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The Good Health Reform Idea That Everyone’s Ignoring

  • October 27, 2009
  • Elbert Ventura

Writing in The Hill’s Congress Blog, Joseph Minarik of the business group Committee for Economic Development brings up an idea that unfortunately has been largely passed over in the health care debate:

Short of starting over with a fundamentally different bill, CED believes that the most constructive change to the current legislation would be the “Free Choice” amendment of Senator Ron Wyden (D-OR).

The CED letter urges Congress to address the underlying problems in the healthcare system: the absence of choice and competition.  Today, 77 percent of private-sector employees with coverage have no choice of insurance carrier. The Finance Committee bill protects this monopoly, leaving 200 million Americans with no choice of health plan.  This system, without competition and without portable coverage for employees, would have the same fundamental problems that we have today.  The legislation in Congress therefore merely expands the status quo and makes its exploding costs even worse.

The disappearance of the Sen. Wyden’s Free Choice Act in the legislative wrangling over health care remains one of the more unfortunate turns in the whole process. The idea had bipartisan support, was well-liked by many progressives, and was genuinely transformative.

The Wyden amendment seeks to add that key element in the act’s title – choice – into the current legislation. Under the plan, employers are required to offer their employees a choice of either participating in the employer’s health benefits plan, or a voucher equal to the value of the employer plan that the worker can then use to purchase coverage in the health insurance exchange. Even better, if the employee can find a cheaper alternative on the exchange, she can keep the change from the voucher.

In the long run, this will have the effect of expanding the pool of enrollees in the health exchanges, maximizing efficiencies of scale, and slowly moving us away from the regressive, taxpayer-subsidized employer-based health system. Perhaps most obviously, it strengthens the consumer’s hand by giving her the freedom to decide what kind of plan she’d like, instead of having to go along with her employer’s plan (which – it should be made clear – she would still have the option of taking).

It might be too much to hope, but progressives in Congress should take another look at Wyden’s idea. Who knew expanding choice could be such a tough sell?

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