According to a recent CBS/New York Times poll, 47 percent of Americans disapprove of the way President Obama is handling healthcare reform.
Wednesday night’s address to Congress could be his last chance to sell lawmakers and the American public on the merits of his proposals.
Obama’s effort has been hamstrung by his preference for a big-government solution to the nation’s healthcare woes. While it’s true that reform is needed, there’s no need to completely remake the health sector. Instead, the president should borrow from more hands-off reforms, like Medicare Part D, which have been both successful and popular in the past.
When addressing reform, Obama frequently overstates the number of Americans without insurance. In a June speech, for instance, he exclaimed that “we are not a nation that accepts nearly 46 million uninsured men, women and children.”
This figure, though often cited, is very wrong. For starters, it includes almost 10 million non-citizens. It includes 12 million Americans who already qualify for government-funded health insurance but haven’t signed up. And it includes over 17 million Americans who make more than $50,000 a year.
All told, somewhere between 8 million and 16 million Americans are “chronically uninsured” and in genuine need of assistance. If the goal is to help these folks obtain coverage, is a trillion-dollar healthcare overhaul really necessary?
No. That’s partly why the “public option” — the proposed government-run insurance program — has been met with such hostility from citizens and lawmakers alike. It’s expensive, radical, and unnecessary.
But only with such a large number could reformers even dream of succeeding with a big-government solution.
A policy better-suited for covering those Americans who are chronically uninsured might look something like the Medicare drug benefit. Since taking effect in 2006, Part D has proven to be one of the most popular federal programs in American history.
A recent survey revealed that 92 percent of beneficiaries were satisfied with their drug coverage in 2008. And, at last tally, Part D was costing about 30 percent less than initial budget projections. The program’s popularity as well as its cost-effectiveness can be attributed in large part to its use of the private-sector competition.
Part D allows Medicare participants to choose from a variety of government-subsidized yet privately-administered drug plans. Seniors get to choose from a number of plans and decide for themselves which one best suits them. Meanwhile, insurers must compete to offer high-quality plans at reasonable prices.
But does Part D really work? The numbers speak for themselves: in 2004 nearly one in four seniors lacked drug coverage. By 2006, when Part D took effect, that statistic dropped to seven percent.
Democratic lawmakers could use this success as a roadmap for expanding coverage while avoiding the kind of drastic government intervention that inspired such rancor in opponents of the public option.
In other words, create a program that allows insurers to compete to offer those 8-16 million chronically uninsured Americans the best plan. The government could then provide subsidies to make that plan even more affordable. This would by no means be easy to implement. But it wouldn’t be revolutionary either, since the policy’s basic framework has already proven to work well.
President Obama is in desperate need of fiscally responsible healthcare reform ideas. A Part D-like insurance program might be exactly what he’s looking for.
