Medicare? Over time, Emanuel's plan would completely phase it out. Medicaid? Same idea.
(Book Review from Newsweek):
Emanuel, an oncologist who chairs the department of bioethics at the National Institutes of Health, advised the Clintons on their disastrously complex health-care plan of 1993. He's come a long way since: he now seems to subscribe to the "keep it simple, stupid" school of policy design. Too many details can scare away those of us who aren't wonks, so he mostly leaves them out of his new plan. Instead he proposes big, systemwide changes, starting with the butchery of some of health care's most sacred cows. Medicare? Over time, it would be phased out. Medicaid? Same. Employer-based health insurance? It's a bureaucratic system built "by accident," he writes, originally designed for post-World War II workers; let's get rid of it. In place of all these institutions, Emanuel says, the government should offer every American a voucher for health insurance—one that covers the same benefits that members of Congress get. Insurance companies would have to accept the vouchers, and each person could choose from a variety of private networks of docs, hospitals and health plans. A National Health Board would oversee it all. And that's pretty much it.
Now the big question: how do we pay for it? Emanuel's plan lowers some taxes by gutting costly programs, but it also adds a new fixed tax on some goods and services to pay for the vouchers. "Americans will come out revenue-neutral on average," he says. "The poor will pay less." And the rich will probably pay a lot more. Sweeping changes are one thing, but sweeping changes and a new tax? Even if the plan could save health care, it'll be a hard sell.
...While he likes Barack Obama's and Hillary Clinton's proposals more than John McCain's, he's underwhelmed by all of them. "I don't think anything they've put out so far is what they're going to end up advocating," he says. "They'll want another plan eventually. I want to be that second choice."
(full article)
Sunday, June 1, 2008
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