Insure the Children

This is an "unusual suggestion" I posted following the election of Barack Obama, when it seemed that everybody — columnists, political sages, bloggers and citizens — was writing missives about 'what I'd do if I were president.' The official transition team even set up an online suggestion box to sample this eager tidal wave of participatory democracy.

Everybody else is already talking about health care. So why would I weigh in? Three words. Start with kids.

The greatest mistake Hillary Clinton made, way back in 1993 — the calamitous opening she gave the neocons, who then came roaring into power — was to try fixing the health mess all at once, in a sweeping act of policy-wonkdom. It only gave her foes an opening to ridicule the complex and centralized federal hubris of her plan. Moreover, it ignored some basics of American psychology. Our inherited frontier ethos idolizes a type of individualist self-reliance that — even when it is mostly illusory — we often cling to at all costs. One result: an attitude that adults ought to find their own way, sink or swim.

Or, at least, enough Americans felt that way to reject any thought of an overall federal system. But Americans are a lot less callous, and effectively more "socialistic," when it comes to kids! An overwhelming majority support public education and (more narrowly) backed affirmative action in schools. Because it is far easier to persuade us that all young people should be helped to the same starting line than it is to suggest fixing the final results of the race.

Let's chew on that distinction, for a moment. "All men are created equal." That isn't the same as ensuring equality of outcomes. (Bill O'Reilly's relentless false accusation is that liberals aim at leveling outcomes — an out-and-out, bald-faced lie that is supremely laughable, especially since capitalism and competitive markets always do better under Democrats.) Nevertheless, "All men are created equal" does suggest that... well... no child should be crippled before the starting gun is fired.

Face it. If Hillary in 1993 had said: Let's just concentrate now on taking care of all the kids, she would have succeeded, easily. Newt never would have had his killer issue. And by now, after 14 years, the Child Health Care system would have had enough kinks ironed out to be covering some adults, too.

And the grownups who were left with private, for-profit insurance? They would be pushing their companies against a wall, demanding they improve or else!

Key point: President Obama has plenty on his plate already and very little spending money. Yet people expect something to be done about health care. Hence, I suggest that he at least consider this option of starting with the kids.

This approach has several advantages:

FIRST: It can be done swiftly. No complicated insurance company illusions. Simply go to Canadian-style single payer just for those under 18. Perhaps bill all parents on their income tax for a basic, FICA-like premium. We'll all love it, especially if the cost is lower than the kid-premiums in our present policies.

SECOND: Conservatives wouldn't dare say no. They'll scream about "slippery slopes," but the American psyche would be on Obama's side this time. So would a hundred million worried parents.

THIRD: Taking millions of children out of the equation should terrify the insurance companies into cooperating on some next step.

FOURTH: All kids would get uniform preventive care, at relatively low cost, attacking the crisis at its most basic level. Moreover, there would not be an issue of European style age-based care rationing, since children get maximum care, no matter what. That quagmire can be put off for a while.

All right, that's my unusual suggestion about health care. I don't expect either side to like it at all! But that's what I do.

THE END