Ezra Klein is known as a bright young policy wonk who enlisted in the DC village, by becoming a blogger and correspondent for the Washington Post with a corner on the health care “reform” debate. Many of his writings have been very sophisticated analyses of one or more obscure feature of the House and Senate “reform” bills, which at the same time are careful to remain within the “village mainstream” of acceptable political prescriptions and advice to policy makers. Many people rely on “Ezra” for his factual “take” on health care “reform” politics, whether or not they agree with his particular prescriptive “take” on policy, or with his “frame” for discussing and posing issues. One thing about Ezra though, no one has ever accused or complimented him because he suggested a simple solution to a problem. He has traded in the complex and benefited from his ability to deal with it. But it seems that he has avoided the simple in health care reform, no matter how obvious it may have been to the rest of us. Well, the millennium has come. Ezra has suggested a simple solution for the present quandary of the Democrats about what to do about health care “reform” legislation.
While carefully noting that:
My preference is that House Democrats pass the Senate bill and then run their fixes through the reconciliation process. . . .
He continues with an alternative that is much preferable from my point of view:
” . . . Democrats could scrap the legislation and start over in the reconciliation process. But not to re-create the whole bill. If you go that route, you admit the whole thing seemed too opaque and complex and compromised. You also admit the limitations of the reconciliation process. So you make it real simple: Medicare buy-in between 50 and 65. Medicaid expands up to 200 percent of poverty with the federal government funding the whole of the expansion. Revenue comes from a surtax on the wealthy.
And that’s it. No cost controls. No delivery-system reforms. Nothing that makes the bill long or complex or unfamiliar. Medicare buy-in had more than 51 votes as recently as a month ago. The Medicaid change is simply a larger version of what’s already passed both chambers. This bill would be shorter than a Danielle Steel novel. It could take effect before the 2012 election.
I really love the simplicity this, and the ease with which it can be explained to people. It is not something foreign. It does not raise suspicions that the Democrats will be coming to get Medicare for Wall Street’s benefit. It raises no spectres of “death panels.” I don’t quite agree with it, however, because I’d go for more.
Specifically, I don’t see any reason why we couldn’t expand Medicare to people over 45 and under 18. And I don’t see any reason why we couldn’t allow Medicare to negotiate with Pharma on drug prices as the VA does. I agree with him about expanding Medicaid and having the Federal Government fund it, through taxation on wealthier people. I’d do the same for funding the Medicare expansion as well. All this could be done through reconciliation with 50 + 1 votes. It would be a stretch to get them, but if the President wanted it he could get those 50 + 1 votes, and we could have the changes take place by sometime in 2011, not by 2012.
Of course, you’ll say that what I want isn’t politically practical because the insurance companies and Pharma would scream like the stuck pigs they would be. Let them scream.
This kind of bill is easy to explain to the public, easy to justify, will dispel the notion that the Administration always legislates for the benefit of Wall Street, and never for Main Street, and will help an awful lot of people: Republicans, Independents, and Democrats. It will give many people something important to them, shrink the number of people subject to the tender mercies of the insurance companies, be implemented very rapidly, piss off only wealthy people who will have to pay higher taxes, reduce the number of uninsured, and be something for Democrats to run on in 2010 that is in line with the traditional image of the Democratic Party.
Finally, it will give credence to the narrative Obama needs to develop: namely that the Democratic Party, the Party of Jackson, Wilson, Roosevelt, Truman, the Kennedys, and Johnson, is after almost 35 years, finally coming home to the people. That is the winning narrative, and the Democrats not only have to message it. They also, and, most importantly, have to close the actual gap between that winning narrative and reality. They have to implement New Deal 2.0.