How Defending the Profits of the Health Insurance Industry is Unique to America

One peculiar feature of the debate over health care reform has been the need by the administration to constantly invoke their intentions to protect the profits of the insurance industry. This refrain appears repeatedly in the President's speeches, and has emerged again in an address by the Vice President :

Vice President Biden added his voice Tuesday to the administration's efforts to reform health care, telling a meeting of state insurance commissioners that tighter regulation of the industry is needed to protect consumers and slow the spiraling cost of medical coverage.

Far from destroying the profitability of health insurance companies, the new regulations envisioned by President Obama would enhance competition and choice for consumers while creating a bounty of new customers, Biden said.

"So, the profits might not be as high per person they cover, but there will be a much larger pool of paying customers," he said.

What's worth noting is that while the other advanced capitalist democracies have a wide array of health-care systems, from the socialized British model, to the government as insurer system in countries like Canada and Taiwan, to a diversity of social insurance systems in Continental Europe and Japan, what they all have in common is that for-profit health insurance companies are the exception rather than the rule. By and large, private insurers in the rest of the industrialized world are mandated to be non-profit, at least at the level of basic care. Of course, this helps keep their health care so affordable compared to the United States.

But, while the Obama administration may play up the need to protect the profits of the health insurance industry, at least they've highlighted their desire for carving a role for a small non-profit sector via the so-called Public Option. But, as we've seen, the entrenched interests of the health insurance lobby is such that even this concession is likely to be discarded in the Senate version of the bill.

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Americans May Receive Universal Preschool before Universal Health Care

While conservatives storm the Bastille in their epic struggle against universal health care, Congress has been quietly moving forward on a higher education bill that could transform pre-K education in this country:

Tucked away in an $87 billion higher education bill that passed the House last week was a broad new federal initiative aimed not at benefiting college students, but at raising quality in the early learning and care programs that serve children from birth through age 5.

The initiative, the Early Learning Challenge Fund, would channel $8 billion over eight years to states with plans to improve standards, training and oversight of programs serving infants, toddlers and preschoolers.

The Senate is expected to pass similar legislation this fall, giving President Obama, who proposed the Challenge Fund during the presidential campaign, a bill to sign in December.

American child care and preschool education is a disorganized mess: not only do private and public sectors compete with each other, but even public agencies like Head Start contend with state-led programs targeting at risk children. The fund would reward those states that are at least making an effort to integrate their pre-K systems by providing governance structures, quality standards, and curricula.

The Early Learning Challenge Fund matters because it represents another step in the long transition in this country towards universal childcare and preschool. Already, starting in the mid 90's, a succession of states moved towards providing universal pre-K education: Georgia, New York, and Oklahoma led the way, followed in this decade by West Virginia, Florida, and Illinois. While these programs vary in terms of funding and children enrolled, they indicate an evolving standard that preschool education is a public good and should be universalized. This is particularly evident in Florida's case, where the legislature failed to pass bills providing universal pre-K access and was eventually overruled by a voter's initiative to change the state constitution in 2002.

In contrast to the embarrassingly superficial national debate over health care, this is a textbook example of how a conservative electorate can support the expansion of government when the issue at hand is presented in a clear and practical way, and isn't subjected to a clamor of ideological slogans.

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