usmbguest5318
Gold Member
- Jan 1, 2017
- 10,923
- 1,635
Don't think I'm outright differing with you. I see the thrust of your position on the matter, and basically I agree with it. But....yes, there's a "but"...But those two features are only problems to people who aren't about finding solutions.
Requiring coverage of pre-existing conditions should never have been necessary, but the insurance industry ages and ages ago figured out, not surprisingly, that people who don't have historic/chronic ailments don't cost must to insure, and the way to minimize the risk that you will have to cover a person with chronic ailments is to deny coverage for pre-existing conditions. For the most part, people who haven't developed something chronic by the time they are ~25 aren't going to for some decades to go. Of course there are exceptions, and if you sum all the people who are the exceptions, yes, it seems like a lot of people, but in reality, if you are an insurer, you aren't going to get proportionally and materially more of them of them than any comparable insurer, unless you structure your policies and pricing so you do. (All the numbers are what actuaries and actuarial economists/accountants figure out for insurers. They don't disclose their figures on that, at least the "big boys" don't.)
Mandatory coverage is nothing more than the result of insurers and the government's actuaries realizing that for insurers to make money and for consumers to afford the premium cost given that elected officials (and the insured) want to have pre-existing conditions covered, literally everyone has to be covered so that the risks and costs associated with covering people with chronic ailments are spread out enough that the premium can be made affordable.
Of course, the insurers making money is a matter of greed to some extent. But, microeconomically speaking, the provision of health insurance has much in common with natural monopolies. Yes, there's room for multiple competitors, but were there just one natural monopolist providing the coverage to everyone, prices could be reduced "uber" dramatically in much the same way things like water from the water company is far less expensive than is bottled water. At some point, however, it becomes uneconomic for there to be multiple providers of healthcare in a given "area." (One can define "area" geographically if you want, but it could just as easily be defined in terms of any or several other sui generis classe(s).)
The highly enlightened recognition that healthcare insurance has much in common with natural monopolies is why "single payer/provider" is appealing. Of course, having a single provider for any given "area" presents its own set of dilemmas that, quite frankly, Republicans don't like dealing with because to do so forces them to do things they claim to hate doing. For example, if one is to have a single payer, one pretty much has to regulate the profits that payer can earn. Were you not to do that, you'd have exactly what we see now in places that have only one insurer on an O-care exchange: super high prices being charged.
Trump's idea of allowing interstate competition seems to resolve that problem, but it doesn't really because it just makes the issue discussed a couple paragraphs above be an interstate one instead of a state by state one. Sooner or later, it will lead to industry consolidation and oligopoly in the industry. Who wins in that scenario? The huge insurance companies, which wouldn't be so bad except for their being the very organizations that literally control everything that banks, Warren Buffett, Microsoft and the federal government don't. (This is why Trump wanted to be president; he's not a major player in, and had no way to control, any of the other groups. Plus, the government is the single biggest one.) Health insurance is pretty close to having a "kinked" demand curve already. Interstate competition would pretty well guarantee that it absolutely does.
Another dilemma for Republicans is that if they convert healthcare to single payer, they have to conjure some sort of bizarre "thing" that doesn't drive all but one insurer out of business, or drive all but one insurer out of business. I don't need to go into the economics of that; the politics of it are enough and easily seen.
From reading the above - it's not at all the most detailed exposition of the matter you can find, but it should be enough to give you a general sense of things - it should be clear that the problem is the politics. Republicans stand on positions of "no more regulation," "what's good for business is good for America," "less government is better than more government," and so on...You know the mantra. But you can't stand on those positions and "do right" by the average earning American, and make sure that "everybody" has healthcare that they can afford to pay for (be it via taxes or directly out of pocket). At least one of those stances has to be forsaken. Yet the GOP have all the power, which means they have to come up with something that actually works, and works better than O-care.
What's all that mean for the American people? Anywhere from one to four years of crazy spin on every sort of compromise solution you think of because every damn one of those fuckers in the Capitol is too chickeshit to bite the bullet and take the political hit in the interest of the American people.
