Healthcare choices

Ezra Klein wrote in the LA Times Sunday about the upcoming choice on health care:

But now that the major candidates from both parties have offered plans for reforming American healthcare (the exception being Thompson, whose campaign has elevated a bored disengagement with substantive policy matters into a sort of avant-garde political aesthetic), it's worth taking a more sober look at what the candidates are promising to do about the issue Americans rank as their most important domestic priority.

The task is eased by the fact that the two political parties have largely converged on distinct diagnoses of what the system's problems are and what reform would look like.

He then sums up the general approaches:

The plans offered by the Democrats differ in details and ambition but diagnose the problem in basically the same way: Not enough people have health insurance, and the fragmented, patchwork nature of our system for obtaining coverage leaves us to the not-so-tender mercies of insurers that have their best interests, rather than ours, foremost in mind.

and

The Republicans are taking a very different approach. Their plans all proceed from the assumption that the problem in healthcare is that costs are skyrocketing because Americans overuse their doctors. This theory postulates that because Americans don't feel the cost of every individual treatment (because it is being paid by insurers and the premiums are being paid by employers), they demand more treatment than they actually need, spending too much and lifting the price of healthcare. The answer to this problem is simple: Make us pay for care directly rather than for premiums.

Klein goes into some detail about the various candidates' individual plans, and then winds up with this:

On each side, the plans are basically united. The Republican plans make you pay more for your healthcare so you'll buy less. They do this by weakening the protection that insurance offers from health expenses. The Democratic plans bring everyone into the system, then use that leverage to reform the insurers and extract savings through efficiencies of scale.

Thompson, who doesn't have a plan, says that "the best way to improve the best healthcare in the world, which is what we've got right here in the United States, is to expand choice."

And that indeed is where the plans differ: the type of choice they offer. The Republican plans make it easier to choose to forgo health coverage or to buy less of it. The Democratic plans make it easier to buy comprehensive health insurance. And the voters will have to choose between the two.

That about sums it up.