David Leonhardt, in a piece in Feb. 28’s op-ed section of The New York Times, had some interesting insights into the evolution of the Affordable Care Act during President Barack Obama’s first term. T.R. Reid, who wrote “The Healing of America” and who spoke at University of Maine in Augusta a few years ago, felt that the ACA was too much of a cumbersome compromise. Leonhardt notes that strategically Obama didn’t feel he could get a more comprehensive plan, I suppose because of industry lobbying. I think many saw the way to universal coverage lay with expanding Medicaid, a plan already up and running, thus avoiding reinventing the wheel, but clearly the pro-market naysayers couldn’t stomach that option.

I’ve always thought the German system has some very interesting elements — private third-party payers; well-regulated, mandated coverage leading to diversification of risk among insurers; and unlinking coverage from employers and allowing the unemployed uninterrupted coverage. That all sounds nice. Folks in the Midwest coal mines might’ve appreciated that element during their recent struggles.

Oh, but there’s those two bogeymen again, “mandate” and his cousin “regulate,” both of whom are not well received by a White House led by self-proclaimed “deconstructionists.” With this dog and pony show, that’s unlikely to happen, and whether your a coal miner in Ohio or working in the wood industry of Maine accessing affordable health care now and into the future will only get worse.

Tom Liscord


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