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Editorial: Langevin-Shays health reform

01:00 AM EST on Saturday, February 23, 2008

Rep. Jim Langevin, a Democrat, has introduced a health-care plan to cover all Americans. Co-authored by Rep. Christopher Shays, a Republican from Connecticut, this is the first bipartisan proposal for universal coverage to emerge in the House. How does it sound? Pretty good.

The model is the Federal Employee Benefits Program, which covers 8 million federal workers — including members of Congress. Mr. Langevin’s plan would create a new federal agency that would negotiate with private insurers to offer a variety of insurance options.

Every uninsured American would have to sign up for one of the plans. Those who don’t would automatically be enrolled in the lowest-cost plan in their region. That’s important. A system of subsidized medical care that doesn’t require everyone to join lets healthy people pay nothing into it until they get sick. We need everyone contributing to the insurance pool.

Employers who don’t offer health coverage to their workers would have to pay a tax into the federal system. That money would be used to cover 72 percent of the premiums, with the individuals paying the rest. Low-income people would have their share subsidized.

One especially appealing piece of this proposal is the requirement that participating insurers spend 90 percent of the premiums on actually delivering health care. That would prevent insurance-company executives from turning a taxpayer-supported program into a scheme to enhance their own private fortunes.

Representative Langevin has a very interesting idea, but we find one thing he said curious. He said: “It’s not single payer. It’s not one size fits all.” It happens that the very successful and popular Medicare program, which covers the elderly and disabled, is mostly a single-payer plan. It is simple, and 98 percent of the money Medicare spends goes for health care, with only 2 percent siphoned off for administrative costs. Sometimes one size serves all.

That said, Mr. Langevin’s plan seems well-thought out. In terms of the politics, it’s not likely to go anywhere in the waning months of the current administration. But sometimes good ideas must be introduced time and again before they become reality.

This plan seems a good idea.

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