Ezra Klein is known as a bright young policy wonk who enlisted in the DC village, by becoming a blogger and correspondent for the Washington Post with a corner on the health care "reform" debate. Many of his writings have been very sophisticated analyses of one or more obscure feature of the House and Senate “reform” bills, which at the same time are careful to remain within the "village mainstream" of acceptable political prescriptions and advice to policy makers. Many people rely on “Ezra” for his factual "take" on health care "reform” politics, whether or not they agree with his particular prescriptive “take” on policy, or with his “frame” for discussing and posing issues. One thing about Ezra though, no one has ever accused or complimented him because he suggested a simple solution to a problem. He has traded in the complex and benefited from his ability to deal with it. But it seems that he has avoided the simple in health care reform, no matter how obvious it may have been to the rest of us. Well, the millennium has come. Ezra has suggested a simple solution for the present quandary of the Democrats about what to do about health care "reform" legislation.
While carefully noting that:
My preference is that House Democrats pass the Senate bill and then run their fixes through the reconciliation process. . . .
He continues with an alternative that is much preferable from my point of view:
” . . . Democrats could scrap the legislation and start over in the reconciliation process. But not to re-create the whole bill. If you go that route, you admit the whole thing seemed too opaque and complex and compromised. You also admit the limitations of the reconciliation process. So you make it real simple: Medicare buy-in between 50 and 65. Medicaid expands up to 200 percent of poverty with the federal government funding the whole of the expansion. Revenue comes from a surtax on the wealthy.
And that’s it. No cost controls. No delivery-system reforms. Nothing that makes the bill long or complex or unfamiliar. Medicare buy-in had more than 51 votes as recently as a month ago. The Medicaid change is simply a larger version of what’s already passed both chambers. This bill would be shorter than a Danielle Steel novel. It could take effect before the 2012 election.
I really love the simplicity this, and the ease with which it can be explained to people. It is not something foreign. It does not raise suspicions that the Democrats will be coming to get Medicare for Wall Street’s benefit. It raises no spectres of “death panels.” I don’t quite agree with it, however, because I’d go for more.
Specifically, I don’t see any reason why we couldn’t expand Medicare to people over 45 and under 18. And I don’t see any reason why we couldn’t allow Medicare to negotiate with Pharma on drug prices as the VA does. I agree with him about expanding Medicaid and having the Federal Government fund it, through taxation on wealthier people. I’d do the same for funding the Medicare expansion as well. All this could be done through reconciliation with 50 + 1 votes. It would be a stretch to get them, but if the President wanted it he could get those 50 + 1 votes, and we could have the changes take place by sometime in 2011, not by 2012.
Of course, you’ll say that what I want isn’t politically practical because the insurance companies and Pharma would scream like the stuck pigs they would be. Let them scream.
This kind of bill is easy to explain to the public, easy to justify, will dispel the notion that the Administration always legislates for the benefit of Wall Street, and never for Main Street, and will help an awful lot of people: Republicans, Independents, and Democrats. It will give many people something important to them, shrink the number of people subject to the tender mercies of the insurance companies, be implemented very rapidly, piss off only wealthy people who will have to pay higher taxes, reduce the number of uninsured, and be something for Democrats to run on in 2010 that is in line with the traditional image of the Democratic Party.
Finally, it will give credence to the narrative Obama needs to develop: namely that the Democratic Party, the Party of Jackson, Wilson, Roosevelt, Truman, the Kennedys, and Johnson, is after almost 35 years, finally coming home to the people. That is the winning narrative, and the Democrats not only have to message it. They also, and, most importantly, have to close the actual gap between that winning narrative and reality. They have to implement New Deal 2.0.
(Also posted at the Alllifeisproblemsolving blog and Correntewire.comwhere there may be more comments)



16 Comments







seems like a a sound plan, lets, and with Ezra on board it might even count as ‘serious.’
but, who has the clout in congress to make it happen, and is motivated to do so?
it calls for the ghost of LBJ…
Don’t know spork. If the House wants to start sending little bills to the Senate, forcing the Senate to take a stand on each one, things could get very interesting. Once a few of these small bills are passed, they’d change the political landscape.
