Wonkery to Bore You

So I mentioned yesterday that there will be plenty of time today to bore my readers to tears with an exegesis on Max Baucus’ health care plan, which strictly speaking, is a white paper. Rather than get in to the gritty details — of which I’m not the best to explain anyhow — the basic fact is that it’s Obama’s plan with a universal mandate, which is to say, it’s Hillary Clinton’s or John Edward’s plan. Here are a few basic points:

  • The plan calls for a conditional universal mandate (“Once affordable, high-quality, and meaningful health insurance options are available to all Americans”)
  • The employer sponsored health care system will remain intact, and in fact, will be the mechanism for the original mandate.
  • Those who opt not to get insurance through their employer (or simply choose not to, or are self-employed, etc) will get their insurance on the “Health Insurance Exchange” which pits private against public plans.
  • Insurers would not be able to set price by conditions, but rather only be benefits offered. Price would be applied flatly to all consumers.
  • All plans will be regulated by the Independent Health Insurance Council which will define terms like “coverage” and “affordability.” Crucially, this group will have some Congressional oversight, but as the term implies, would have some degree of independence (appointed by the President).
  • The plan would build on public programs, including the creation of a generic plan, expansion of S-CHIP, Medicarid, and Medicare to all those retired or unemployed over 55.
  • Baucus calls for the implement Health IT and payment reforms.
  • I think that’s all. Not sure though.

Since the “Call to Action” is only a white paper, the plan is more remarkable as a political document. Since Baucus chairs the Senate Finance Committee, it’s likely that any reform would go through his office, but there had previously been talk about starting with Kennedy or even the Wyden-Bennet bill. Baucus must now be considered a major player. This is probably a smart play for Health Reform reform for a few reasons.

First, Max Baucus is a fairly conservative member of the Democratic party and is well known for protecting industry interests; this will position him well for articulating a realistic vision for health care reform. Secondly, Obama will have a number of priorities to deal with before health care; by the time he gets around to focusing on it, it’s likely his political capital will prove insufficient. Lastly, Clinton’s failure to pass health care reform stems in large part from an inability to work with Congress; with reform starting in Congress, it’s unlikely that Presidential politics will interfere, especially because Baucus’ paper is more ambitious than the plan on which Obama campaigned.

It’s important to remember this only sets the debate, but it’s a pretty good place to start.


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