Ezra Klein follows up on his post from yesterday with this one. In it he argues that no one to the right of Obama has suggested an alternative. But what he means to say, is that no one on the right has suggested an alternative that meets his objectives.
He describes Obamacare as "a policy to make sure most every legal resident of the United States has access to comprehensive, affordable health care. In order to achieve that goal, it helps poorer Americans pay for insurance and regulates the products offered by insurers to make sure they’re worth paying for." I imagine that's what he (and liberals) want any alternative to do.
The problem is that this is not how non-liberals would describe Obamacare, and though that may be the goal, Obamacare does so much more than that. I think people of all philosophies can agree on a policy to make sure most every legal resident of the United States can afford basic healthcare. The only difference with my wording and Ezra's is that I've reduced comprehensive to basic. Of course, this goal had already been achieved before Obamacare since anyone can get treatment in an emergency room. That's why the Republicans haven't really proposed much in the way of alternatives, because they believed this is the important objective, and it has already been achieved.
The difference, I suppose, is that Democrats wanted to exchange basic for comprehensive. Admittedly, I'm not really sure what comprehensive means. This was something lost in the debate, as happens. It's hard for people like me to argue when we don't know exactly what we're arguing about. I would welcome a debate as to what level of care everyone should have but they're not getting.
What I gather this means for liberals is that everyone should have access to an affordable insurance plan that covers preventative medicine and any reason you may want to go to the doctor. Now, if this is really the goal, then all that has to be done is give people the subsidy to afford it. That accomplishes the access goal. But, of course, that's not where the Democrats stopped. In addition, they had to mandate a whole slew of benefits that insurance had to cover and mandated how much insurance companies could charge. If the objective was just granting access, why are regulations necessary?
Because the objective is not "granting access," the objective is remaking the health insurance industry into an industry that liberals approve of. That industry can't charge seniors more even though they're more costly, can't charge other groups more if they're more costly, can't spend too much on administrative costs. These are all bad practices.
So the goal wasn't only to provide access, but to root out distasteful practices. To achieve the goal stated above should be relatively simple. All Republicans would need to propose would be to keep the subsidies and cut everything else. (Guaranteed Issue would also need to be addressed, and I think state pools or national pools expressly for the uninsurable is the way to go).
Wednesday, April 3, 2013
Tuesday, April 2, 2013
Libertarians versus Liberals
Ezra Klein is a knowledgeable and convincing liberal. Most of the time I have a hard time refuting his arguments as they are consistent opinions that are based in fact.
Sometimes, though, I find a gap in his reasoning. In this piece, I found a couple, and they illustrate the same gaps that many liberals have when talking about issues, gaps that portray their inability to understand the libertarian point of view.
He's talking about how the premiums are very likely to go up once Obamacare hits (for many reasons but adverse selection and mandated benefits are the primary drivers). He argues that this misses the point because people will be purchasing superior insurance. Plus, they'll receive subsidies, so their actual expenses will decline.
There are two gaps in his argument. Let's start with the smaller one. He acts as if these subsidies come from nowhere, when, in fact, the subsidies are of course provided by tax-payers. So, yes, the newly insured might be paying less out of pocket than they were before, but society's payments have increased. But this misses the point, the point is that premiums would have been lower without those mandated benefits. It would be far less costly to insure everyone if the benefits weren't so extensive (no copay birth control, no copay for several benefits, for example).
The larger gap is how he ignores people's choices. He takes for granted that everyone wants the more expensive insurance plan (which I grant is probably the case when someone else is paying for it). He proposes a hypothetical choice between high deductible, low premium, very stingy insurance versus high premium, cover everything insurance. He argues that everyone would choose the latter, and that's what Obamacare is striving for.
If the latter option is so great, why does Obamacare have to mandate these benefits? If everyone who ccould afford it would choose it, why doesn't it already exist? It has to be mandated because no one is choosing it, and Ezra Klein and Barack Obama and all the other liberals think everyone should have that type of insurance no matter the cost.
This is just more evidence that Progressives don't believe that people are capable enough to make decisions for themselves. They've decided that high premium, cover everything insurance is the preferred type of insurance, so you should be forced to have it no matter the cost to you or to taxpayers.
He sums up with this. "The intent of Obamacare is to ensure that almost all Americans are covered by high-quality insurance that they can afford." That's exactly right, the intent of Obamacare was not to ensure that all Americans could afford high-quality insurance, it was that they "are covered." This is the difference between libertarians and liberals, the former wants to make sure you have a choice and do what you deem best, the latter wants to make sure you adhere to what they believe is best for you.
Sometimes, though, I find a gap in his reasoning. In this piece, I found a couple, and they illustrate the same gaps that many liberals have when talking about issues, gaps that portray their inability to understand the libertarian point of view.
He's talking about how the premiums are very likely to go up once Obamacare hits (for many reasons but adverse selection and mandated benefits are the primary drivers). He argues that this misses the point because people will be purchasing superior insurance. Plus, they'll receive subsidies, so their actual expenses will decline.
There are two gaps in his argument. Let's start with the smaller one. He acts as if these subsidies come from nowhere, when, in fact, the subsidies are of course provided by tax-payers. So, yes, the newly insured might be paying less out of pocket than they were before, but society's payments have increased. But this misses the point, the point is that premiums would have been lower without those mandated benefits. It would be far less costly to insure everyone if the benefits weren't so extensive (no copay birth control, no copay for several benefits, for example).
The larger gap is how he ignores people's choices. He takes for granted that everyone wants the more expensive insurance plan (which I grant is probably the case when someone else is paying for it). He proposes a hypothetical choice between high deductible, low premium, very stingy insurance versus high premium, cover everything insurance. He argues that everyone would choose the latter, and that's what Obamacare is striving for.
If the latter option is so great, why does Obamacare have to mandate these benefits? If everyone who ccould afford it would choose it, why doesn't it already exist? It has to be mandated because no one is choosing it, and Ezra Klein and Barack Obama and all the other liberals think everyone should have that type of insurance no matter the cost.
This is just more evidence that Progressives don't believe that people are capable enough to make decisions for themselves. They've decided that high premium, cover everything insurance is the preferred type of insurance, so you should be forced to have it no matter the cost to you or to taxpayers.
He sums up with this. "The intent of Obamacare is to ensure that almost all Americans are covered by high-quality insurance that they can afford." That's exactly right, the intent of Obamacare was not to ensure that all Americans could afford high-quality insurance, it was that they "are covered." This is the difference between libertarians and liberals, the former wants to make sure you have a choice and do what you deem best, the latter wants to make sure you adhere to what they believe is best for you.
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