Reform
The news seems remarkably not so focused on the health care bill today or yesterday. I thought this article was a nice chunk of real journalism. I appreciated the perspective.
I know I’m not supposed to like the bill. I don’t like the part where the government forces you to buy insurance in the private market for something you can’t help (I can avoid being forced to buy liability car insurance by not owning a car, but this is something I have to do because I am a citizen).
But, the basic principle of medical care is to treat the sick and do no harm. The sick will be treated, insurance or not. If they’re not treated, we have a lot more problems in our society than insurance reform.
Many people can’t buy reasonable insurance in the open market now because of the classical moral hazard: among the pool of uninsured, the ones looking for insurance are the ones who expect to need it.
If you force everyone to buy insurance, the moral hazard breaks down somewhat. You probably still could see that the pool of currently uninsured is on average in worse shape than the currently insured. I assume we have more sick people than healthy college students skipping out on the extra expense.
The fortunate chunk of the population has nice insurance subsized by their employers in a tax-advantaged way. The subsidy makes the offer very attractive to the employees, so you have a high purchase percentage inside a relatively large pool of risk. This is the insurer’s dream. They make good money here.
Basically, the way I see it, this bill kind of allows the government to pretend it’s employing everybody not already in a nice risk pool. The government subsidizes, regulates, or coerces the premium costs down to attractive levels on the behalf of these people.
The anti-liberty aspect is that instead of relying on people’s good sense and attractive economics, the government then puts a big penalty-shooting gun to everybody’s head and says “buy.” But is this a necessary and proper violation of rights?
It may be. Insurance is costly to the individual, but uninsuredness is incredibly costly to society.
While you can administer it some places, I think a full-public option would be a disaster in the States. We need the private sector insurers to keep the private sector hospitals in check. We need Medicare to fight hard to cut down the bad behavior in that area, as well.
This may be the best American solution, at least in principle. If insurers are already getting ready to raise premiums, the free market is still alive. Now let’s see how good the government is at working out an option for those who have not fared so well in the past.
A thought: if the government reinstitutes the draft for some reason, it’s in some ways an affront to force people to go and join the military. But it’s for a reason. If there is a strong reason to force people to stop dirt-bagging and buy insurance even if they don’t think they need it, maybe it needs to be done. Because I’ll tell you what, right now these folks’ insurance is bankruptcy court.
Taxing the fortunate is the other leg on this table. So it goes. In my view we should seek to reduce costs elsewhere. This one is important.
Plus, if you need an upside, this should raise the value of municipal bonds, allowing local governments to borrow more cheaply to improve infrastructure and schools. Just a little sunshine to your high taxes day.