I've been meaning to write this for months, but Obama's proposal today to regulating insurance companies' ability to increase rates, reminded me of what I think it takes to pass reform. To be politically salable, health care reform has to have nearly universal benefits. During the presidential campaign it was enough to say expand coverage to those poor souls who don't have coverage. But push come to shove, when it looks like it's costing money, the public needs to see that it benefits.
Note the difference in support for Public Welfare and for Social Security. Social Security is seen as benefiting everyone. Welfare can be viewed as narrowly benefiting a smaller subset of society. Add on that either case there may issues of race and class operating in the background and you gain understanding of the public politics.
Health Care reform that can be passed in the US Congress needs to have universal benefits that are clear and tangible and appear to be worth the cost. This new proposal is not a great reform, but it does point the doable political direction.
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