Ambivalence Revisited

Yesterday, I talked about the recent upsurge in interest in the “Public Option” (Bad News and More Bad News) and my mixed feelings about the whole thing. Well, I’m inspired by Lambert to revisit this topic:

Who kidnapped Paul Krugman? Partial truths, false statements, bad writing… It’s almost like he’s turning into an access blogger!

I read Paul Krugman’s piece yesterday with some interest ::

Here’s the story: About 800,000 people in California who buy insurance on the individual market — as opposed to getting it through their employers — are covered by Anthem Blue Cross, a WellPoint subsidiary. These are the people who were recently told to expect dramatic rate increases, in some cases as high as 39 percent.

Why the huge increase? It’s not profiteering, says WellPoint, which claims instead (without using the term) that it’s facing a classic insurance death spiral.

. . .

Now, what WellPoint claims is that it has been forced to raise premiums because of “challenging economic times”: cash-strapped Californians have been dropping their policies or shifting into less-comprehensive plans. Those retaining coverage tend to be people with high current medical expenses. And the result, says the company, is a drastically worsening risk pool: in effect, a death spiral.

. . .

Finally, there have been calls for minimalist health reform that would ban discrimination on the basis of pre-existing conditions and stop there. It’s a popular idea, but as every health economist knows, it’s also nonsense. For a ban on medical discrimination would lead to higher premiums for the healthy, and would, therefore, cause more and bigger death spirals.

So California’s woes show that conservative prescriptions for health reform just won’t work.

And Krugman goes on to discuss what he believe WOULD work. And his discussion made me so uncomfortable, I blocked the whole thing from my mind ::

And if you put all of that together, you end up with something very much like the health reform bills that have already passed both the House and the Senate.

Because if Krugman thinks those bills are actually going to “work” — that they’re more than just fragile baby-steps that start us on the path to doing something serious some day — well, I didn’t know what to say about that.

When he says, “Finally, there have been calls for minimalist health reform that would ban discrimination on the basis of pre-existing conditions and stop there.” I guess he’s right. But, what about the other calls — for Single Payer (Medicare for Everyone) — Krugman doesn’t mention this possibility at all.

And how about the possibility of letting the Death Spiral for the Health Insurance parasites continue to it’s logical conclusion ::

But the main point is this: California’s death spiral is a reminder that our health care system is unraveling, and that inaction isn’t an option. Congress and the president need to make reform happen — now.

CRAP — I’m such an idiot. It’s been obvious for almost a year (the second we started talking about Health Insurance Reform instead of Health Care Reform) that we were heading toward a bailout of the insurance industry. But, I thought it was just because there was no way WE were going to get bailed-out :: why isn’t Krugman writing about the death spiral that PEOPLE are in over a lack of health care?

I didn’t realize that the insurance industry was in a death spiral and that they can’t survive without the bailout. What would letting the death spiral play out mean to us?

My ambivalence has just about melted away . . .

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