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health insurance, yet again

Some miscellaneous snippets:

I claimed in this post that "the more information there is about individual risk, and the more choice individuals and insurers have based on that information, the less well insurance works." I concluded, therefore, that a workable insurance system doesn't have to be single-payer, but it has to cover everyone regardless of individual risk: no exclusions or higher premiums for pre-existing conditions, age, race, family history, etc. and no individual opt-outs. If insurers can exclude people based on individual risk, they'll exclude the high-risk people, and if individuals can exclude themselves, it'll be the low-risk people, which leaves almost nobody actually participating in the system.

In the past few months' increased discussion of health care reform, I've heard one good argument against single-payer: it makes health coverage a political football. I'm sure we can all think of some specific procedures that would be covered when there was a Democrat in the White House but not when there was a Republican in the White House. Having a "public option" in competition with the private sector means that if the public program doesn't cover, for political reasons, things you want covered, you can go to a company that does. One wonders why this hasn't been a problem for the numerous countries that have effective, efficient single-payer or nationalized-health systems; perhaps those countries just don't think of biomedical decisions as political, the way the U.S. does. Residents of those countries are invited to chime in!

It has been suggested that the "public option" is just the "camel's nose", a way to sneak the U.S. into a single-payer system. From my perspective, that wouldn't be such a bad thing, but in any case there's a fail-safe: if the "public option" is introduced in competition with the private insurance industry, the only way it can expand towards being a single-payer system is if it WORKS -- which the right-wingers are adamant it can't possibly do because it's run by the government.

Of course, I have some frustrations with the proposals currently on Capitol Hill: I gather most of them boil down to "we'll bribe the pharmaceutical industry and the insurance industry with lots of government money so they allow us to insure the poor." I gather that's considered a political necessity, but one doesn't have to like it.