Another Sign of the End Times: Health Insurance Competition Advocated on the Front Page of the New York Times

Times economic columnist David Leonhardt writes an amazingly perceptive article today about how competition and choice could spark real reform by transforming the health insurance market. A few choice tidbits:

Consider the following health insurance plan.

It refuses to pay for certain medical care and then doesn’t offer a clear explanation. It does pay for unhelpful care that ends up raising premiums. Its customer service can be hard to reach or unhelpful. And the people who are covered by this insurer have no choice but to remain with it — or, at best, to choose from one or two other insurers that are about as bad.

In all likelihood, I have just described your insurance plan.

Health insurers often act like monopolies — like a cable company or the Department of Motor Vehicles — because they resemble monopolies. Consumers, instead of being able to choose freely among insurers, are restricted to the plans their employer offers. So insurers are spared the rigors of true competition, and they end up with high costs and spotty service....

Americans give lower marks to their health insurer than they do to their life insurer, their auto insurer or their bank, according to the American Customer Satisfaction Index. Even the Postal Service gets better marks. (Cable companies, however, get worse ones.) No wonder President Obama’s favorite villain is health insurers.

You might think, then, that a central goal of health reform would be to offer people more choice. But it isn’t.

Leonhardt then points out that both the allegedly reform-minded Democrats and the corporate shill  Republicans are protecting the health insurance monopolies. Indeed, Leonhardt adds:

On one hand, big interest groups are lobbying hard to keep some form of the status quo. Insurers don’t want people to have more choice. Neither do employers and labor unions, which now control huge piles of money spent on health care. Nor do hospitals and drug makers, which benefit from all the waste now in the system. 

So what to do? Leonhardt then looks at various proposals to increase choice and competition, including one by Sen. Ron Wyden (D-Ore.). 

In the simplest version, families would receive a voucher worth as much as their employer spends on their health insurance. They would then buy an insurance plan on an “exchange” where insurers would compete for their business. The government would regulate this exchange. Insurers would be required to offer basic benefits, and insurers that attracted a sicker group of patients would be subsidized by those that attracted a healthier group.

The immediate advantage would be that people could choose a plan that fit their own preferences, rather than having to accept a plan chosen by human resources. You would be able to carry your plan from one job to the next — or hold onto it if you found yourself unemployed. You would never have to switch doctors because your employer switched insurance plans.

The longer-term advantage would be that health insurance would become fully subject to the brutal and wonderful forces of the market. Insurers that offered better plans — plans that drew on places like the Mayo Clinic to offer good, lower-cost care — would win more customers.

Can this really be in the New York Times, much less on its front page? Have I somehow entered an alternate universe in which economic sanity reigns? There's more:

Given all the problems with health care — the high costs and decidedly mixed results — how comfortable are you defending the status quo? Why force people into a system you think is better for them?

If people were instead allowed to choose, all but a small percentage might indeed stick with their employer plan. In that case, a Wyden-like proposal wouldn’t amount to much. It certainly would not destabilize the employer-provided insurance system.

Then again, if lots of families did switch to a plan on the exchange, the impact would be quite different. With fewer employees signing up for on-the-job insurance, companies might shrink their benefits departments. The number of companies offering insurance would keep dropping. The employer insurance system could begin to crumble.

But wouldn’t that be precisely the fate that the system deserved?

Yes. A million times, yes! 

See my article "Markets, Not Mandates," for another version of how competition and choice could meet the needs of consumers and drive down health care costs. Leonhardt has redeemed himself from his earlier mangling of the concept of rationing

Read whole Leonhardt article here

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • Joe M||

    So what to do? Leonhardt then looks at various proposals to increase choice and competition, including one by Sen. Ron Wyden (D-Ore.).

    You accidentally left that at inside your quote.

  • Space Fiend||

    This plan would be too elegant and common sensical for Congress to seriously consider it.

  • Lester Hunt||

    Maybe there is such a thing as creeping capitalism.

