Krugman on why "universal coverage via insurance co's" is doomed to failure

[papau]

..health care should be a federal responsibility. State-level plans should be seen as pilot projects, not substitutes for a national system...some states just won't do the right thing..almost 25 percent of Texans are uninsured.

So why did Arnold reject (veto) the very workable single payer system passed by the California legislature? Why did he not learn from the similar Hillary Care plan and it's failure - even with the insurers after they begged for that design. Indeed has Hillary learned from the her failure to follow her own single payer proposal, agreeing to follow Bill's more "politically wise" insurance company based plan back in 93?

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http://economistsview.typepad.com/economistsview/2007/01/paul_krugman_go.html

Golden State Gamble
By Paul Krugman The New York Times Friday 12 January 2007

<snip> ... he also wants to keep insurance companies in the loop. As a result, he came up with a plan that, like the failed Clinton health care plan of the early 1990s, is best described as a Rube Goldberg device - a complicated, indirect way of achieving what a single-payer system would accomplish simply and directly.

There are three main reasons why many Americans lack health insurance. Some healthy people decide to save money and take their chances (and end up being treated in emergency rooms, at the public's expense, if their luck runs out); some people are too poor to afford coverage; some people can't get coverage, at least without paying exorbitant rates, because of pre-existing conditions.

Single-payer insurance solves all three problems at a stroke. The Schwarzenegger plan, by contrast, is a series of patches. It forces everyone to buy health insurance, whether they think they need it or not; it provides financial aid to low-income families, to help them bear the cost; and it imposes "community rating" on insurance companies, basically requiring them to sell insurance to everyone at the same price.

As a result, the plan requires a much more intrusive government role than a single-payer system. Instead of reducing paperwork, the plan adds three new bureaucracies: one to police individuals to make sure they buy insurance, one to determine if they're poor enough to receive aid, and one to police insurers to make sure they don't discriminate against the unwell.<snip>

[rodeodance]

1. sounds like Mitch Rommey's plan--or very similar.

[papau]

4. Yes - and I fought against that one - and was told it would "fixed" later - we shall

see if Democratic types - that control everything in Mass - will dare to "fix" this via removal of the insurance company part.

So far my email to the implementing/overseer group for this law have not been answered - and it appears they do not want input from anyone not sponsored by an insurance company.

But if you make less than 40,000 a year, the Mass Law is actually a great idea - even with wasted tax dollars for insurance company profits. For those over $40,000 per year, it looks like an administrative nightmare with likely lousy, poorly designed as to benefits, poor value for your dollar, guaranteed profit to the insurance companies policies being offered to those without employer provided HMO coverage.

[rodeodance]

2. sounds like Mitch Rommey's plan--or very similar.

[antigop]

3. I saw Krugman's column and wondered what he really meant in his last line

>>
And the answer is, damn the insurers — full speed ahead.
>>

Is he saying,
1) Go ahead -- do it -- let it fail -- then do it the right way by eliminating the insurers?
or
2) Try it even though the insurers will be a problem -- but at least they'll be doing something.

I really wasn't sure. I thought he meant #1, but then when he was noncommittal on Arnold's plan, maybe he meant #2?

[papau]

5. I read it as both - more State plans that we fix later, plus a national single payer push

The insurance companies hold meet and greets for all state and federal legislatures - raising money via fund raising, and threatening them with sponsorship of opposing candidates if they vote wrong. I spoke to the CEO of a huge Midwest insurance operation (mostly casualty, but some life) and his pride and joy accomplishment was how he controlled Missouri state and federal politicians (including the powerful and Democratic Representative Richard A. Gephardt back in the 80's) from Columbia.