Andrew Samwick writes:
So all the government needs to do is establish a premium schedule for
Medicaid and require proof of insurance on the tax form to be exempt
from paying that premium. The premiums should rise with income to the
point where any middle class working family with employer-provided
coverage would likely prefer the employer coverage. The premium levels
should be high enough so that the taxpayer isn’t paying through the
nose for someone else’s premiums. That’s universal coverage in two
straightforward steps, without a lot of disruption to the way health
insurance is currently provided or an enormous infusion of government
Here is more. He is likely right that this is the easiest path toward near-universal coverage. But I am not sure I understand the actual goal of the plan. Many people who do not currently have coverage are taxed so that they will obtain coverage. In other words, in terms of a consumer sovereignty standard, these currently uninsured are brought to a less preferred position and thus made worse off. This is a major tension in many health care plans, namely how much the goal is coverage per se and how much the goal is to make people better off by their own standards. It is harder to make people better off than it is to get them covered, yet the latter is easier to claim as a political victory.
I should add that this plan, without amendment, would encourage rather than discourage health care cost inflation.