Sunday, November 9, 2008

The hybrid healthcare system

photo: from wikimedia commons, Barack Obama hearing from Ohio voter Marian Edwards about health insurance

At a small social gathering recently, a policy wonk doctor and I chatted about what the Obama era might bring to healthcare.

"I think he's going to try to do something quickly", the policy wonk said. "The difference between 1992 and now is that big business then was opposed to government involvement just on principle. But now they want it off their table. They can't keep bearing the cost of the whole system. They're ready."

I think the goal should not be a single-payer system. It should be a system that could eventually become a single-payer system in which the government runs an opt-in portion that gradually more and more people opt in to as business ditches health benefits. This is akin to building a hybrid car with the capacity, once a better battery is available on the market, to become a plug-in hybrid with a much greater share of electric power.

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