Where’s This Going?

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September 7, 2009 6:31 a.m.

Am I the only one who thinks that if the Dems pass a bill with mandates and subsidies for poor and moderate income people to purchase it but no public option or competition with the insurers, that it will be pretty much a catastrophe for the Democrats in political terms?

You ‘solve’ the problem of the uninsured by passing a law forcing them to buy health insurance which, by definition, most a) cannot afford or b) are gambling they won’t need because they’re young and healthy. Either you end up with low subsidies which still leave it onerous to buy, thus creating a lot of disgruntled people, or you get generous subsidies, which cost a lot of money.

It’s sort of like reform with all the cool political downsides but none of the reform.

Of course, political terms are not the only calculus on which to evaluate these questions. And the model I’m describing sounds more or less like the system they have in Switzerland and Massachusetts, which many health care experts I have a lot of respect for still believe would be a big improvement over the current situation. But I do wonder whether, if the details are not thought through carefully, you might not end up with a system less effective at driving down costs than driving down the number of Democrats serving in Congress.

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