Paul Krugman has a fascinating column in the NYT's today. Here is a sample and read the entire article here.
"Reform, if it happens, will rest on four main pillars: regulation, mandates, subsidies and competition.
By regulation I mean the nationwide imposition of rules that would prevent insurance companies from denying coverage based on your medical history, or dropping your coverage when you get sick. This would stop insurers from gaming the system by covering only healthy people.
On the other side, individuals would also be prevented from gaming the system: Americans would be required to buy insurance even if they’re currently healthy, rather than signing up only when they need care. And all but the smallest businesses would be required either to provide their employees with insurance, or to pay fees that help cover the cost of subsidies — subsidies that would make insurance affordable for lower-income American families."
The whole point of this is creating a large pool of people to spread the risk. I had dinner with my Australian friend on Friday night, and he loves his country's health care system. He has basic care provided by the government, and because he's successful he chooses to buy an additional, private policy. That costs him -- wait for it -- $108 dollars a month. And I'm afraid that might be Australian which would make it even cheaper in U.S. currency.
Some of my concern is driven by pure selfishness -- I want affordable health insurance. Some of it is broader self-interest. I'm an unabashed capitalist, and this looming health care crises is going to wreck our economy. The President is right -- inaction is not an alternative.
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written by L Pala, July 30, 2009
Amnesty Int'l has a letter you can sign that's going to your Congressman. If thousands of us sign it, will it have any impact?
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I used to be paying 12% of my gross income for insurance . . . bare minimum catastrophic insurance, the cheapest I could get. I was constantly financially stressed, with almost no budget for even the smallest luxuries. When my rates went up again, and I dropped my insurance, I realized that I hadn't seen my doctor or dentist in two years, because I never had enough spare money for an office visit. And I both earn way more than minimum wage and have comparatively few expenses. I cannot imagine how a genuinely low-income household can cope with paying that much.
It's easy to talk about the people who go without insurance as not paying their fair share. But paying the cost of health insurance can be a genuine hardship. And, in particular, a lot of people who are now uninsured are people half my age or less, who will not just be forced to pay for insurance, but be forced to pay for it at higher rates to subsidize older people like me, many of whom have higher incomes and more assets than they do. I sympathize with them. And I note that there's a public choice booby trap in the mandate setup: If insurance is voluntary, and the new plans still aren't a good deal, people who find them a hardship won't sign up for them, and Congress will get the message that they're still not offering favorable enough rates; but if mandates are imposed, Congress will never get that message, no matter how badly they hurt the people they claim to be helping.
This whole setup strikes me as looking more and more like "capitalism" in the bad sense: big corporations (the insurance companies) getting behind the government's passing laws that give them a guaranteed income at the expense of the individuals who make up the actual public, and selling it as a "public interest" measure against corporate greed. It's been going on at least since the railroads lobbied for government regulation of rates, which enabled them to equalize their rates upward across the country. No good will come of it, especially for anyone young or poor.