I've noticed that many opponents of health care reform seem to deeply misunderstand what is actually being proposed, so figured it might do both proponents and opponents some good to lay out in simple terms exactly what reformers would like to see.
First of all, no one would force you to give up your health insurance. Much of the anger out there seems to be based on a fear of not having that freedom of choice. If you like your current policy, you can keep it. You can buy all the private insurance you want - knock yourself out! What is being proposed is that people who cannot afford or cannot attain private insurance, e.g. because of exorbitant costs, a pre-existing condition, a fixed income, or whatever other reason, would have recourse to a public option. That is, they could purchase an insurance policy from the government. The government's role is that of an "insurer of last resort." The government isn't going to be running the healthcare industry, they are simply going to be offering insurance to those who need it, much like extended Medicare (a very popular *government* scheme).
Second, there would be an individual mandate saying that people have to have health insurance. This seems to be another source of anger out there, with protesters suggesting that it's wrong to force insurance on people. In fact, it's not unusual and not unprecedented - we already do this with auto insurance. If you drive a car, you are required to have a minimum of liability insurance in case you are in an accident. Similarly, people would be required to have health insurance to avoid cases where an uninsured person gets sick and ends up in the emergency room where taxpayers are liable to pick up the tab.
The third idea is that insurance companies would be prohibited from charging different premiums, or denying coverage, based on your medical history or perceived risk. This is sometimes called "community rating." This relates to the first point above in that it would lower the access bar for many people to acquire a private policy. It would also greatly lower administrative costs of insurers because they have huge bloated bureaucracies dedicated to weeding out and denying risky applicants. This last point is important - people assume that a government plan would be bureaucratic and unwieldy compared with private plans, but it's quite the opposite.
Those are the keys ideas, believe it or not: a public option, an individual mandate, and community rating. Simple as that. No death panels, no internment camps. Hopefully you'll find these notes useful in talking to people about health reform. I'll post some more points and arguments soon.
Friday, August 14, 2009
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