It’s not that complicated

IT’S NOT THAT COMPLICATED…. It’s pretty obvious that debating the intricacies of health care policy isn’t easy. There are a lot of moving parts, involving a lot of agencies and one-sixth of the American economy. A typical American can be forgiven for getting confused about what the reform fight is all about.

But Paul Krugman raised a good point yesterday that bears repeating: looking at the general outline of what’s being proposed, it’s not that complicated.

The essence is really quite simple: regulation of insurers, so that they can’t cherry-pick only the healthy, and subsidies, so that all Americans can afford insurance.

Everything else is about making that core work. Individual mandates are a way to prevent gaming of the system by people who don’t sign up until they’re sick; employer mandates a way to hold down the on-budget costs by preventing a rush by employers to drop insurance; the public option a way to create effective competition and hold costs down further.

But what it means for the individual will be that insurers can’t reject you, and if your income is relatively low, the government will help pay your premiums.

That’s it. Any commentator who whines that he just doesn’t understand it is basically saying that he doesn’t want to understand it.

Understanding the difference between a public option and a co-op takes more effort. For that matter, as we saw this week, many see a significant difference between a public option and a “robust” public option. There are cost curves, community ratings, exchanges, mandates, and donut holes, all of which can seem a little tricky. There are plenty of nuanced details, which matter, but which need not take away from the basic understanding of what’s at stake and what policymakers want to do about it.

The Politico asked this week, “Is health bill too complex to grasp?” The answer is no, at least insofar as getting the gist of the effort.

NPR health policy correspondent Julie Rovner explained on the air last week, “The problem with health care is that it’s so big and so complicated that the public is never really going to understand all the moving parts of this.” That’s likely true, but it may not matter. The government will regulate insurers, so they can’t screw you over the way they have been, and will offer subsidies and options to those who can’t afford insurance.

It doesn’t fit in a bumper sticker, but it almost fits in a tweet. That counts for something, right?