I think it falls neatly into the village narrative, if only because it will never happen. No corporate palms are greased, and there that’s always the problem. They let Ezra write, but that’s about it.
Problem is that Dems are going to have to face the voters and a lot of them are starting to panic. During Christmas they nevr expected Brown to win. The consequences of their idiocy have come upon them suddenly, and the village is struggling to hold on to the center-right narrative.
No matter what anyone thinks of Healthcare, or what kind we want or end up with, it’s underlying problem is in the way it’s paid for.
They have no problem funding the Wars and the Military but can’t find a good way to pay for healthcare.
We all know that if everybody was working the money problem would be less.
We also know that the only thing they can think of is taxes.
I still say if they started a Healthcare fund, selling stock, and paying a decent interest rate while people investment was federal insured and safe the people would have a place to invest without the risk of the Markets and Banks.
Another way would be a Lottery if well designed could bring in untold amounts of money. The Government is so greedy they can’t see if the winnings were tax free even the well off would play.
Instead of some new way to fund it they have shown us their way. Tax just about everybody they can, in every sneaky way the can.
Neither Repubs who say they have all the right ideas, or the Dems who have shown their colors, have even mentioned some new way to fund anything including healthcare.
Tax the bastards is their moto.
Why not find a way to let us pay for things without stealing our money in the form of taxes.
There is a way, just create the money and then use it to pay for health care. See: here, here, and here.
That’s clean, simple and could pass. A Medicare buyin at 45, plus the 200% rule would go a long way towards a fix. Effective immediately.
Within two years the entire USA would be ready for Medicare open enrollment.
You’d think so. But that’s not what happened with original Medicare. the momentum stopped. I think the key here is defeating deficit hawkism. The belief that everything must be paid for through taxation or borrowing is a false belief and condemns the nation to Hooverism.
FDR weakened this belief in the 30s and it remained discredited for some time. But since the monetary system was based on a commodity, gold until Nixon’s day, the taxation and borrowing myths persisted. The underlying theory necessary to overcome the myths has developed only slowly since the 7s and 80s and even now is widely known or accepted. See my links @ 7 to begin to get into this stuff.
It would also go toward reducing the unemployment numbers. There are a lot of people out there putting off retirement or taking a full time job when they’d really prefer to work part time because they need access to health care. When business that now lose a lot of the Medicare employees because they don’t get it until they are retirement age start seeing how much cheaper it is to hire people covered by Medicare, they will be pushing to get all their employees covered. Even if they are taxed, it’s easier to plan for and pay a fixed percentage than to be at the mercy of premiums that change every year, and never in a good way.
I agree. There also may be creative things such as offering health inusrance as a fringe benefit for all employees within certain age limits. As long as the same rule applies to all employees I think it would be legal. This would lift some of the burden of providing insurance off employers and allow them to hire more people.
this is the essence of TINA, the neoliberal mantra from thatcher: “There Is No Alternative.”
Right but the so-called experts on what is practical were until yesterday supporting a bill whose key reforms wouldn’t kick in until 2014, because they wanted to be able to say that the bill was revenue neutral. Then after passing the monstrosity that no one can understand, they were going to try to defend this stupid bill in 2010 and 2012 with no visible key benefits amidst sharply rising health insurance costs. So, who are the experts on what’s politically practical? Us or them?
p.s. i’m definitely behind medicare expansion (not the buy-in). rec’d.
Me too. The buy-in is something that might happen though because of their focus on deficit hawkism. We ought to argue against it by saying that if we don’t make people pay for it that will stimulate the economy and create jobs.
If Obama got that plan through…he’d be “KING” for life.
He’d be more popular than he is now, but he still needs to produce jobs, and to do that he needs to avoid deficit neutrality like the plague.