My mother, now retired, worked in health insurance from the time she was 18 to the time she retired at 65 (with a brief hiatus for raising my sister and myself). She was in customer service, processing claims for, well you know, disgruntled patients who couldn't understand why the hell the insurance company wouldn't cover this or that or why there was a delay in a check being sent out. Not a fun job, but because of it, my mother has always been a great resource for our family's insurance needs. When the time came for me to restructure my business's insurance benefits for our employees, my mom was extremely helpful.
So I haven't decided who I want to back in the '08 Dem primaries (well, I had already decided on Feingold, and oh how I wish he was still in it.... alas...). So I'm taking a look at all of them. I was delighted to see John Edwards release his plan for universal health coverage so early in the game, and I was encouraged by nyceve's diary analyzing it. I downloaded the Edwards campaign's PDF of the plan's details to study it myself. I pretty much liked what I read. As nyceve pointed out, it's politically smart for Edwards to approach this behemoth from the angle of competitive American capitalism--let a public health entity compete with the big insurance companies rather than make a full-fledged move to a single-payer system. Okay, truth be told, I'd rather we went whole hog to single-payer, but given the political realities, the Edwards plan seemed to me a good step in the right direction.
So I sent the PDF of the plan's details to Mom, for an expert opinion. I am blessed to come from a rather liberal set of parents--lifelong Democrats both (though my dad voted for Nixon in 1960 while stationed with the Army in Germany: "I knew he was the vice-president and I didn't know anything about this young Kennedy fellow"!). My mom began her response to me from the political angle, then moved into the plan itself (parenthetical notes in her message are mine):
First let me start with the story in our local paper -- "Edward's Health Care Plan to Raise Taxes". It's true he does want to raise taxes on incomes over $200,000. But that fact was not mentioned until the 8th paragraph. He is being labelled as a tax & spend democrat. He has to come out hard with his message and his plan. He could start by reminding the public of Bush's drug plan, written by drug companies to profit drug companies and which is one of the biggest tax costs to the public. It would help if he has backing from some big industries, the AMA and ordinary citizens. Because if he doesn't push his plan & doesn't have backing, the beating he is going to take from the "republics'" and insurance companies is going to knock him out of the race. (I love the fact that my mother is shortening "Republican" to "Republic" here--too funny).
Now, the plan, as I see it, could work. The Health Markets he talks about would have to be streamlined, that is, not have as many layers as the insurance companies and third party payers have built into the system to insure their profits. For example, when a company buys insurance for its employees, the plan is often not comprehensive enough to cover preventive care, mental health visits on a par with other office visits, drugs, and dental. If the plan does have comprehensive care the premiums, the deductibles, coinsurance, and out of pocket limits are very costly. This sort of health care policy keeps real wages down and, in depressed economic areas, keeps employees in dead end jobs.
We know that preventive dental care paid off for Dad (My dad's dentist saw a spot on his tongue, which turned out to be cancer, caught early enough to have been treated with minor surgery alone. Send that dentist flowers!). It is sad to think that so many people are not going to get the same level of care, or in fact no care, until it is too late.
Love you, Mom
So Mom basically approves of the plan, provided Edwards gets the regional Health Markets right. Good! Let's make sure Edwards knows what we expect from these Health Markets, and press him to make them as efficient as possible. But it should be clear: coverage trumps cost. If rich people have to pay even higher taxes than he's proposing, so be it; coverage for the poor is more important. Also, a very good and critical discussion took place in nyceve's diary, also linked to above, and I encourage you to go read it.
To my mind, my mom's political points are even more spot-on than her quick analysis of the plan. Edwards is gonna need some serious back-up, from health industry groups, from economists, and from us. All kinds of political forces--from both sides of the aisle, I'm afraid--will be aligned against anyone and anything that wants to upset the status quo. To be a viable candidate--or an effective president--this fight must be prepared for, must be smartly planned and smartly fought. Edwards has been through a national campaign already. I hope he's learned from some of the mistakes of the Kerry/Edwards campaign.
I still haven't made up my mind about who to support in the primaries, but his health plan is definitely being filed in the "pro" column for my consideration of John Edwards. That is, until one of his Democratic rivals does better...