Surprise
Posted by Chris Martin at 9/28/2009 11:33 AM 
Categories: Health policy
Tags: I hate it when I am right
Categories: Health policy
Tags: I hate it when I am right
Monica Davey reports this in Today's NY Times:
The first problem is that the mandate is really not going to do what it was supposed to do economically. Insurance companies are selling policies that allow the young and healthy to opt out of the risk pool and leave the less fortunate in the geezer ghetto. The reform proposals actively promote these policies.
The second is that the health insurers were more concerned about keeping real competition and regulation out of the mix so they sponsored the Baucus farce that prolonged negotiations and gave the tea baggers plenty of time to voice their paranoid rants. And who knows how much they passed under the table to these same tea baggers? Insurance companies have failed to keep their part of the bargain.
So now the insurance companies and the established beltway wisdom come back to tell the Democrats that the mandate is the core of the reform and please spend your political capital on getting it through.
A mandate without a strong public option, a public option open to all individuals and businesses, is political suicide. I don't care how Olympia Snowe or Max Baucus vote. A strong public option without a mandate is imperfect but will be a start.
In more than a dozen statehouses across the country, a small but growing group of lawmakers is pressing for state constitutional amendments that would outlaw a crucial element of the health care plans under discussion in Washington: the requirement that everyone buy insurance or pay a penalty.Which lawmakers are mainly Republicans. Surprise again! And it turns out that they did not just get this idea on their own:
“This does head us for a legal showdown,” said Christie Herrera, an official at the American Legislative Exchange Council, a group in Washington that advocates limited government and free markets, and which on Sept. 16 offered guidance to lawmakers in more than a dozen states during a conference call on the state amendments.As a card-carrying economist Wonks Anonymous understands why mandates are important. He also understands that policy wonks had thought that a mandate would secure the support of health insurers and speedy passage of reform.
The first problem is that the mandate is really not going to do what it was supposed to do economically. Insurance companies are selling policies that allow the young and healthy to opt out of the risk pool and leave the less fortunate in the geezer ghetto. The reform proposals actively promote these policies.
The second is that the health insurers were more concerned about keeping real competition and regulation out of the mix so they sponsored the Baucus farce that prolonged negotiations and gave the tea baggers plenty of time to voice their paranoid rants. And who knows how much they passed under the table to these same tea baggers? Insurance companies have failed to keep their part of the bargain.
So now the insurance companies and the established beltway wisdom come back to tell the Democrats that the mandate is the core of the reform and please spend your political capital on getting it through.
A mandate without a strong public option, a public option open to all individuals and businesses, is political suicide. I don't care how Olympia Snowe or Max Baucus vote. A strong public option without a mandate is imperfect but will be a start.
How about Monica Davey, for a start, acquainting herself with the economic conditions and policies when the first major welfare state was set up by Bismarck in Germany, at a time of full employment?
In Britain, it was introduced, also bit by bit, by Neville Chamberlain and other Ministers of Health starting in 1918. This was despite, before 1932, Chancellors of the Exchequer, except Churchill, doing their worst.
France, following defeat in the Franco-Prussian War, prospered pretty well and was able to put up a good fight against Germany in 1914, in contrast to 1939. My guess would be that their state health service was introduced then.
Scandinavia was prosperous.
Stockport, England.
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