There’s an old jibe about legislation: A camel is a horse designed by committee. At least it’s true when sides are compromising to find agreement. Rarely does the process generate an outcome of equine beauty. On a positive note, the result may be functional and sturdy, if a bit ungainly.
We long for simple answers: a flat tax with no deductions or customized loopholes. Sadly, it is a creature with the beauty of a thoroughbred but not much horse-sense. America’s a complicated country. We’d all like a one-size fits all plan that’s fair. At the moment our tax law is complicated but nobody thinks it’s fair. We might be able to write a plan that a four year-old would understand but there will be critics – always- and simplicity does not necessarily result in fairness.
Universal healthcare the presents a simliar challenge. While a single payer plan with the same benefits for all resulting in high quality care is a worthy goal, in our heterogeneous country, One does not want to bear the burdens of the Other – no matter if One has benefited historically from the Other’s free or cheap land or labors. So be it.
Our benighted health care plan has absorbed an inordinate amount of attention for 7 years, even more so since the ascendancy of Ubu Trump. This year’s several variations had the virtue of being simple but had nothing much to do with health care. They were about the RE-redistribution of wealth. They didn’t tackle costs at all. If anything, insurers would have had freer rein to break the insurance market into segments. As for Medicaid, that “problem” would be eliminated first by burdening states with financial and administrative responsibility. The states then could make their budgets by curtailing the program in every different way imaginable. The result would be Health Care 1.0, a return to the politics and economics of the past. State by state coverage would kill the possibility of broad, diverse pools, the kind that make universal healthcare viable.
Trumpcare would have disfavored the old and infirm who, with or without pre-existing condition coverage, would have to bear their own costs directly. The young and feckless could take their chances and ride bareback. Still, the young and feckless should appreciate that even if they eat right, exercise regularly and take good care of themselves, one day they’ll get sick and die. Don’t bother to ask – the high deductible tolls for thee.
And that, good people, is why there are horses and camels. While the GOP caucus has been fiddling, Senators Alexander and Murphy have been trying to put out the fire. They’ve come up with a plan to stabilize the insurance markets, one which appears to have Ubu’s approval as a stop gap, one of those temporary measures that ripen into monuments. At least the future ex-president would not get to pull down the system by unilaterally defunding the subsidies and playing hide-away with the enrollment program, which is his current game plan. Democrats will vote for it. The ball is in the GOP’s court.
The Alexander-Murray Plan, which is bipartisan (!), starts by accepting that Obamacare is the law and that the subsidies must be restored to maintain it. In turn, states would be permitted to offer a policy variant that affords less care and therefore costs less. Healthcare lite perhaps, but health care nevertheless. In a capitalist system, money always holds privilege. That’s an explanation, not an endorsement -and that’s why many of our horses have humps.