  • ||

    Joe M: Thanks. Fixed.

  • ||

    But, but, I thought there could be only one health care reform plan! [cue Queen's "Princes of the Universe"]

  • ||

    Kinda hackneyed and seems in search of excuses to inject the government, but still an improvement.

    What I don't understand is that if they GET the concept that the problem is lack of competition because consumers have bene cut out of the price feedback loop, then why don't they also get the concept that non-employment-based, catestrophic/high-deductible insurance would improve competition.

  • Militant Lefty||

    Quick! Boycott the NYT! I've always opposed them! ALWAYS!!! *sobs while remembering that weekend we spent together in '07*

  • ||

    Hazel Meade: Then how could the government save us? ;-)

  • ||

    Republicans, meanwhile, have shown no interest in making insurance choice part of a compromise they could accept



    The Republicans are pushing buying insurance across state lines, but you would need to reform the employer deduction into a individual voucher or tax credit to really make that lead to competition.

    Oh right, didn't McCain lose an election because Obama pounded the idea of replacing the employer deduction with an individual tax credit with tons of ads?

    He writes a whole article about the Wyden plan and the voucher concept, without pointing out that the similar McCain plan, while having a general outline recommended by economists (and me), failed horribly in polling.

    Is it shocking that Republicans, and politicians in general, are reluctant to loudly push something that failed in the polls? It's much easier to stop something than to have to propose your own solution.

    Note that insurance companies have actually had improving poll numbers since Obama's plan has been discussed.

  • *||

    Paul Krugman will be paying Leonhardt a late-night visit.

  • Amber Waves||

    "Can this really be in the New York Times, much less on its front page? Have I somehow entered an alternate universe in which economic sanity reigns?"

    No, the Times has been slowly turning their boat around in tandem with the increasing realization that Obamacare is tanking.

    The primary goal of the NYT is to always maintain the image that they are never wrong.

  • ||

    Replacing the employer deduction with a tax credit was the policy that Candidate Obama attacked like no other. It was literally the only Obama ad I saw on television in Virginia, and I saw it several times a day. The ad was universally agreed to be highly effective.

    And Leonhardt is wondering why more politicians aren't suggesting it?

  • Naga Sadow||

    Pro Lib,

    There can only be one?

  • TallDave||

    Amazing.

    I am agape.

  • ||

    Paul Krugman will be paying Leonhardt a late-night visit.

    Ew. Thanks for that image.

  • TallDave||

    Maybe there is such a thing as creeping capitalism.

    Just ask the Russians. Or the Chinese.

  • Space Fiend||

    I have to admit I'm not up on the nuances of this proposal - but what about offering a voucher as an option, even possibly costing less then comparable employee insurance? This would obviously be possible, especially for young and healthy people.

    That way, you preserve the tax incentive for employers to provide an insurance option while still allowing those individuals that want to to opt out, just like with school vouchers.

    Of course, an even better solution would be to just cut taxes in general and get rid of this perverse incentive altogether.

  • TallDave||

    Replacing the employer deduction with a tax credit was the policy that Candidate Obama attacked like no other.

    And now his critics are called angry mobs of un-American scaremongers.

    Unreal.

    The great thing about this idea is it can truly match costs to risks and get rid of mandates. You can choose what to insure against.

  • ||

    Hmm, the idea is logical, free market-ish, and relatively simple and straightforward. For those reasons, I love it. Sadly, for those exact same reasons it'll never happen.

  • ||

    Naga,

    Yes. A fact that Gov. Schwarzenegger is already fully aware of.

  • ||

    Paul Krugman will be paying Leonhardt a late-night visit.

    Just his beard. It does all the false consciousness purging.

  • TallDave||

    To be fair though, McCain's proposal wasn't that sensible.

