If I feel a pain in my backside, I go to the doctor and have it checked out. If it's something serious, I get it fixed, and if it's not, I stop worrying about it. I do not let the problem linger. I'm able to take preventative measures, catching potential emergencies in their early stages before they develop into more serious and expensive conditions.
I am able to do this because I have health insurance. Forty-five million Americans cannot do this because they do not.
In this land of plenty, it is an outrage that so many citizens are not covered for the medical costs to keep them healthy. Not having health insurance is both bad for one's health -- the death rate for people without health insurance is 25% higher than for people with insurance -- and bad for one's pocketbook -- the leading cause of personal bankruptcy is unpaid medical bills.
No American should be left to face this situation, yet finding a way to deliver more health coverage to Americans has rarely been a successful political endeavor -- just ask Hillary Clinton. Conservatives want to allow health care consumers more autonomy to select only the coverage they need, while liberals want the government to provide a safety net of insurance to everyone. The two visions of the problem are diametrically opposed and neither side has been willing to work with the other to solve the problem.
Until now. In Massachusetts, a conservative governor and a liberal legislature came together to develop -- believe it or not -- a reasonable compromise. Facing a loss of federal government aid if the number of uninsured citizens was not reduced, Massachusetts put together a program designed to cover 95% of the state's residents within three years. The plan confronts three distinct categories of uninsured -- the very poor, the working poor, and the not poor at all -- with three distinct solutions.
For the very poor, those living below the federal poverty level, the state will provide essentially free coverage, following a liberal model of state-provided coverage. For the working poor with incomes above the poverty level but too meager to afford health coverage, the state will pay part of their premiums on a sliding scale based on income. This is a liberal solution -- the state pays -- with a conservative slant -- only as much as you need. And for the not poor at all, a surprisingly large group of mostly young male professionals of good health who have chosen to live without health care even though they could afford it, the state will force them to pay a penalty of up to half the cost of private health insurance if they still choose to go without insurance. This is a conservative solution -- adjust incentives to adjust behavior, allowing for personal autonomy -- with a liberal slant -- get more people covered.
On the national scene, a similar compromise is less likely. Congressional Republicans, especially House members from safe seats, are intent on expanding a program of health-savings accounts -- tax-free accounts individuals can use to pay for health care -- as the solution to the problems of health insurance. Unfortunately, HSAs are of little use to those who simply cannot afford health insurance. Over 70% of uninsured Americans have family incomes under $50,000. HSAs offer these citizens nothing more than the current unaffordable system.
The Massachusetts plan remains untested and some on both sides are not sure it can be successful. I'm not one qualified to evaluate it one way or the other. But the plan is already a triumph in two senses. First, it shows that Republicans and Democrats can work together and compromise toward a common goal. And second, it shows that a common goal of the two parties is an increase in the number of Americans with affordable health insurance.
Sensible policy crafted for the benefit of the people? As hard as it may be to believe, such things can happen. At least in Massachusetts. In Washington, partisanship and stubbornness remain pains in all of our backsides -- conditions we must treat quickly. Say, in November.
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