Unhealthy obsession.Ezra Klein says that the states are "structurally incapable" of sustaining health care programs because of their vulnerability to recessions and inability to run deficits ("Over Stated," July/ August). Yes, some state programs have failed for fiscal reasons, but most were based on the unstable ground of insurance providers. So did the programs collapse, or the foundation under them? Klein also fails to address the case of European countries that have maintained successful programs. In fact, states are better suited to do the heavy political lifting needed for universal coverage to succeed. Unlike Congress, states don't need to contend with filibusters. Additionally, state legislators are less insulated from their constituents than congressional lawmakers are. It seems a bit ironic for Klein to look to Congress to solve the problem. After all, every federal attempt at universal coverage over the past eighty years has failed spectacularly. In addition to ignoring this federal failure, Klein also manages to ignore the states' successes. In just the last fifteen years, state-run programs have added at least 20 million people who were previously without coverage. Combined, state programs cover more Americans than Medicare. The states are also learning from each other's struggles. In New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , children's coverage was expanded to 400 percent of the poverty level using the joint state-federal SCHIP SCHIP State Children's Health Insurance Program (State Children's Health Children's Health Definition Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. Insurance Program), providing all but universal children's care. Countless other states are raising their SCHIP coverage levels as well. The boldest plan yet comes from Wisconsin, which circumvents the flawed insurance premium system altogether by instituting payroll-based funding. The plan would cover all residents not already covered by public programs, and would provide comprehensive coverage with no premiums and low copays. The plan is estimated to save $1.3 billion a year while generating $1 billion in new business activity. Securing universal health care will need effort at every level. The federal government is particularly well suited to a funding role, which would distribute the risk of individual states' deficits. On the other hand, state implementation of programs circumvents the political gridlock Gridlock A government, business or institution's inability to function at a normal level due either to complex or conflicting procedures within the administrative framework or to impending change in the business. in D.C. and can offer programs more tailored to residents' needs. Is it really wise to put all our eggs in the federal basket? Adam Thompson Senior Health Policy Specialist Progressive States Network The Progressive States Network is a grass-roots political organization in the United States that aims to transform the political landscape by sparking progressive actions at the state level. Ezra Klein responds: Mr. Thompson conducts something of a bait and switch A deceptive sales technique that involves advertising a low-priced item to attract customers to a store, then persuading them to buy more expensive goods by failing to have a sufficient supply of the advertised item on hand or by disparaging its quality. in the first paragraph of his fine letter. Within three sentences, he's moved from discussing the states to European nations, which imbue im·bue tr.v. im·bued, im·bu·ing, im·bues 1. To inspire or influence thoroughly; pervade: work imbued with the revolutionary spirit. See Synonyms at charge. 2. their systems with federal powers, a model I believe the U.S. should emulate. Mr. Thompson then focuses on state success in the form of ... Medicaid and SCHIP, both federal programs. I sympathize with Verb 1. sympathize with - share the suffering of compassionate, condole with, feel for, pity grieve, sorrow - feel grief commiserate, sympathise, sympathize - to feel or express sympathy or compassion his plight, though. I do not dispute the political failures at the federal level. But the many political successes at the state level have failed to create even one working universal program (which was the subject of my article), while the many political failures at the federal level do not obviate ob·vi·ate tr.v. ob·vi·at·ed, ob·vi·at·ing, ob·vi·ates To anticipate and dispose of effectively; render unnecessary. See Synonyms at prevent. the fact that reformers need only succeed once. My point is that now is the time to fight for that one success. |
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