13 September 2009

Now, Here's A Thought...

On Wednesday our president likened the hot-potato public option to private and public universities, which struck me as a great analogy. Then I realized it was not as good as it seemed for his purpose, but could be even better than he realized.

As we heard it, and assuming he is not 'lying' (shame on me for ringing that bell) the public option would be a federal program. But public universities are state run. Why have we not been looking at state organized options, which really would be like state universities.

Medicaid is state run. Federally and state funded, it is state administered. Now there are lots of problems with the program, especially in funding it. I suppose this, and that it is meant for low income folks, has kept it from being used even as an analogy. Read more about it here. I can well understand how this would scare folks as a potential future. But this is not the only public form we can consider.

Blue Cross and Blue Shield were for a long time non-profit state chartered health care systems. They are premium based programs that operated more like utilities than government programs. You can read about them as well.

In 1986 the BCBS lost their full tax-exempt status, according to something I read, and that's what got me thinking....

What if the BCBS was remodeled as a state based health utility system, a sort of electric company for health care? We would pay for it as we do electricity, too. If they were also tax-exempt not-for-profits, chartered to provide low cost health care, they could serve as the primary care system I mentioned a few posts ago.

They already manage care for 1/3 of all Americans, many government employees, and yours truly. Perfect it is not, but like our elder friends on Medicare who also then can supplement coverage if they want with private plans. I am sure private companies would love to do that kind of risk based coverage they do now but only for select services and needs.

I am surprised that we have not seen more ideas like this. First from my beloved Democrats, I love them because if I did not I would wring their necks half the time. Hey guys, get creative here. Federal government isn't alone. Use the federal part, the states. Second, for my equally beloved Republicans, whom I wish to throttle more than half the time because I share fewer of their particular values. See how federal law can empower local government and set the stage for creative and responsive answers to the health care question.

This won't happen of course. I am just a preacher, writing a blog read by less than 100 people. Even when I send stuff to my elected officials it is filed and forgotten. But as a many of faith, I continue to hope that someone like me, a little out of the mainstream but with a large vision, might help out a bit.

Besides, after all those fulminating posts it was time for a positive word.

1 comment:

Stephen said...

Well Dad, I think it's a decent idea of making it state run. My only two worries are that most states I believe have a balanced budget clause, so could not affford it at the time. However the federal government can give a completely funded mandate. My second worry is this, what if what Engler did to welfare in MI could be done to Health Insurance here. Engler made a welfare to work program that paid the "beneficiaries" less than living wage, offered no education, and offered no childcare services. Engler just created a cheap labor force for his friends to capitalize on. Couldn't a state government have the same problem with Health Insurance.