HEALTHCARE “CHOICE”….Jonathan Cohn writes in TNR on Tuesday about what Republicans mean when they talk about healthcare “choice.” The Health Care Choice Act, sponsored by Rep. John Shadegg of Arizona, would indeed increase your choice of private healthcare plans, but it does so by allowing insurers in one state to sell in any other state, thus obliterating state regulation of insurers. The result would be

a “race to the bottom,” as even the legitimate insurers would flock to the states with the most lax regulations about solvency and marketing practices, much as credit card companies now flock to Delaware because of its minimal oversight and taxes. Even in those states determined to be vigilant, this move would render local rules on health insurance irrelevant.

Getting rid of those regulations, of course, is precisely what Shadegg and his allies have in mind, since they think needless state regulations are responsible for making health insurance so expensive in the first place. As proof, they cite some state rules that really do seem dubious ? or, at least, suspiciously likely to benefit certain well-connected groups of health care providers. But along with regulations guaranteeing coverage of podiatry or acupuncture are mandates to cover cancer screening, psychiatric treatment, and other services that most Americans rightly deem essential. Other regulations are designed to prohibit insurance companies from discriminating among customers based on age or propensity for illness.

Some choice. As Cohn points out, real choice would require a universal healthcare plan that genuinely allows everyone to choose the doctors and hospitals they like best. The problem, he concludes, is that “Those aren’t the kind of choices that conservatives want to give Americans, since they happen to require expanding government. But they’re the kind of choices Americans would appreciate most.”

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