Wednesday, April 04, 2007

New fiction

A Place Called Logic

The presidential election cycle of 2008 started almost a year earlier than usual; by February 2007 a lot of people of both parties were in the race and a few were even beginning to drop out.

By late fall of ’07 Biden, Brownback, Dodd, Hagel, and Romney were gone. By early ’08 it became clear that Gore and Gingrich were going to stay out. Edwards had been recognized as a lightweight leftist, Kucinich admitted he was too short to be president, and Richardson faded into the New Mexico highlands. Or maybe Arizona. Nobody really cared. Huckabee struggled on but was roundly ignored.

Basically as the primaries cranked up it became Obama versus Clinton on the Democratic side, and McCain against Giuliani for the Republicans. The war in Iraq dragged on, and Bush’s approval rating dropped to twenty percent.

The Democratic convention was first; it was late August in Denver. Clinton went in with a slight lead over Obama, but made a couple of dumb remarks and lost to the Illinois senator on the third ballot. Obama declared that he would announce his running mate in his acceptance speech the day after the final ballot.

Most people felt that because Obama was the first black to get the nomination, his running mate would have to be a white male. Since his only political background was as a legislator, he probably needed a VP with executive experience. Many people thought that since Obama was reported to have been raised at least partially as a Muslim, his running mate should be a protestant Christian. And since Obama was from Illinois, his second in command should be from the south or west.

A look at the prominent national politicians revealed just one person who satisfied all these criteria, and yet not a single member of the press speculated in the media in the direction of the actual choice.

Obama gave a brief, generic, but very smooth acceptance speech. The final sentence was short and dramatic: “Ladies and gentlemen, I still believe in a place called Hope!” He then turned to face the right stage entrance, and simply smiled.

The crowd mumbled. “He can’t pick Bill Clinton! It’s unconstitutional!” “He can’t pick Hillary! She’s not from Hope, and she wouldn’t take the job anyway!”

Obama waved his right hand, and the candidate walked briskly to the stage. Mike Huckabee! The Huck smiled broadly, waved to the crowd, and shook Obama’s hand. The audience was stunned to silence. A white southern Baptist preacher from Hope, Arkansas! And nary a soul had guessed it.

Huckabee was quickly and almost unanimously approved by the delegates, a generic and largely meaningless platform was passed, and the convention adjourned.

The Republican convention convened the next day in St. Paul. They quickly put together McCain-Giuliani ticket, declared their allegiance to fiscal responsibility, and got out of town.

The race itself was painless. McCain was seventy-one years old, and his jowls hung down almost to his shoulders. There were debates, but little was decided. Obama more than held his own in the two debates with McCain, and in fact there wasn’t much disagreement. Both sides vaguely promised some unspecified form of universal health coverage. It was interesting that Obama never used the word ‘insurance’, but only such terms as ‘care’ and ‘coverage’. In the VP debate, Giuliani talked a lot about nine-eleven and crisis management, and the Huck declared that his understanding of Middle America was a lot better since that was where he was from.

Obama-Huckabee carried forty states and fifty-eight percent of the popular vote. Obama quickly put together a transition team, and in an interesting move, hired Alan Greenspan as an economic consultant. Greenspan declared that he was happy to be around for the transition, but at age eighty-two was way too old to enter the cabinet after the inauguration. Greenspan had famously, half a century earlier, been a close associate of Ayn Rand, the late author of ‘Fountainhead’ and ‘Atlas Shrugged’.

There were several three-man late-November meetings in Florida between Obama, Greenspan, and the Huck. Nothing was said publicly about the subject matter of these encounters. Obama promised to address health care as an early priority, with a major set of proposals before the spring of ’09.

The inauguration took place in January, and Obama again promised to address health care soon, in the state-of-the-union address.

And so he did, in words to this effect: Forty percent of Americans have no health insurance, or inadequate coverage. This number is far too low. We aim to get it up to ninety percent by the end of my first term, and to a hundred percent by the middle of our second term. By then, if my programs are approved, health insurance will be completely illegal in this country. But everybody, or almost everybody, will have adequate health care. Here is how that works.

Health care prices, and drug prices too, have run amuck in America. Our practitioners deliver products and services more efficiently and better than ever before, but prices are exploding. Are doctors greedy? Of course not! Are drug companies evil? Not a chance! So what is wrong? Here it is: we have separated supply from demand in the health-care industry, and when that happens, prices must rise.

You give a family full-coverage health insurance; they are going to spend until the system breaks. They want the best for their kids, as do we all. And the system is broken. If you had full-coverage food insurance, what would you eat? Well, I would eat tenderloins and lobster. With a side of truffles. But I don’t eat those things, because I can’t afford them.

I will propose to congress legislation which will first encourage, and then require, the end of employer-supplied health insurance in this country. Each employer will be required to remove ten percent of its employees from its health insurance plans every six months, starting in a year. Employers will be allowed to supply health care, but not health insurance. Here is how my plan will work:

Each employer will be paid one thousand dollars in tax credits for every employee they remove from health insurance programs. They will be paid five hundred more dollars per employee to whom they provide on-campus health care. Thus a company which is providing three thousand dollars per year in health insurance to an employee will have forty-five hundred dollars with which to provide on-campus health care the first year and at least three thousand per year thereafter. The details will have to be worked out. Smaller companies, which cannot afford to build on-campus clinics, will simply pay their employees more and let them shop for health care in the competitive market. Large companies may open their clinics to the public at open-market prices.

So what will all this do to the health-care market? Supply will be increased, by the large clinics which the big companies will build. Since these will be on-campus in most cases, the companies will not be able to simply buy existing facilities.

Demand will be reduced, because workers and retirees will have cash instead of insurance. Cash that could be used to buy a boat if not needed for health care. People will shop carefully for both price and quality. Doctors and hospitals will have to compete.

Poor people will not get the best health care, just as they now must drive used cars and eat at McDonald’s. No lobster. That must be reserved for the rich. It’s our system. Imagine a massive clinic, the size of a Wal-Mart, making huge profits by providing lower-middle class health care at dirt-cheap prices. Prices will be cheap because across the street will be another clinic. The size of a K-Mart or Fred’s.

Medicare is expensive for the government, and will continue to be. But it will not be insurance. Each Medicare recipient will get a check, with which she may shop for medical care, or whiskey. Payments will be adjusted so that the total cost to the government is the same as current levels. Medicaid will be handled the same way. We are hopeful that charitable organizations such as churches will contribute at the lowest end of the economic scale, just as they do now for food.

With Huckabee’s help, Obama got a version of this through congress and after some rough sledding for a couple of years, it worked pretty well. Everybody lived happily ever after.

1 comment:

Anonymous said...

Good stuff. Maybe Obama will stumble across it...

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