Map of life expectancy at birth from Global Education Project.

Thursday, December 23, 2010

For more wonkery on the same subject . . .

I recommend William Pewen's blog at Health Affairs. Basic points, all true:

1) The individual mandate, in spite of the compelling practical arguments in its favor, does create potential problems when it interacts with legal sophistry. Justices could easily decide either way as to its constitutionality and construct sufficient arguments to not look ridiculous, but you and I both know that their ultimate motivations will be political. And hey, it's 5 to 4.

2) Without the mandate, the PPACA won't work. This is because of basic features of the market for health insurance, which by the way don't resemble anything they teach you in freshman economics. (Sorry to be a broken record on that one.) If insurers have to issue insurance to everybody, at more or less the same price, people who think they are unlikely to need it won't buy it, which will make it more expensive for people who are likely to need it, which will drive out the somewhat likely, making it even more expensive for the highly likely -- in other words, The Death Spiral, and the insurance market has been destroyed.

3) There was a much simpler and better way to do this all along: Medicare for everyone. Universal, comprehensive, single payer national health care. No constitutional problem whatsoever. Congress has unequivocal power to raise taxes to promote the general welfare. QED. The reason we didn't do this is because conservatives wanted to protect the private insurance industry, which was shoveling money at them. And now they are trying to get the very creature they birthed declared unconstitutional. And they might just succeed.

So let's say it again:

We need universal, comprehensive, single payer national health care.

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