Can we do something like this with health care?
Looking up the Pendelton Civil Service Reform Act
, one reads: (emp add)
Pendleton Civil Service Reform Act
The United States Civil Service consists of all appointive positions in the executive, judicial, and legislative branches of the Government of the United States, except positions in the Uniformed Service. (5 U.S.C. § 2101) The Pendleton Civil Service Reform Act (ch. 27, 22 Stat. 403) of 1883 United States federal law established the United States Civil Service Commission, which placed most federal government employees on the merit system and marked the end of the so-called "spoils system." The act provided for some government jobs to be filled on the basis of competitive exams.
Drafted during the Chester A. Arthur administration, the Pendleton Act served as a response to President James Garfield's assassination by Charles Julius Guiteau. The Act was passed into law on January 16, 1883. The Act was sponsored by Senator George H. Pendleton, Democrat of Ohio, and written by Dorman Bridgeman Eaton, a staunch opponent of the patronage system who was later first chairman of the United States Civil Service Commission. The most famous commissioner was Theodore Roosevelt (1889-96).
The law only applied to federal government jobs: not to the state and local jobs that were the basis for political machines. At first it covered very few jobs, but there was a ratchet provision whereby outgoing presidents could lock in their own appointees by converting their jobs to civil service. After a series of party reversals at the presidential level (1884, 1888, 1892, 1896), the result was that most federal jobs were under civil service. One result was more expertise and less politics.
It was in their own short-term interest to lock in a job, but by doing so changed its status for the better over the long-term. Brilliant!
Maybe employees could be ratcheted into an expanded Medicare (through a process advantageous to the employeer in the short term, with payback through an agreement that leads to long-term reform)
Actually, you could use a rachet mechanism in other areas, like carbon-credits.
Why doesn't legislation use more Game Theory
when its being crafted? Especially for solutions that might be best implemented gradually over a period of time.