    Under McCain's heath care plan, individuals would be eligible for a $2,500 credit and families a $5,000 credit to help pay for health insurance if they do not subscribe to, or do not have access to, employer-provided health care coverage. The government would send the money directly to insurers...McCain's plan would cost $3.6 trillion over 10 years, the campaign said. McCain would pay for the program by eliminating the tax break employers get for offering insurance

    I don't think the employers have a $2500 limit. They should just transfer the employer credit to individuals: full deduction of your insurance cost.

  • mark||

    What's this? A 30-page health insurance reform bill? This is literally all it would take. I only wish Rep. Bachmann would take her name off of it, it's like poison.

  • John McAdams||

    I'm afraid this looks like a stalking horse for single payer.

    The hostility to private insurance companies, and the phrase "government regulated" before "exchange" are the give-away.

    There is one huge advantage to employer-based health care: the fact that HR departments can bear the information costs and transactions costs of buying insurance.

    And I frankly don't see much of an "agency" problem. Employers have a big incentive to keep their employees happy. There is a huge "agency" problem in politics.

    But . . .

    First, employers should have more choices, such as buying insurance across state lines.

    Second, having employer-based insurance compete with individually purchased insurance is a fine idea, so long as it's not rigged to kill private insurance.

  • JB||

    So are Leftists now going to boycott the NYT?

  • ||

    So are Leftists now going to boycott the NYT?

    Well, they certainly won't buy their arugula there any longer.

  • TallDave||

    They should just transfer the employer credit to individuals: full deduction of your insurance cost.

    Everyone would get a one-time transitional offsetting raise in the amount of their insurance cost. Then we'd quickly see crazy competition for individual policyholders, esp. on the Internet (like the one that drove term life prices way down in the 1990s). A bustling marketplace of insurance options with individually tailored plans and rewards for health living...

    OK, I gotta stop, I'm drooling.

  • kilroy||

    In the simplest version, families would receive a voucher worth as much as their employer spends on their health insurance.



    Bullshit. The simplest version would take the employer bullshit completely out of the equation. There is NO reason the employer should be involved in a family's health insurance. None.

  • ||

    Leonhardt, unlike some his colleagues, seems to have a pretty good (that is, similar to mine) grasp of business and economics.

  • mark||

    The only way I would reluctantly accept a "reform" in which I "receive" a "voucher" that comes from my own damn money, often in the form of a direct payment to an insurance company (spew), is if this plan is the only way to stop ObamaCare. And as long as it's not a trojan horse for anything just as bad. I mean it has an individual mandate, which goes against Ron Paul's Coercion is Not Health Care Act.

  • ||

    I don't think the employers have a $2500 limit. They should just transfer the employer credit to individuals: full deduction of your insurance cost.



    It's a refundable tax credit, not an income deduction. A refundable tax credit (which works like a voucher) is much better than an income deduction for the poor (without net income taxes), and anyone else would much rather reduces their taxes by $X than reduce their taxable income by $X. Indeed, it's better for the middle-class than the rich for the same reason-- deductions are worth more if you're paying a higher rate, the credit is always worth the same.

    If you pay at the 25% marginal rate, a tax credit of $2500 is like a deduction of $10,000.

    Of course, the fact that I have to explain this to H&R commenters is one reason why the plan was so easy to attack.

    Also, full deduction or tax credit for insurance cost regardless of the scale of coverage does creates a problem. Your choices are either even more government regulation in what's allowed to be included, or capping the tax credit and having people buy the most efficient policy. A fixed dollar amount voucher is the most efficient way.

  • ||

    mark,

    Would you prefer it if it's called a tax credit instead of a voucher, so you can pretend that you're just being taxed less of your own damn money?

  • Alice Bowie||

    I would love to see them take the EMPLOYER completely out of the picture.

    Why is there a need for vouchers. Whatever the employer is paying now for each employee can be returned to the employee.

    Let the employee buy whatever policy he/she wants.

    No tax credit. No nothing.

    The price is the price.

  • Alice Bowie||

    If the government chooses, it can make healthcare premiums and costs tax deductable.

