Health Care For All: Let's Get It Started

The Democrats are committed to a toe-to-toe battle over the Medicare prescription drug benefit with pharmaceutical companies and the Bush administration, but that is just the first round of the health care fight.  Full victory is universal coverage. Thursday, a progressive coalition officially rang the bell on that fight.

Jacob Hacker, the author of “The Great Risk Shift,” and Roger Hickey of the Campaign for America’s Future are leading the charge. Hacker outlined his plan at the Economic Policy Institute as part of that think tank’s “Agenda For Shared Prosperity .”

Hacker’s pitch is that this is not a pie-in-the-sky, politically impractical plan, but it builds on the Medicare system that we already know works well for seniors. It would require an estimated $120 billion a year in additional federal spending, but what Americans will get for that money is lifetime guaranteed health care coverage. Employers and states would not be burdened as they are by the current non-system, and costs will be cut through the combination of the federal government’s bargaining power with pharmaceutical companies and the administrative efficiencies inherent in a Medicare-like system. People who have good private sector coverage through their employers can choose to keep it, but would not have to worry about losing their coverage, or being saddled with unaffordable premiums, if they lose their jobs.

“Health Care for America is not single payer—a vision that, for both political and budgetary reasons, is unlikely to be achieved in the near future,” Hacker says. “Nonetheless, Health Care for America does embody many of the key virtues of a universal Medicare-like program. At heart, it rests on the time-tested idea of social insurance, the notion that major financial risks should be pooled as widely as possible across rich and poor, healthy and sick, young and old.”

But Hickey warned in  a post at TPM Cafe that advocates should consider this a long-term struggle. "The odds for universal health care coverage are greatly improved after the midterm elections, but nothing is certain and nothing will happen overnight," he wrote. "The public needs considerable time to learn the pro and cons of the various paths to universal coverage, so they can tell their representatives the best way to go."

The Washington Post  showed once again today how fiercely the pharmaceutical industry (and other supporters of the status quo) will fight change, and how reluctant many Democrats will be to rock the boat. The Post reports that Democrats abandoned a plan for a government-run drug program for seniors "largely out of concern that the pharmaceutical industry would stall a complex change, denying them a quick victory on a top consumer-oriented priority." Expedient politics, yes, but a sign that advocates for bold change have their work cut out for them, even among their presumed allies.

The health care plan is just one part of a larger effort by the Economic Policy Institute to encourage progressives to forge creative policy prescriptions for the economic inequality exacerbated by six years of conservative government.

Freshman Sen. Jim Webb, D-Va., opened the conference by citing how dramatically the gulf has widened between CEOs and workers. Webb said that when he was a college graduate in the 1960s, the average CEO earned 20 times what the average worker made; today, that CEO’s paycheck is 400 times that of the average worker. “The growing divide along class lines that we are seeing is not good for anyone,” including the wealthiest Americans, Webb said. “It is not healthy in a democracy such as ours to have such a wide gap between rich and poor.”

Webb said that he and several other Senate progressive and populist Democrats—Sherrod Brown of Ohio, Jon Tester of Montana, Byron Dorgan of  North Dakota and Bernie Sanders of Vermont—are meeting on a regular basis “so we can talk about economic fairness for the people doing the hard work of this society.”

“This is a greedy moment in American history,” said Lawrence Mishel, president of the Economic Policy Institute, compounded by the belief “that there is nothing that we can do about it.”

The challenge is to dispel that sense of powerlessness with bold and practical policy solutions, and being willing to invest the time and energy in getting the public and political support to get those solutions translated into public policy.

“We need some big answers to some big problems,” Mishel said, to reverse the consequences of a failed conservative, laizssez-faire  agenda that has not generated widespread growth. “The conservative answer of a tax cut for every problem has not worked.”

Views expressed on this page are those of the authors and not necessarily those of Campaign for America's Future or Institute for America's Future