Obama’s legislation comes from an alternative idea, begun under the Eisenhower administration and developed under Nixon, of a market for health care based on private insurers and employers. Eisenhower locked in the tax break for employee health benefits; Nixon pushed prepaid, competing health plans, and urged a requirement that employers cover their employees. Obama applies Nixon’s idea and takes it a step further by requiring all Americans to carry health insurance, and giving subsidies to those who need it. So don’t believe anyone who says Obama’s health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama’s health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.
Have the previous 50 years been a success for healthcare in America? Have these historical solutions put us on the right trajectory toward a sustainable health solution? Has anyone discussed the possibility that we screwed up 50 years ago? Have we been so narrow in our thinking that all we can do is perpetuate an unsustainable industry? Kaiser Permanente has the right model– they don’t sell fixing sickness, they sell keeping you well. In fact, they are less profitable when they fix sickness. But today, given the new regulations, Kaiser probably couldn’t legally be formed. Going forward, does employer-based health insurance make sense when most of us now change jobs every 2 to 3 years?
It looks like we have a boomer solution to a millenial problem.