Posted by
Andrews on Thursday, September 10, 2009 10:55:17 AM
There are two ways to interpret Obama's "ah, just gimme anything" policy on health care reform. One, the more charitable, is that he is a pragmatist who doesn't have a clear policy in mind, but wants only a general "reform". That has it's own problems, and I shall deal with it in a later post. For now, let us look at the less charitable interpretation, that Obama supports any policy because he knows no matter what specifics are adopted, it will result in a single-payer plan.
Now, before you scoff, realize that many on the left have said the very same thing. Krugman, even our president, before he was president, said that a "public option" was just a step on the road to single payer. So it is not as if this were some right wing paranoia, it has been recognized by many prominent thinkers on the left, and there is no way our president is unaware of this.
So, why is the "public option" but a step on the road to nationalization?
Well, there is one simple explanation. Public insurance will not "compete". The story is that the public option will just be a "safety net" for thsoe who cna't afford insurance. But that, right there esplains why it won't "compete". To compete, it would have to charge enough to cover costs, to work as any competitive business would. But if a competitive business could make money catering tot he presently uninsured, then it would be doing so. They can't afford insurance at competitive prices. So the "public option" will have to be priced below market. And as it will be taxpayer subsidized, unconcerned with profit, it will, inevitably, charge less than a competitive plan.
So, which would you buy? Market priced insurance or underpriced government insurance? Now, I assume they will have some sort of minimum qualifications, but for those who qualify, all would be fools to pay for a competitive plan. And, as they benefit, it is likely those who are just above the cutoff will want that advantage too. And as with current "medical assistance" we will see qualifications go form poverty level to three times poverty to four times and so on. Until the government controls the lion's share of insurance.
Even before that point, the policy of the government will come to dominate medical billing and policy. Even now, the DRGs of medicare and medicaid control a lot of medical policies. HMOs are basically a private evrsion of government DRGs. The policies established by government for only the limited number they cover now have a huge influence. How much more when they control many times the number of recipients? And so, even before government controls all insurance, their policies, who is covered and who is not, what procedures are "cost effective" and so on, will have influence on all medicine, whether government insured or not.
And that ignores the fact that through licensing, regulation, committees which approve hospitals, imaging centers and so on, all exercise additional control over medicine, either locally or federally. And with the federal government exerting more control over medicine, how much local autonomy do you expect to remain. Before long the whole of medicine will be firmly under federal control.
By why should I bother arguing, let me quote
a Nobel laureate and darling of the left:
Crucially, they also allow people to buy into a publicly run plan,
which would compete and, I believe, actually would in the end kill the
private plans in the competition.
POSTSCRIPT
For those interested in my earlier writing on both medical reform and the harm done by big government, I recommend the following recent posts: "
The Insurance Sham", "
One Real Life Example", "
Confirmation (From the Past and Present)", "
Power and Disorder", "
The Cost of Big Government", "
The Single Greatest Weakness", "
Symmetry and Asymmetry in Government", "
The Inherent Disappointment of Authoritarianism" and "
The Beam in Thine Own".