David Wessels over at the Wall Street Journal ($) has this column in yesterday’s edition that focuses on John Kerry’s health care finance plan. The entire column is well worth reading, and here are a few snippets:

But Mr. Kerry knows that for many American workers and businesses, the big worry is cost. So he has added another dish to his health-care table. He proposes that the federal government shoulder most of the cost when someone gets really sick. It would pay 75% of medical bills over $50,000 a year for any person covered by an eligible (more on that later) private employer. He says this would cut premiums for employers and employees by 10% or, as he boasts on the stump, by $1,000 per family.
The notion is so old it sounds novel. The Kerry campaign credits Stuart Altman, a veteran health-policy wonk at Brandeis University, for the plan. Mr. Altman drew it from memories of his years as a Nixon administration bureaucrat. A similar scheme was written into an ultimately unsuccessful bill in 1974 by Wilbur Mills, then chairman of the U.S. House Ways and Means Committee.
The concept is simple: Government becomes the ultimate reinsurance company, spreading the risk of expensive illness among taxpayers instead of sticking it with an unlucky employer. “We’re always worried that insurers will dump sick people,” notes David Cutler, a Harvard University health economist. “So the idea is that we won’t make them pay for really sick people.”
If Mr. Kerry wants to spend money so employers and insured workers pay less, then subsidizing firms that employ sicker and, often, older workers is reasonable.
But …
It’s expensive: $257 billion over 10 years, estimates Kenneth Thorpe, a former Clinton administration health economist now at Emory University.
It doesn’t save society any money and does nothing to restrain the American appetite for more drugs, more tests and more exams, whether or not they’re worthwhile. It simply shifts some costs now paid by employers and employees to taxpayers.

Mr. Wessels then closes by focusing in on one of the key issues, one that is sadly not a part of the usual public debate on health care finance:

If the proposal becomes law, Mr. Kerry and his advisers may discover it could do something they haven’t anticipated: provoke a broad public debate over how much health care is enough.
If the government starts picking up the tab for the one-half of 1% of privately insured Americans whose medical bills exceed $50,000, it will open the door to questions — and possibly rules — about whether such care is wise in every case. Should stomach-stapling surgery be covered? How about bypass surgery in 90-year-olds? Who decides when to pull the plug?
As The Wall Street Journal illustrated in articles last year, decisions in the U.S. on who gets expensive care and who doesn’t are made quietly and differently by intensive-care coordinators, transplant schedulers, and insurance bureaucrats. This Kerry proposal could break that debate wide open.

As Brad DeLong points out in this insightful post and as noted in this earlier post here on Health Savings Accounts, this key issue and others relating to the overhaul of America’s flawed health care finance system desperately need to be addressed in this campaign season. Although I have reservations about the Kerry plan’s reliance on third party payor systems as the primary mechanism for controlling health care costs, I agree with Professor DeLong that Kerry should be complimented for facilitating the debate of these key issues that the Bush Administration has largely ignored.