Healthcare: The Line In The Sand

The next great public policy debate in the United States will involve a health care reform idea championed by an academic who has no medical background and doesn’t serve in the Obama administration, and whose original proposal was published in a largely unread book.

Jacob S. Hacker first caused a stir in 1997 when, as a Yale graduate student, he described the failure of President Clinton’s health care efforts in em>The Road to Nowhere<. In the years since, he has continued to criticize Democratic overambition on health policy, eventually fashioning his own alternative. His idea has become the focus of a heated and increasingly bitter debate on Capitol Hill. House Speaker Nancy Pelosi, a Democrat, has declared it essential for any health care reform; Republican Senator Mitch McConnell calls it a deal-breaker. Conservative and liberal organizations are gearing up for a grand skirmish.

The idea? Americans would have a new government-run plan, modeled after Medicare, as an option for health insurance. No one would be compelled to enroll in it. Democrats contend that people would have more choice, and the competition would improve all coverage.

Though it may seem modest, the Democratic idea of introducing a public-plan option is worth fighting over. For the Republican minority in Congress and even for moderate Democrats, this is the line in the sand. They believe that instead of encouraging competition, the public-plan option will actually undermine it, will increase red tape, and will exacerbate inefficiencies in the health care system. It could even spell the beginning of the end of private insurance.

To read the rest of the lengthy essay from New Atlantis that I co-wrote with Manhattan Institute senior fellow Paul Howard, see here.