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health insurance: back to the future

Read this brief article. Then go back and check the date at the top.


Oh, if only some NYT Nobel Prize winning economist had warned him . . .

I've always hated mandates. It solves the wrong problem (health insurance companies can't make enough money) and the argument about auto insurance is false because I can choose not to have a car -- and many do -- to avoid paying insurance.

Why don't we just call it a tax and have the government provide the insurance, rather than call it a mandate and give the money to private sector companies?


B-b-but that would be raising taxes, in the middle of a recession! We can't do that!

Seriously, if health care in the U.S. is to become more efficient (not to mention more compassionate), it has to be universal. If insurers can exclude particular people (or effectively-exclude them through high premiums), that will remove the high-risk people, and insurance won't serve its purpose. If individuals can exclude themselves, that will remove the low-risk people, premiums will (justifiably) go up, and insurance won't be affordable. So whatever we come up with has to be mandatory on both insurers and the insured. Obviously a single-payer system would be simpler, and probably more cost-effective, but it would put an entire industry out of business so it'll never happen.

I have no problem with the "individual mandate" terminology as long as there's a realistic public option. I would even consider the possibility if there was a realistic not-for-profit option. Without either of those, you're right: it's just a massive government giveaway to the insurance industry -- which we'll have to pay for by raising taxes :-)

The car-insurance analogy isn't perfect, particularly since the rules differ from state to state. In some states, I think, you HAVE to have car insurance if you own a car. In others, you pay an "uninsured motorist fee" that effectively buys a sort of minimal insurance from the government (a public option). In other states (I think), neither of those things happens, and (I assume) they take care of things through lawsuits, wergeld, blood feuds, etc. But it's at least familiar, and people have for the most part already accepted it.
Day-um. That's awesome.