Tuesday, January 05, 2010

OVERVIEW OF NELSONCARE

When you cut through all the esoterica, the health insurance reform effort had three pillars: portability; universality; and cost.

Skipping the polemics of whether government involvement in maintenance of carriers is good policy or bad policy, universality without cost control measures is just eminent domain in a different colored shirt.

Whether we like the way the House did it or the color of Pelosi's contact lenses, the house version addressed all three pillars.

The Senate, on the other hand, managed to do two expensive things. They bribed
with your money at least two members to vote for the thing. Then, in order to pass it, they took out the cost control provisions (OK, they left in the interstate boundary part, but that's lame). So they gave us portability and universality without the cost control features to make participation an opportunity instead of an obligation.

It's hard to argue that the delivery system now is very good. It is nothing more than one way of rationing (I laugh when people say "we'll go to rationing"--Rationphobe, we're rationing on wealth and employment now, not to mention geography. There's always rationing. We just use a different metering device from some other Western Countries.) It is equally hard to argue that the Senate version leads to anything any better. I don't think I'd love living under the House version either but at least it deals with all three pillars. The Senate didn't throw the baby out with the bath water. They held it under until it drowned.

Very strange.

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