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Business leaders jumped into the universal healthcare pool this week, as 36 companies formed the Coalition to Advance Healthcare Reform and called for a system where all individuals are required to carry health insurance. The announcement further shifts the center of gravity of the healthcare debate, where opposing health insurance for every American is understood as unreasonable. But that doesn't make the Coalition's emergence an unequivocally healthy development.
The crucial debate now is over what role our government should play to secure affordable, quality coverage for all. The coalition, which includes some insurance and pharmaceutical companies, appears to favor continued restrictions on our government's ability to keep insurance companies honest and serve all the public.
The coalition is not backing a specific plan yet, but it has "core principles" that were laid out by the group's founder, Safeway CEO Steve Burd, in a column for the conservative Washington Times. Their first principle? "Because market forces are largely absent in today's healthcare system, costs are spiraling out of control," writes Burd. "Market forces, if properly introduced, can fix this problem."
Uh, come again? He doesn't see that it's market forces that entice insurance companies to cherry-pick the young and healthy as customers to score an easy profit, leaving millions behind without insurance, leading to higher costs for everybody? This complete misreading of the problem doesn't bode well for any future policy proposal.
The emphasis on "market forces" sends a signal that the coalition wants universal coverage in name only, where our government mandates individuals to get private coverage but does little to reign in the detrimental practices of the insurance industry. Everyone might be covered, so to speak, but for too many, it would be paltry coverage at high cost.
The nominally universal system that the coalition proposes would, of course, be a great deal for the insurance companies. They would get millions of new customers in one fell swoop without having to comply with much new regulation. But for the rest of us, it would be nothing more than a dressing up of the same failed healthcare system. Costs would continue to be squeezed where they shouldn't, leading to a continued rationing of care, and allowed to run rampant elsewhere. The coalition principles give a nod to assistance for low-income families, but that won't necessarily protect them from getting squeezed along with the middle class.
There are better ways to achieve universal coverage that don't depend on market players as insurance companies somehow changing their DNA. There's single-payer, where our government provides health insurance and puts private companies out of business -- though that comes with the major political hurdle of convincing those who are happy with their insurance to switch to a new system.
And there's the new Health Care for America proposal from Yale professor Jacob Hacker, which would create a Medicare-style public plan for all Americans under 65. The public plan would compete with private plans, but on a fair playing field with no cherry-picking. Employers would have to provide good quality coverage or help fund the public plan.
These are the three main visions for universal coverage: a government-managed system completely replacing the private insurance industry, a new public plan that competes with private insurers on a government-regulated fair playing field, or reliance on private insurers to fix a problem largely of their own making.
Business leaders, who are in the best position to understand how the status quo hurts them and the country in a global economy, deserve credit for helping to shift the healthcare debate. But the Coalition to Advance Healthcare Reform will have to rethink some of its "core principles" if it is truly interested in meaningful change.
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