Financial Times Editorial Comment: Medical miracle

Financial Times Editorial Comment: Medical miracle
Copyright The Financial Times Limited 2009
Published: December 9 2009 20:03 | Last updated: December 9 2009 20:03
http://www.ft.com/cms/s/0/87715ed2-e4fc-11de-9a25-00144feab49a.html


Prospects that the Senate will pass a bill to reform US healthcare brightened this week, as a possible compromise emerged over the “public option”. If the Senate can push this new measure through, as it should, Democrats in the House of Representatives must choke down their reservations and go along. Healthcare reform can then reach the president’s desk.

Advocates of the public option want a public health insurance scheme to compete with private plans. Conservative Democrats, as well as Republicans, have resisted the idea – and every non-Republican vote in the Senate will be needed to get a bill passed. The main goal of reform, affordable health insurance for (nearly) all Americans, can be achieved without the public option. Making this hostage to a divisive and inessential provision was a mistake.

The Senate compromise is an answer so obvious that one wonders why it was not on the table already. It would create a new national insurance plan modelled on the scheme offered to federal workers. Private non-profit firms would offer insurance, overseen by the agency that supervises the private plans in the Federal Employees Health Benefits Programme.

In reality, this would add little to earlier proposals. They allowed for regulated private plans, with no exclusions for existing illnesses, in an insurance exchange. It is a question of marketing. Conservative Democrats can go along with the compromise because the plans will be all private. Liberal Democrats can too, because the scheme looks public. Honour is satisfied.

In the Senate, encouraging signals are coming from both sides. Democrats in the House, though, are more committed to a “robust” public option – which this is not. One called it a “whitewash . . . not even reminiscent” of a public option. But the compromise puts them in a difficult position. Would they risk sinking the entire push because they oppose a plan as good as the one available to government workers? That looks indefensible.

There are other sticking points. To sweeten the deal for liberals, the compromise includes an expansion of Medicare – the programme for the elderly, which liberals have long sought to enlarge – to those aged 55 and over. That could strain the budget: Medicare is already insolvent on a long-term basis. Also, it will alarm many healthcare constituencies: Medicare pays suppliers less than private plans. But the main thing is that the public option impasse may have been broken. Prospects for this badly needed reform are looking better.