Ramesh Ponnuru and Yuval Levin are given space in the New York Times to argue for a conservative alternative to ObamaCare. Part of their plan is to surreptitiously do-away with the employer-based health care system. It’s a worthy goal in itself, but it’s interesting how these two chaps go about lobbying for it. In discussing John McCain’s 2008 plan, they recognize the biggest obstacle for changing from an employer-based system.
The chief problem was the same one that frustrates ambitious health reformers on the left: Most people like their insurance and do not want Washington to change it.
So, how do they get around this?
…as more Americans bought their own insurance, consumer pressure would bring down costs for everyone. Ultimately, companies could get out of the business of managing their employees’ health insurance altogether.
What they want to do is give everyone a voucher to buy insurance. But, since they don’t want people to panic, they won’t give the voucher to people who are eligible for employer-based insurance. Or, more precisely, they will only give those people enough money to offset the cost of their employer-based coverage. In this way, employers will no longer have any incentive to offer coverage and will drop their insurance plans. Eventually, everybody will be thrown into the “individual market.”
This alternative sacrifices some advantages of the McCain plan. It would not do as much to shift control over insurance to workers. They would have to stay in their jobs to keep their existing plans. But it would cut costs and help people the tax code now pushes out of insurance markets. And it would do so, critically, without threatening the insurance arrangements of the satisfied majority. Over time, this reform could help the individual market grow and become more attractive to more Americans. Voters might then become receptive to relaxed restrictions on using the tax credit to exit the employer market.
It’s right there to see if you compare the two blockquotes above. First they say that companies could get out of the business of providing health insurance to their employees and then they say that their plan would not threaten the insurance arrangements of the “satisfied majority.” Those two things are completely incompatible and logically contradictory. What they should say is that their plan will allow politicians to trick people into thinking that they’ll be able to keep the employer-provided health care they currently have, when, in fact, the plan aims to take that coverage away and replace it with a voucher.
This is not the only problem with their plan. It costs more to get insured as an individual than it does to get insured as part of a group. But they seem to think that consumers will apply pressure to bring down costs if they get thrown out of group plans and face unaffordable costs. This ignores the actuarial logic involved in setting rates. In other words, this is another unserious, ideologically-driven bit of drivel.
Illogical. If costs are high for large companies with sophisticated negotiators and financial clout, how could they possibly be cheaper for Joe Six-Pack buying on his own?
I guess the theory is that a political will that is currently lacking would spring forth from suddenly enraged, uninsured people who would demand affordable rates.
More likely, political will that is currently lacking would spring forth from suddenly enraged, uninsured people who would demand that the government finally do what every civilized nation has done and provide tax subsidized health care.
I almost said every other civilized nation, but that would be giving the USA too much credit. As I watch class against class, race against race, and young against old, I can no longer regard this pack of jackals as civilized.
Ramesh Ponnuru wrote something that was full of cow manure? I’m shocked, shocked, I am!! Tell me it’s not true!!
Well, now he has a partner in crime.
I’ve heard of Yuval Levin before(just the name .. as coming from NRO or similiar outfit). Have no clue who he is, or how he fits in the wingnut welfare pyramid.
they’re Republicans…so, of course, what they wrote is a lie
Conservatives know that the current health care system is a huge problem for them because the logic of real health care leads to some form of single payer system — unless they are heartless enough to let people die at the emergency room door under a no wallet-no service regimes (which is counter to the Hippocratic oath but when has the Hippocratic oath stopped politician-physicians like Paul Broun, John Barrasso, or Tom Coburn).
The issue is the wide gap between provider fees and patient incomes. One has to come down or the other has to go up. Employee-provided health insurance is a way employers have of locking employees into bad wage agreements. The logic is that employer bargaining power delivers more for the money in health insurance than the employee could get buying individual insurance. But that is mostly a result of how states regulate health insurance, dividing it into large employer market and small employer-individual market. Guess who has the assets to keep it that way. It isn’t he small business owners.
The real reason that employers want to keep employer-provided health care (aside from the golden handcuffs effect on labor) is that it permits the executives to get Cadillac-style health care and write it off of the company taxes. Under a single-payer basic coverage system, they would have to pay all of that cost of insurance out of their own pockets.
The policy answer to every issue from conservatives is “Give Em a Voucher” and problem solved! I believe the House GOP still has not revealed their awesome health care plan as they conveniently forgot the replace part after spending so much energy on the repeal part.
http://www.washingtonmonthly.com/archives/individual/2011_04/029051.php
You do realize that the DLC/Turd Way is big on the voucher idea, right?
Well they had to write something! And it was important to baffle ’em with bullshit because if the tribe that so faithfully took Fox at its word and never read anything about the HealthCareReform Bill are now churning out Obama’s talking points at TownHall’s over Ryan’s plan it won’t be too long before their brains tell them, hey maybe ObamaCare was an ok deal…
All I need to know about private insurance was in Steven D’s diary a week ago.
We played health care roulette and finally dropped ours back in the mid 1980s when the choice became health insurance or food. I wound up suffering a lot of pain for over 10 years because of a lifting injury that required surgery we couldn’t afford. I finally got lucky and went to work for county government, which had “good” insurance. Still paid 3+K in copays for the surgery, but it was successful and at least the pain is gone.
Now, if you happen to have a family member who is diagnosed with a so-called “mental illness” and needs hospital care, I don’t know that there is such a thing as “good” insurance.
Personally, I’d be rather pleased to see all those insurance executives flipping burgers for a living down at the local greasy spoon. Our system is no more than legalized larceny.
Great points. I think StevenD and Wendell Potter have given an accurate picture of the problem with the current system as it exists. I read Potter’s book, and from what he writes, I think his experience with Nataline Sarkisyan was what prompted him to leave the health insurance industry.
Boo:
Frankly, the dishonesty doesn’t bother half as much as the unpunctuality.
The time to offer a policy program like this is when we were debating policy programs for health insurance reform. Like two years ago.
I note that other than you this column got no buzz in blogistan on either side of the barricades.
This is the “Myth of the lone frontiersman” again. The MOTLF is the key intellectual idea of today’s Repukeliscum libertarian. This idea is that we are all Howard Roark, running our own cabin on the frontier, shooting our own injuns, rapin’ our own women. We are all empowered Free Men, and no Social Worker or Voting Rights worker is needed for a Real Man.
As such, they continue to make comments which are TOTALLY MORONIC. The main thing that you get with a corporate insurance system is CLOUT. Individuals have no power. When an individual gets sick, they get dropped from their insurance. No insurance company cares about suits – their lawyers are ON RETAINER, paid by the hour, while you have to pay YOURS by the hour, and by the hour starts at $125/hour. As soon as it comes down to your lawyers vs their lawyers, the individual is toast, due to cost issues.
This proposal is insanely stupid, but as another comment says, Ponnuru has never written anything but shit.
How come these “free market” yahoos never address the fact that the need for health care is inelastic and universal, almost as much as the need for food or shelter? When you’ve got an inelastic demand on the one hand and a provider who can pick and choose how, when, and to what degree to service that demand, you DON’T have free market forces and competition bringing down the cost of the necessity. You’ve got people who NEED something desperate to pay anything to get it. Hardly a recipe for affordability, is it?