Sink or Swim
The GOP’s Dickensian fix for health care.
Jonathan Chait
TNR
March 5, 2010
When you consider the differences between Democrats and Republicans on health care, you probably think in terms of scale. Democrats want to enact a big reform, while Republicans favor incremental progress. House Minority Whip Eric Cantor coos, “We want to take a much more commonsense, modest, incremental approach, trying to address the first issue first, which is cost, and then go on to try to deal with some of the things that the president and Speaker Pelosi want to do.” Within a recent six-month span, Republicans on the Senate floor used the phrase “step-by-step” to describe their approach to health care an astonishing 173 times.
The reality is quite different. What separates the two parties is not how far to go, but in which direction to go. The divide is simple. Democrats propose to shift resources from the rich and the healthy to the poor and the sick. Republicans want to do just the opposite. Republican health care plans reflect the party’s increasingly widespread belief that good health, like other forms of prosperity, is a matter of personal responsibility. Democratic plans to help the sick at the expense of the healthy therefore amount to socialism.
Health insurance, if you think about it, is a redistribution scheme. It transfers money from the winners (people who don’t need much medical care) to the losers (people who do). It differs from other redistribution schemes because, unlike programs that redistribute from rich to poor, the winners and losers can’t be sure in advance which category they’ll be in. That’s why people enter into it voluntarily--today I might be healthy, tomorrow I may contract some horrible disease.
The problem with this system is that, while you can’t be certain who will win and who will lose in the medical lottery of life, you can make some educated guesses. The health insurance industry is good at making those guesses, and getting better all the time. The business of insurance is to keep expensive customers out and cheap customers in.
(More here.)
Jonathan Chait
TNR
March 5, 2010
When you consider the differences between Democrats and Republicans on health care, you probably think in terms of scale. Democrats want to enact a big reform, while Republicans favor incremental progress. House Minority Whip Eric Cantor coos, “We want to take a much more commonsense, modest, incremental approach, trying to address the first issue first, which is cost, and then go on to try to deal with some of the things that the president and Speaker Pelosi want to do.” Within a recent six-month span, Republicans on the Senate floor used the phrase “step-by-step” to describe their approach to health care an astonishing 173 times.
The reality is quite different. What separates the two parties is not how far to go, but in which direction to go. The divide is simple. Democrats propose to shift resources from the rich and the healthy to the poor and the sick. Republicans want to do just the opposite. Republican health care plans reflect the party’s increasingly widespread belief that good health, like other forms of prosperity, is a matter of personal responsibility. Democratic plans to help the sick at the expense of the healthy therefore amount to socialism.
Health insurance, if you think about it, is a redistribution scheme. It transfers money from the winners (people who don’t need much medical care) to the losers (people who do). It differs from other redistribution schemes because, unlike programs that redistribute from rich to poor, the winners and losers can’t be sure in advance which category they’ll be in. That’s why people enter into it voluntarily--today I might be healthy, tomorrow I may contract some horrible disease.
The problem with this system is that, while you can’t be certain who will win and who will lose in the medical lottery of life, you can make some educated guesses. The health insurance industry is good at making those guesses, and getting better all the time. The business of insurance is to keep expensive customers out and cheap customers in.
(More here.)
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1 Comments:
The best exchange during Obama’s Summit was between John Kline (R-MN) and Rob Andrews (D-NJ). Kline had advocated for Associated Health Plans (AHPs) … Andrews agreed with the concept noting that the Democrats plan has “exchanges”. Insurers offering plans in the exchanges would have to offer a package meeting minimum standards.
Andrews asked Kline who determines when a woman is released from the hospital after a caesarian section. Kline wants the insurance company to decide … Andrews wants the doctor.
Another example was given that fits into the problem. Harry Reid talked about a worker who was excited to have his first child … he had insurance and was not worried. When the baby was born it had a cleft palate … the doctors said not to worry that they could correct it … everything looked good … until he got the denial form the insurance company … Reid did not explain why, but currently since states can mandate minimums of what has to be covered, that may have been a factor. As of a 2008 report, only 14 states require that cleft palate corrective surgery be required.
Kline, Cantor and the GOP wants the insurance companies to decide … the Dems want consumer protection.
And regarding those Health Savings Accounts, those policies are going up also. "We were paying out more in claims than we were collecting in premiums," said Aron Ezra, spokesman for Blue Shield adding "We lose membership because fewer people can afford to get it."
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