26 November 2008


I remember saying that health care policy was the one thing in Hillary Clinton's platform that was categorically better than Barack Obama's was the health care plan. Clinton's plan was universal but relied on the existing structure of health insurers (disappointing). Obama's plan was similar but was not universal because did not include a mandate that everyone participate in the system (worse).

It turns out Obama was thinking several moves ahead.

The Obama plan as presented during the campaign had a gaping policy hole in it. If private insurers were required to cover individuals regardless of pre-existing conditions, but individuals weren't required to purchase coverage, then it would be reasonable for people, and especially for the young and healthy, to forgo coverage until they got sick. That would have bankrupted the private health insurance industry by driving its premiums so high that it couldn't compete with the alternative public plan.

At that point, one of two things would have happened. The private insurance industry would have collapsed — good riddance to bad garbage — thus backing the country into a single-payer system, or the private insurers, with their army of lobbyists, tame think-tank pseudo-scholars, and captive Congressmen and Senators would have had to demand a mandate, which the Democrats could then graciously grant.

Now it looks as if the insurers have jumped the gun, agreeing to offer individual insurance with no exclusions for pre-existing conditions as long as there's a mandate to buy insurance.

If Obama had proposed such a mandate, the health insurers would have had “Harry and Louise” all over your TV set talking about how oppressive the whole idea was and how they could never afford it. Now it's their idea.

This Obama guy seems to know what he's doing with this politics stuff.

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