Map of life expectancy at birth from Global Education Project.

Monday, September 10, 2012

Can the people get clear on the concept?

As you may have heard, Mitt has been furiously flip-flopping on health care reform, telling Press the Meat that of course there are provisions of Obamacare that he wants to preserve, such as guaranteeing coverage for people with pre-existing conditions. Then a couple of hours later his campaign said he didn't exactly mean that, he meant this:

His campaign later told TPM he wasn’t signaling a shift in policy and was instead referring to his existing stance in favor of protections on preexisting conditions only for those with continuous insurance coverage — not for first-time or returning buyers. 

Do you see what is wrong with that statement? If you already have insurance, then by definition you have already not been denied insurance for a pre-existing condition. Any medical conditions that you develop after you have acquired your current insurance policy are, a fortiori, not pre-existing

Even Romney's critics, including TPM and Paul Krugman, have apparently failed to notice this basic semantic problem. Why is Mitt trying to have it both ways? Because a) guaranteeing coverage for people with pre-existing conditions is popular and b) it is impossible without the individual mandate, which is not popular and which he claims -- even though it's at the heart of his own Massachusetts reform which is otherwise essentially identical to Obamacare -- is a tool of the Antichrist.

What we need to get through the heads of the casually informed public is the following True Fact:

  • If you require coverage for pre-existing conditions without requiring that everybody have health insurance  ->
  • healthy people will not buy insurance because they know they can buy it if they get sick -> 
  • only sick people will have insurance which means it will be too expensive for most people -> 
  • ergo, you haven't really required coverage for pre-existing conditions because it won't be affordable and furthermore you will have destroyed the market for health insurance.
That's the reason for the individual mandate. There's no other way to do it. Good, affordable insurance requires universal buy-in. That's how the world works. Even if you're a Republican.

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