We Need a "Can-Do" Attitude on Health Care

After their roaring two-house victory, the Democrats are squeaking about micro-policies. There'll be no impeachment, we're told, though maybe a bit more oversight of Halliburton-style war profiteering. No withdrawal from Iraq, only a "phased redeployment." And, the New York Times assures us (11/12/06), that the Dems " have largely dropped ... talk of a Canadian-style national health insurance." Instead, they might try to reverse the Medicare drug plan's ban on bargaining for drug price discounts.

They've caught the can't-do spirit that hovers over that former malarial swamp, Washington D.C. Well, maybe they caught it long ago, when the Republican congressional sweep of '94 sent Bill Clinton into long policy ruminations on school uniforms and midnight basketball. Since then it's been non-stop can't-do, with the initial exception of war: Can't do Social Security, can't do universal health insurance, can't do hurricanes. Then it turned out that we couldn't do war either, at least if that meant whipping the Taliban or finding an honorable way out of Iraq.

Well, here's a "phased redeployment" plan: First, bus the troops to the nearest functioning airport in Saudi Arabia, then put them on regular commercial flights to the U.S. According to Travelocity, the airfare part would cost about $1500 a person (coach class), or $225 million for 150,000 troops. If the government won't come up with the ticket price, I'm sure thousands of ordinary citizens would happily dig into their own pockets. Hell, I'd spring for first class.

When it comes to health care, the more cautious Dems trace their can't-do spirit to the great Hillary health reform debacle of 1993. We tried, they say, and it didn't work. But what did they try? The Hill health plan would have created a vast new level of bureaucracy to contract for health insurance from the existing health insurance companies, thus tightening their evil grip over American health care. I described that plan in a 1993 essay in Time as "the ultimate medical nightmare:"

You slip under the anesthesia confident that your problem will be solved with some simple procedure -- a polyp excision, for example, or tubal ligation. But when you wake up you find your breasts are missing or your intestine now terminates in a plastic bag.

Look, millions of voters didn't swing toward the Democrats because they wanted a $15 discount on their statins and beta-blockers. They voted out the can't-do Republicans in part because health costs are an immediate threat to ordinary Americans' livelihoods and lives. They want a solution, and they want it now.

How could we do that? The cautious way would be to expand Medicare to cover everyone. No new program would have to be devised, and the fight over whether Medicare would lead to socialism was resolved over 40 years ago. Just extend it to everyone of any age.

The only problem with that is that Medicare is as full of holes as the Bush rationale for the Iraq war. It's not enough to have Medicare Parts A and B, you need supplementary health insurance to cover the co-payments. As for Part D, aka "Part Doughnut Hole," no one has as yet been able to comprehend it, though it seems to work fine for people who are willing to substitute shark cartilage and lemon grass tea for prescription drugs.

So the most sensible plan is the one put forward by Anna Burger, head of labor's Change to Win coalition. She proposes extending the health insurance plan that currently covers Congress to everyone. "If it's good enough for [congress]," she asks, "Why isn't it good enough for every American?''

Hey, we can do it, or at least something very similar. Recall that as of a week ago, raising the minimum wage was another "can't do" issue: Can't do it because it might lead to inflation or unemployment, might offend the Chamber of Commerce or, god knows, cause acne. But six states just raised their minimum wages and Nancy Pelosi has promised to raise the federal minimum in her first 100 hours as Speaker of the House.