Republicans Should Back Universal Health Care Coverage

Marc Ambinder has a fascinating article on why the Republicans should back universal health care coverage.

The time for universal health insurance coverage has come. Everybody seems to know that -- except for the Republicans, all too many of whom cling to traditional denunciations of universal coverage as socialism. Senate Finance Committee Chairman Max Baucus has been holding talks with Republican lawmakers over the past week, and all signs point to opposition from the GOP.

But for the welfare of the country and their political party, Republicans should, instead, seize the lesson of Nixon's trip to China. With one brilliant foray, Nixon converted the massive threat posed by the isolated China into an asset, secured a favorable mention in history, and stripped the Democrats of a key issue. By embracing their own brand of universal health coverage, Republicans can do the same. There's a massive constituency behind the policy. Buffeted by the recession and the threat of losing their employer-provided health insurance, the American people want universal coverage. Much of the US business community wants it too. CEOs rarely say "Know what I love about my job? Buying health care." The chore is so unrewarding -- corporate buyers have failed to create effective cost or quality improvements -- that many small business CEOs simply skip it. As a result, millions distort the efficient allocation of labor in our economy by opting for jobs in dying, big companies that offer health insurance, rather than productive ones in small companies that do not. Furthermore, our employer-based health insurance system forces American businesses to pack our massive health care costs -- about 70 percent greater as a share of GDP than other countries' -- into the cost of their exports, a huge albatross in a globally competitive economy.[...]

The Republicans could instead offer a consumer-controlled universal coverage system, like that in Switzerland, in which the people, not the government, control how much they spend on health. There are no government health insurance programs. Instead, the Swiss choose from about 85 private heath insurers. Rather than being stuffed into the degrading Medicaid program, the Swiss poor shop for health insurance like everyone else, using funds transferred to them by the government. The sick are not discriminated against either -- they pay the same prices as everyone else in their demographic category. Like the US, Switzerland is a confederation of states that, as in the US, oversee the insurance system. Enforcement by the tax authorities has produced 99 percent enrollment.

This consumer-driven, universal coverage system provides excellent health care for the sick, tops the world in consumer satisfaction, and costs 40 percent less, as a percentage of GDP, than the system in the US. The Swiss could spend even less by choosing cheaper, high deductible health insurance policies, but they have opted against doing so. Swiss consumers reward insurers that offer the best value for the money. These competitive pressures cause Swiss insurers to spend only about 5 percent on general and administrative expenses, as compared to 12-15 percent in the US. And unlike Medicare, the private Swiss firms must function without incurring massive unfunded liabilities. Competition has also pushed Swiss providers to be more efficient than those in the US. Yet they remain well-compensated. [...]

The Republican choice is clear. They can whine while the Democratic Congress enacts a government-controlled system, or they can embrace a Republican approach to Universal Coverage.

It would be a big move for the Republican Party to move away from being the party of no and working towards developing quality policy on an issue. Iowa has one Republican that could be a leader on this issue in Sen. Grassley. If a Senator like Grassley would show bipartisanship on a key issue such as health care, more Republican Senators would follow his lead and the nation would be much better off.