At the behest of a David Brooks column from last week, I finally got around to reading Stuart Butler's proposals for health care reform. If you think (as I do) that the current system of health care finance in the United States is unjust, economically inefficient, and in need of major structural change, then this is not the proposal for you. However, unlike a lot of recent health care proposals from the right -- the Health Savings Account gambit and that sort of thing -- this plan isn't aimed at making things worse than they already are.
In that sense, it's really something progressives ought to worry about. While totally inadequate to the scale of our health care problems, Butler's proposal to create state-sponsored "insurance exchanges" able to take advantage of the tax benefits currently afforded to employer-based plans would provide real help to some people, doesn't threaten anyone's interests in a really obvious way, and could provide an appealing way for employers to wriggle out of responsibility for administering health care plans without needing to endorse anything devilishly socialistic.
In that sense, it's a very politically plausible proposal. If I were a conservative looking to block an ambitious progressive health care plan, but afraid of being unable to beat something with nothing, I'd be running to embrace what Butler's selling here.
| 
Heads in the Sand
I don't think this will fool anyone. It doesn't guarantee universal coverage, and, equally important, it doesn't solve the problem of adverse selection, which makes it virtually impossible for individuals to buy insurance on their own. Adverse selection is the primary reason why nothing short of national health care will work.
Posted by Josh G. | September 10, 2007 11:09 AM