Prescribe a Smart Fix for NY Healthcare

With health care costs entering their fourth straight year of double-digit increases, everyone -- employers, providers, the insured and the uninsured -- is wringing their hands about the rising costs of health care.

To deal with the angst, New York either needs a heavy dose of anti-anxiety medication or an honest solution to the growing health-care mess.

Two starkly different plans now on people's lips in Albany purport to offer the latter. One, modeled after the new law championed by Massachusetts Gov. Mitt Romney, I'll call Romneycare. The other, dubbed Fair Share, is endorsed by unions and New York State's Working Families Party.

If we were comparing two drugs, Romneycare would be the hands-down winner for New York State. It costs less, is more effective and has much less dangerous political side effects.

Unfortunately, Fair Share is the plan making gains in Albany.

The key Romneycare breakthrough is its bipartisan appeal. That Romney, a Republican, got liberal Democrats to accept limits on subsidies is amazing. That Democrats got Romney, a Republican presidential candidate in 2008, to make the plan universal is even more so.

The plan is built on the rock of individual responsibility. Massachusetts started by ending the free ride some take by refusing to buy insurance, seeking free care when they need it and shifting their costs to others. And the poor aren't left out in the cold: They'll get subsidies to help purchase affordable coverage.

The Fair Share approach, by contrast, requires large firms to spend set amounts of their payroll on health insurance for their workers or else pay the state the cost of insuring them. The idea here is to hold big companies (particularly Wal-Mart, which is the bill's real target) accountable for their piece of the solution.

*But here's the problem: 99% of New Yorkers in firms affected by the law already work for firms that offer coverage. In New York, as around the country, the uninsured are concentrated in small firms that can't afford insurance -- not the Wal-Marts of the world. Fair Share gives them short shrift.

* Corrected from originally printed article.