26 April, 2006

Health coverage

I am tempted to write 750 words on this and put everybody to sleep. Instead, let me keep it short. Every American attempt to improve the condition of health insurance makes me want to throw men in suits from rooftops. The latest is Massachusetts' clever scheme that will require all residents who can afford it to buy health coverage and will subsidize insurance for the remainder.

This plan will give private companies a captive market, reducing what minimal incentive they now have to keep prices down.

People who compare the situation to car insurance, which is also mandatory in the U.S., forget that people who don't want car insurance don't need to get a car. There is no similar way to opt out of Massachusetts' health plan.

The only people who opposed the plan were standing up for small businesses, which will be penalized if they fail to offer their workers health coverage. While it is valid to note that some marginal businesses will close down or move when faced with the new cost, that is beside the point. The problem is not that this law is anti-business but that it is nowhere near anti-business enough. It picks on small businesses while providing a guaranteed cash stream to the big insurers.

The alternative is just the other side of that huge one-way mirror called the Canadian border. Go over and take a look sometime.

And now, back to our regularly scheduled feature: A 3 a.m. demonstration against the IMF in Washington D.C. that I somehow completely missed! (I must not have been at the Fairmont that night.) I find screaming to be stupid, annoying and unhelpful, but this event sounds funny all the same.


good post.

i (unsurprisingly) wholly agree with this:

"Every American attempt to improve the condition of health insurance makes me want to throw men in suits from rooftops."

My suspicion is that it's gotten to a point where we're going to have universal or near universal health care within about 10 years--perhaps much sooner, but it's going to be shoddy, in many pieces, and enormously more expensive and complicated than need be. The only way we would get a good plan is if there's a massive upsurge in truly progressive--and not just liebral--activity on it, rather than a response to the economic conditiosn that are making it inordinately expensive for either states or companies to want to bear the burden.

Also, since you're interested, if you haven't ever read the Steinmo and Watts article "It's the Institutions Stupid"  about why universal health care consistently fails in the Untied States, you might want to take a look. I'm inclined to lend more weight to the culture argument (or rather the complicated dynamic between culture, politics, and institutions) than they do, but it's a good starting point. 

Posted by mfermndfq

nifty article. the model continues to work after the big change is enacted, in a minority's ability to starve a popular program to death by obstructively debating its funding stream, staffing requirements, eligibility requirements, etc etc etc.

the cultural discussion seems strange for leaving out what right wingers harp on, that guaranteed payment would encourage bad care (something like how tips encourage better service at restaurants). in that argument, which many people accept, government waste (however it came to be) is proof that the private sector's (stated) quality advantage only exists because it gets paid for services rendered.

the variety of twists there are tough to follow. built in of course is an attack on collective bargaining and individual recourse which are the righties' real enemies. and an assertion, virtually incontestable because of the depth of its embedding, that salaried workers are less productive. AND the unbelievable assertion that markets deliver better prices to the services buyer not "even" but "ESPECIALLY" when the buyer is at a severe power disadvantage in the negotiation.

so there's a big part which is "i don't trust doctors" which the article doesn't address. 

Posted by hibiscus

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