Tuesday, November 24, 2009

Kidding Ourselves On Costs

The “health care reform” debate started out being a move to extend health insurance to the people who don’t have it. At the time, I had a hard time understanding why that was called “health care reform,” but that’s the way of politics; “health insurance extension” would certainly not have garnered many votes for president.

When it became transparent what the “health care reform” was really about, it had to be reformulated to “bend the curve of health care costs” in order to appeal to the vastly larger number of people who already have health insurance but believe they are paying too much for it. Or can be made to believe that they are paying too much. It is still unclear to me how lowering the cost of health insurance can be called “health care reform,” but it’s also unclear to me how any of the ideas which are being presented are expected to lower the cost of anything.

Realistically, of course, they are not expected to lower the cost of anything; they are only expected to get Democrats reelected.

But the idea of “lower costs” always appeals to the American people, so “health care reform” became a big hit, especially the “public option.” Nobody knows what that actually is but it doesn’t matter because, whatever it is, it will be there to “hold insurance companies accountable,” whatever that means, and “give Americans a choice.”

In fact, the “public option” was originally a nation-wide coverage plan based on Medicare, a proposal which was killed off months ago and has been replaced with “insurance exchanges,” which were themselves pronounced ineffective and unacceptable at the time that the original “public option” was being proposed. These exchanges are now the ideal solution and have even been renamed the “public option,” taking on the name of the former “only possible solution” that was rejected earlier.

It doesn’t matter what the “public option” actually is, so long as there is something in “health care reform” which Democrats can call a “public option.” What it actually is or what it actually does is essentially irrelevant. One Senator after another has gone on talk shows and sworn to defend the “public option,” saying that the final form of it doesn’t matter; it can be “opt out,” or “opt in,” or have “a trigger,” or even as of yesterday have a “hammer” mechanism, so long as they get the “public option” in the bill in some form.

Is a bad bill better than no bill? I don’t really know; if it gets people covered by insurance, it probably is. But we are seriously and massively kidding ourselves if we think that government intervention is actually going to reduce costs.

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