  • mark||

    JT, is that really how the Wyden plan works? I think you're thinking of the Coburn-Ryan plan.

  • LeeJoe Cruz||

    One memory that is seared into my mind in the 08 campaign is about the healthcare policies.I can remember that my tv was always set on AFN News and there was Fox and Friends in the morning. As I was putting my boots in Bagram Afghanistan, I remember hearing a few days before the election that McCain's Plan would cost 3.3 Trillion over 10 years and Obama's was 3.6. I remember shaking my head at the indignant aire the lady had, as if there was a difference.

  • Alice Bowie||

    And stop companies from trying to pass off their healthcare coverage as some sort of a benefit. It's more of a ball and chain than a benefit.

  • gmatts||

    "Given all the problems with health care - the high costs and decidedly mixed results - how comfortable are you defending the status quo? Why force people into a system you think is better for them?

    If people were instead allowed to choose, all but a small percentage might indeed stick with their employer plan. In that case, a Wyden-like proposal wouldn't amount to much. It certainly would not destabilize the employer-provided insurance system.

    Then again, if lots of families did switch to a plan on the exchange, the impact would be quite different. With fewer employees signing up for on-the-job insurance, companies might shrink their benefits departments. The number of companies offering insurance would keep dropping. The employer insurance system could begin to crumble.

    But wouldn't that be precisely the fate that the system deserved?"

    Isn't this exactly what the Social Security debate revolved around a few years back?

  • ||

    I don't see a problem with the employer provided benefit of insurance. There's no good reason to keep an employee from trying to get benefits from the employer if the employer is trying to get talented workers.

    But, individuals who do not get benefits from their employers should be allowed to pool into groups to negotiate good rates with insurance carriers.

  • ||

    But, individuals who do not get benefits from their employers should be allowed to pool into groups to negotiate good rates with insurance carriers.

    There's nothing stopping them now.

  • ||

    JT, is that really how the Wyden plan works? I think you're thinking of the Coburn-Ryan plan.



    Yeah, I'm not talking about the Wyden plan, I'm talking about McCain's plan. AFAIK, the Coburn-Ryan plan is fairly similar.

    A $2,500 tax credit would be like a $10,000 deduction for the middle class; the $5,000 tax credit would be like a $20,000 deduction. The average total cost (employer plus employee) of health plans in the US is $13,000 for a family of four.

    The tax credit under McCain's plan was actually better than deducting the full insurance cost for most people. But, as TallDave's comment makes clear, people get easily confused about the difference between a tax credit and a tax deduction.

    That complexity made it easy for soundbite ads to sink the plan. If you've got to explain the plan, it's not going to work.

  • ||

    I remember hearing a few days before the election that McCain's Plan would cost 3.3 Trillion over 10 years and Obama's was 3.6. I remember shaking my head at the indignant aire the lady had, as if there was a difference.



    Well, if you believe that there's no difference between 3.3T of tax cuts and credits for individuals to exercise choice and buy their own insurance and 3.6T of government spending for individuals to participate in a government-run plan, then fine.

  • ||

    His critique of the actual problem with the current healthcare situation is pretty good. His fix, while better than Obama Care, is not so good though. It all falls apart in this paragraph: (warning, I don't know how to quote/italicize here)

    "In the simplest version, families would receive a voucher worth as much as their employer spends on their health insurance."

    Why do we need a voucher for this? People aren't used to paying for *all* of their health insurance, its true, but is he afraid the shock of that would be too much?

    Wages would increase to compensate for the lack of health insurance premiums employers pay (ok, this would probably not happen instantly, but over time) so that total employee compensation would remain roughly the same.

    Vouchers only complicate the matter.

    "They would then buy an insurance plan on an "exchange" where insurers would compete for their business. The government would regulate this exchange."
    The whole thing bugs me. I don't need to buy my auto insurance on an exchange; I pick a company & policy based on my needs/preferences and call/go to their office.
    Government regulated exchange sounds fishy and vague enough to sneak ObamaCare in through the back door with.

