Don’t Throw Me In That Briar Patch!

Don’t Throw Me In That Briar Patch!

Well, this is interesting:

“The health insurance industry said Wednesday that it would support a health care overhaul requiring insurers to accept all customers, regardless of illness or disability. But in return, the industry said, Congress should require all Americans to have coverage. (…)

The industry’s position differs from that of Mr. Obama in one significant respect. Insurers want the government to require everyone to have and maintain insurance. By contrast, Mr. Obama would, at least initially, apply the requirement only to children.”

Several things about this are very significant. First, the insurance industry helped to block Clinton’s health care plan. If they are entering the negotiations about what sort of national health care we will end up with, they are a lot less likely to play a completely obstructionist role. And that’s very good news.

Second, requiring all Americans to have health insurance is very good policy, at least if it’s coupled with some kind of subsidy for people who wouldn’t be able to afford insurance otherwise. Obama did not propose to require it, which I very much hoped was because he suspected it would be political poison, not because he was opposed to it in principle. (I don’t mean that he was being disingenuous: politicians fail to propose policies that they think would actually be good all the time, and as long as they do not plan to propose those policies, there’s nothing disingenuous about it.) This aspect of his policy didn’t bother me that much: in practice, if you’re going to ban discrimination on the basis of preexisting conditions, you need to have some sort of penalty to discourage people from signing up for health insurance only after they get sick, and the difference between having such a penalty and having a mandate (which presumably also includes a penalty) seems to come down to whether or not you tell people that they must sign up. Moreover, I thought he was probably right on the politics.

That said, having someone else insist on mandates makes me want to adopt a mock-horrified look and say: oh please don’t throw me in that briar patch!

There are, of course, a whole lot of details to be worked out, the kinds of details in which devils are found. For instance:

“The new policy statements are silent on two important issues: how to enforce an individual mandate and how to regulate insurance prices, or premiums.

While insurers would be required to sell insurance to any applicant, nothing would guarantee that consumers could afford it. Rate regulation promises to be a highly contentious issue, since it pits the financial interests of insurers against those of consumers.

At present, insurance premiums are generally regulated by the states and often vary according to a person’s age, sex, medical history and place of residence within a state. In the individual market in most states, a person with a history of serious or chronic illness can be charged much more than a healthy person of the same age and sex.”

Still, this is really good news.