Jacob S. Hacker writes,

If one word captures the essence of Health Care for America, it is “guaranteed.” Health Care for America would guarantee coverage; it would guarantee a generous package of benefits; it would guarantee greater choice; and it would guarantee real savings and improved quality.

…Health Care for America has just three central elements:

  • the new Health Care for America Plan, which would be open to any legal U.S. resident without good workplace coverage;
  • a requirement that employers (and the self-employed) either purchase coverage comparable to Health Care for America for all their workers or pay a relatively modest payroll contribution (6% of payroll) to fund Health Care for America coverage for all their employees;
  • a requirement that Americans who remain without insurance take responsibility for their and their families’ health by purchasing private coverage or buying into the Health Care for America Plan.

The benefits of the Health Care for America Plan would be comprehensive. Besides Medicare benefits, the plan would cover mental health and maternal and child health and include strict limits on total out-of-pocket spending. (Medicare currently lacks such limits, and Health Care for America would authorize a study of how best to incorporate cost-sharing limits into Medicare in the future.)

It is very hard for an honest person to compete against someone who believes that he can “guarantee” universal coverage, less out-of-pocket spending, unlimited access to health care, and lower costs. In Crisis of Abundance, I maintain that there is a trade-off among insulating consumers from costs, giving them free choice of medical services, and holding down costs. There is plenty of evidence to support that point of view. But evidence is irrelevant to Jacob Hacker’s guarantees.