probably a higher priority, but healthy diets are also important. If healthy school lunches were free to students, maybe obesity and hunger could both be alleviate to some extent.

Anonymous said...

One note about "European-style rationing" -- private options still always exist for those who are able to afford to pay for them.

Republican scaremongers have gotten away with spreading the myth that if we go to a universal healthcare system, you will be completely at the mercy of that system. In truth, in places like the UK, there is a healthy private system, running alongside the government-run system, which provides surprisingly affordable services in cases where the national cover might be inadequate.

My retired parents (not wealthy by any means) have used the private system more than once for minor procedures.

David Brin said...

Already moved on!

Desperately trying to finish by new years!