Charlie Dent is my Congressman. I don't think the guy is stupid, or even insane, although I think much of his caucus in Congress is both of those things. Sometimes though, when he speaks, he makes the case for the other side really easy. In the video above, he made two points absolutely crystal-clear.
- We need a "public option" to make health care affordable.
- The individual mandate is essential to getting healthy, young people into the health care system.
Now, let me be fair here and say that Dent disagrees with me on BOTH of those points. When Dent talks about "cost control," his solution to that would be Tort Reform and allowing insurers to compete across state lines. The problem with his position there is that Tort Reform's record so far, where it has been tried, is mixed on lowering costs. The problem with eliminating state-line requirements for health insurance is that it will encourage all providers to move to the state with the least requirements for care. In other words, whatever state is most in the bag for health insurers will get all of the companies, and we'll be living under the laws of state legislators we don't elect. Now you can easily fix that by enacting "minimum coverage" standards that any company competing in the pools would have to meet, but Dent, like most of his caucus, opposes most or all of the regulations in the Health Reform law, so it's hard to believe they'd back other regulations now.
The only way to achieve the adequate "cost control" that Dent talks about is to introduce a market force to the insurance market that has no regard for cutting a profit each year. While a series of "non-profits" may make sense at first glance here, the record on them driving down costs isn't great, because while they don't have to make money for profits, they still operate on the same economic scales as their private brethren, still pay their executives on the same scale, and basically operate in the same ways as corporations. The only actor in the market who can operate on a grand enough scale to drive down prices, and can afford to do so, without regard to profits, is the federal government. Dent's argument for better cost control is the best argument for the Public Option you can make, as well as for major PHARMA reform as well (both of which were things the Democrats declined to take on in the bill, to their detriment.).
The second one is more interesting, because it's the foundation of many conservative challenges to the bill. Dent says we need to get younger, cheaper to insure people into the market. He suggests we can do that by letting them by catastrophic coverage, coverage that has low premiums and high deductibles. I agree we should make that kind of coverage plentiful to people my age, it'd be very helpful to the public. With that said, it doesn't change the fundamental reason people that are younger don't buy health insurance: they don't need it. It's one more expense for people who are drowning in college debt and having more and more trouble finding work. This is why you have an individual mandate. The "exchanges" need these low-cost people paying into the insurance pools to help keep prices down (people who are paying in, but not using a lot of care, help pay for people who are older and less healthy), and the only way to get them in is to have a mandate. You can subsidize care, and offer less expensive care all you want, it's still an expenditure that a lot of younger people see as unnecessary. Now, they would be much better off, as would our health care system, if they participated younger, for the long haul, but that's another story all together. You can make my premiums $1, if it's $1 I don't have to spend, why would I do so?
Thanks to Lehigh Valley Ramblings for putting up these interesting videos.
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