Yes, we’re all concerned about the millions of Americans who lack health insurance, writes the New York Times’s Ross Douthat. For congressional moderates, that’s a tempting reason to vote for Senate Finance Committee chairman’s Max Baucus’s bill mandating that every American buy coverage that Baucus thinks the government can make affordable.
Here, according to the Boston Globe, is what happened in Massachusetts, which has had an “insurance mandate” in place for years:
The state’s major health insurers plan to raise premiums by about 10 percent next year, prompting many employers to reduce benefits and shift additional costs to workers.
Increases will range from 7 to 12 percent, capping a decade of consecutive double-digit premium increases, according to a Globe survey of the state’s top health insurers. Actual rates for 2010 will depend on the size of the employer and the type of coverage, with small businesses and individuals expected to be hit hardest. Overall, premiums are more than twice as high as they were 10 years ago.
If you’re a wavering moderate who’s concerned about the uninsured, then, whatever bill emerges from this month’s negotiations might seem like an opportunity that won’t come round again.
But any lawmakers voting “yes” should have no illusions about what they’re voting for. This version of reform probably won’t make health care more affordable for most Americans, or place the system on firmer footing for the long run. Despite all the talk about a once-in-a-generation opportunity, our political class will have barely finished congratulating itself before rising costs will force everyone back to the negotiating table to consider more radical approaches.
We know what one such approach would look like. It’s the eventual endgame that liberals pushing a “public option” are aiming for: a federal takeover of the health-insurance sector, paid for by rising tax rates, in which the government guarantees universal access while using its monopoly power to hold down costs.
But there’s another path, equally radical, that’s more in keeping with the traditional American approach to government, taxation and free enterprise. This approach would give up on the costly goal of insuring everyone for everything, forever. Instead, it would seek to insure Americans only against costs that exceed a certain percentage of their income, while expecting them to pay for everyday medical expenditures out of their own pockets.
Such a system would provide universal catastrophic health insurance, in other words, while creating a free market for non-catastrophic care. In the process, it would marry a central conservative insight — that we’ll never control spending so long as Americans are insulated from the true price of their medical care — to the admirable liberal premise that nobody should go bankrupt paying for life-saving treatment.
Read the whole thing.