    "Insurers would be required to offer basic benefits..."
    What if I don't want an insurance plan that covers basic benefits? If I know I'm going to need something, I don't want it part of my insurance. I don't want my auto insurance to cover filling up my gas tank because instead of me paying $2.50 per gallon it means I would be paying [$2.50 + Insurance company overhead]/gallon.
    "..., and insurers that attracted a sicker group of patients would be subsidized by those that attracted a healthier group."

    So health insurance providers are strongly discouraged from trying to minimize/mitigate risk with the penalty for doing so subsidizing companies that don't. In order to stay afloat, wouldn't they either need to charge *everyone* really high premiums or rely on government subsidy (which ultimately comes from us anyways? Am I just having a brain fart or does this last bit kind of blur the distinction between competitive private insurance and Government Healthcare?

  • Mike Laursen||

    There's nothing stopping them now.

    I'm not sure that's true. Can they, for example, create a pool that crosses state lines?

    And although they may not be stopped, there may be disincentives that harm the chances of successfully starting such a pool. For one thing, how many people are going to join a pool that solves health insurance cost problems without government help, when the government is claiming they're soon going to pass a sweeping bill that fixes everything.

  • LeeJoe Cruz||

    "Going to Cost." So no I make no distinction. Plunder is still plunder in the name of the law or otherwise. There should be no healthcare laws at the federal level. It's not mandated to the Federal Government in article 1 section 8.

  • ||

    I'm not sure that's true. Can they, for example, create a pool that crosses state lines?

    A ha! Well, then I guess yer right.

    And although they may not be stopped, there may be disincentives that harm the chances of successfully starting such a pool. For one thing, how many people are going to join a pool that solves health insurance cost problems without government help, when the government is claiming they're soon going to pass a sweeping bill that fixes everything.

    Well there are disincentives to everything. Sometimes government intervention is just something you have to work around.

    But I've brought up the idea of people in say, one city, voluntarily getting together to buy group insurance policies in 'progressive' message boards and it is met with much hostility. So maybe yer right about that one too.

  • ||

    There's nothing stopping them now.

    Maybe not everywhere, but in NY, you cannot.

  • kilroy||

    "I don't see a problem with the employer provided benefit of insurance. There's no good reason to keep an employee from trying to get benefits from the employer if the employer is trying to get talented workers."

    Nick,

    Do you get your auto insurance from your employer? Why not?

    I'm not saying an employer shouldn't be allowed to provide health insurance. Hell, I'd be willing to let anyone (Wal-Mart?) negotiate lower rates for their constituents. Where I draw the line is the government subsidy of health insurance provided to employers. There's no reason to provide a special "deal" to employers.

    Once it's tax neutral the employer will almost certainly choose to pay the employee more in salary as an incentive to join the company. This lets the employee make the decision where they value placing the extra $.

  • Sviluppo||

    Here's something I've always wondered about the idea of individual plans and competition:

    You probably won't really know how well your insurance company works until you need it for some major illness or are using it often enough to notice problems. But at that point, what other insurance company is going to want to cover you, and if one is, it would seem prohibitively expensive to switch.

    Under the current individual health insurance market, the insurance companies have every incentive to drop expensive or sick customers. We're told that the only way for health insurance companies to remain profitable is to keep practices like rescission, higher rates for those with previous illnesses, and refusing to cover those with pre-existing conditions.

    So instead of lots of healthy employees paying into group plans to cover the few sick, we're now having healthy taxpayers covering the few sick... Isn't that just single payer with an added layer of welfare in the pockets of the insurance companies?

  • Sean W. Malone||

    "And stop companies from trying to pass off their healthcare coverage as some sort of a benefit. It's more of a ball and chain than a benefit."

    This is true... Now... But you should remember that the only reason that employers started providing health insurance was because of the wage controls imposed by FDR.

