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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Saturday, October 15, 2011

"Class" Health Care Provision Roadblock

The program was intended for people with severe disabilities who wanted to live in the community, though benefits could also have been used to help pay for nursing home care or assisted living. It would have been financed with premiums paid by workers, through voluntary payroll deductions, with no federal subsidy. Premiums were supposed to have ensured the solvency of the program over 75 years.

The inability (at the moment) of the Administration to put in place the "CLASS" program is being used by Republicans to show the problems with the PPACA as a whole. The fact that they (the darn spend-thrift socialists) determined it could not fiscally be applied, however, underlines the overall fiscally conservative nature of the whole affair. Maybe, if Republicans weren't assholes and did more to work with the Democrats to pass such a moderate piece of legislation, it could have been better?

A voluntary program for clearly needy individuals with a fiscal check (put in by a Republican amendment (poison pill?) -- amendments one area where Republicans did take part) does not seem to me the best part of the law for them to target. In fact, the problems with the provision underline overall Democratic arguments. For one thing, it shows the importance of the individual responsibility provision (the "mandate"), a purely voluntary set-up not enough to cover the costs. As a Businessweek artice noted:
Because it is voluntary, Class faced a “problem of adverse selection,” in which only people who need the insurance, or think they will, would sign up, he said.
A major piece of health legislation, especially one passed in troubling conditions (Republican obstructionism resulted in bad policy decisions, or rather, not as good ones to enable passage), is going to go through some growing pains as it is put in place. But, it could also be that -- as with the underfunded stimulus package -- that there were too many restraints, resulting in not as good policy. Our system is set up to be conservative in various respects, but the current system (particularly with how the filibuster is applied) can be too conservative. As one expert noted:
“The aim here was a good one,” he said in an interview. “But the program as written in law was over-constrained.”
I will let the experts determine the logistics here, but it seems to me that the problem is that purely voluntary overconservative techniques to serve the needs of the public are problematic. Republicans should be a bit wary about being too glad about what happened here.