Health care for the Blue Dogs — Jacob Hacker

Earlier this week, Jacob Hacker, editor of Health at Risk: America’s Health System—And How to Heal It, wrote an op-ed in the Washington Post on the “Blue Dog” Democrats’ apprehension about Obama’s health care plan.

Hacker argues that while the Blue Dogs “are right to hold Obama and Democratic leaders to their commitment to real cost control,” they should also recognize the plan’s potential to keep costs down. Moreover, health care reform is particularly vital for rural Americans, many of whom are voters in Blue Dog Democrat districts. Hacker writes,

Many Blue Dogs fret that a new public health insurance plan will become too large, despite the CBO’s projection that the overwhelming majority of working people will have employer coverage and that the public plan will enroll less than 5 percent of the population. Their concern should be that a public plan will be too weak. A public health plan will be particularly vital for Americans in the rural areas that many Blue Dogs represent. These areas feature both limited insurance competition and shockingly large numbers of residents without adequate coverage. By providing a backup plan that competes with private insurers, the public plan will broaden coverage and encourage private plans to reduce their premiums. Perhaps that’s why support for a public plan is virtually as high in generally conservative rural areas as it is nationwide, with 71 percent of voters expressing enthusiasm.

As mentioned in an earlier post, Hacker’s essay in Health at Risk explores some of the political and ideological contexts that have shaped the health care debate. How can reformers combat the rhetoric of those who claim health care reform will be too costly and introduce too much government interference in their lives? As Hacker suggests in his essay health care reform has been sunk in the past despite enjoying the support of most Americans. What are reformers to do? Hacker writes:

When the rhetoric heats up reformers will need to be able to fight fear with fear—the fear of government with the fear of losing private coverage, the fear of taxes with the fear of medical bankruptcy and debt. Reformers will also need to be able to fight fear with hope: with a clear, simple, and unthreatening vision that builds on what exists and meets public concerns head on—a vision that may lack the ineffectual satisfaction of a fine-tuned policy blueprint, but which provides the political satisfaction of actually having a chance of passage.