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From Tallahassee to Washington, Part I

Florida Governor John E. Bush wants to outsource Medicaid to the private sector. He wants to do it because, surprise, he is worried about facing Hillary Clinton in 2008 for the Presidency. It's premature to suggest that such a Bush-Clinton match will be had, but ol' "Jeb" is not taking any chances. Medicare and Medicaid both are facing cost explosions. This is largely due to the two programs covering more and more drug types, treatments, and afflictions--and with its recipients less and less likely to have another means to health insurance. This gap is pronounced in the working world now, which makes single-payer health care possibly only an election cycle away.

If universal health care becomes inevitable, the Republicans will favor a market-style solution. In effect, something close to Jeb's idea where private companies still will own the hospitals, pay the doctors and sell the drugs. The government will then give you a stipend to spend as you see fit. Bush is no fool, he realizes that to sell this idea nationally he has to prove that it works in his home state (being a governor and all).

Bush can't experiment with Medicare: he lives in a state with a huge elderly population and the federal government funds the program completely. Medicaid costs are split between Washington and the states, however. Further, Florida's economy is largely based on a lower wage structure that states with more manufacturing jobs. Its voters in 2004 responded to this by raising the minimum wage. But this does not make health insurance more affordable; Floridians have to hope that big employers of low-wage workers offer them a policy. That is, unless they manage to qualify for Medicaid by being under 18, pregnant, disabled, or even HIV-positive.

So make no mistake, John Bush has a Florida Legisluature dominated by Republicans. He can get any initiative passed he wants. And those are whatever policies he intends to incorporate into a national platform for 2008. Jeb only will declare himself if it appears that the Republicans have a shot. His opposition is likely to coalesce around two men: Mitt Romney and Chuck Hagel. All three will begin their explorations once the midterm elections wind up in November of 2006...but anything can happen in two years. If the economy turns sour, or if there's another terrorist attack...Jeb would be hurt the most. If calamity stays only on the horizon, he remains the toughest out of the bunch.

The Democrats may not end up running Hillary Clinton. But in any even they intend to take issues such as health care and education and go after the Republican nominee (as the placeholder for Bush) with both guns blazing. However, just as Jeb might scuttle plans in the face of bad news, other prominent Democrats might defer until later, allowing an unknown dark-horse to challenge the House of Bush. Too bad Bill Clinton is prohibited by law from running again.

posted by Thomas at 7:37 PM 0 comments