Andy Grove gets modest about health care reform

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Former Intel boss Andy Grove has a letter to the presidential candidates in the latest Fortune. An excerpt:

Your staff is probably working on a big, ambitious plan to fix health care.

Depending on whether you lean left or right, it’s either a universal health-care plan or a way to increase market influence throughout the health-care economy. I have a best-of-all-worlds idea too. In my system the government would cover preventive care and catastrophic health-related expenses. The ordinary medical expenses would be left to individuals. The reason I like this approach is that it has built-in incentives to support preventive care, and it would also protect people from financial ruin due to illness. Yet for most situations, the power of the consumer economy would be allowed to do its magic.

The only problem with my plan – and yours – is that it’s too much. Look at the history of health-care reform in our country. Presidents have been putting forth plans for comprehensive health-care reform for 100 years. That’s not a typo. Woodrow Wilson proposed universal health care. So did Harry Truman, Richard Nixon, and Bill Clinton … None of them got there. I believe none of you will either.

So what’s Andy’s suggestion? First, fix emergency rooms, using a 1% surtax on all health-care billings to pay for improvements. Second, change Medicare incentives (and use technology) to encourage the ailing elderly to stay at home as long as possible instead of checking into a nursing home.

That’s it. It seems, given all the bold plans in the air at the moment, decidedly underambitious. Or is Andy just being smart?