    It was a benefit at that time, because it was one of the only ways employers had of improving their offerings to potential employees. But since it's been ensconced by law - now we've got more problems.

    There's no reason to stop employers from offering benefits like Insurance..... If you were planning on working for the same company for many years - if you're happy with your employment and they are treating you well, why not? It might be different in scale, but many people I know have employer-provided cars, cell-phone service, air-travel, etc. If you quit working, you lose your car, your phone and your cushy travel arrangements... Not the end of the world, sure, but still things you have to give up by leaving.

    You wouldn't stop employers from providing those benefits though, would you?

    Point is though - they shouldn't be getting special legal benefits for it. Just make the whole thing equal in the eyes of the law. All health care being tax-deductible would be a fine start.

  • ||

    No, kilroy, I don't get car insurance through my employer, but at my last job (an auto insurance company) they did offer employees a 20% discount. Why should any company be restricted from offering whatever they want to their employees? I agree they shouldn't receive a tax break that no one else can also receive. If that causes employers to drop the offering of insurance, fine. But don't mandate it.

    Besides all that, my employer doesn't have as much an incentive to offer me car insurance as they do to offer me health insurance. I'm not talking about taxes breaks. I'm talking about wanting employers who take an interest in their employees health so they will be sick less or stressed less and show up to work and perform well. And, they can use it to attract talent.

  • ||

    Wow. Sentence structure and grammar aside, I stand by my point.

  • ||

    It's not mandated to the Federal Government in article 1 section 8.

    It's not mandated, but it's allowed.

    The Congress shall have Power To lay and collect Taxes...to pay the Debts and provide for the common Defence and general Welfare of the United States...


    Congress lays taxes to provide for the general welfare. That's all the constitutional authority they need.

    (The constitution blows, btw.)

  • ||

    Plunder is still plunder in the name of the law or otherwise.



    Reducing your taxes is plunder?

  • ||

    Besides all that, my employer doesn't have as much an incentive to offer me car insurance as they do to offer me health insurance. I'm not talking about taxes breaks.



    Fine. So by your argument Nick, there's no problem with eliminating the special tax break for employer-insurance then, or treating individual-bought insurance the same?

    I have nothing against employer-provided insurance if it's on a level playing field. You're right that employers might have other incentives for providing it. Let's test that by making things even.

  • LeeJoe Cruz||

    While I know the Constitution "Blows," it in no means gives the Federal Government the right to regulate Healthcare. The Fact that the nearly every President before Lincoln veto-ed attempts at federal funding of roads makes your point of view Risible at best. The Constitution in it's design, is meant to be an exacting document which details specific powers. "The General Welfare" as you know it is no way, shape or form related to the Olde English Common law.

  • stuartl||

    Insurers would be required to offer basic benefits, and insurers that attracted a sicker group of patients would be subsidized by those that attracted a healthier group.

    Like Inigo Carmine, I don't get this part of the proposal. To carry it to an extreme, wouldn't it promote making your customers less healthy? If you provide services that cause a sicker group to use your company, shouldn't you just charge more?

  • LeeJoe Cruz||

    As I understand it, the Federal Government would still be taking taxes from the People and redistributing funds to tax credits. Am I wrong? I can accept that lol

  • kilroy||

    "Why should any company be restricted from offering whatever they want to their employees?"

    They shouldn't, including auto insurance. Most companies don't offer auto insurance because there is no government benefit to do so.

    "I agree they shouldn't receive a tax break that no one else can also receive. If that causes employers to drop the offering of insurance, fine. But don't mandate it."

    Agreed. No tax subsidy and no restrictions.

    Personally, if given the choice between:

    Job A @ $100K + $13K in Health Insurance

    and

    Job B @ $113K

    I'll take Job B all else being equal.

  • ||

    As I understand it, the Federal Government would still be taking taxes from the People and redistributing funds to tax credits.



    They would be effectively giving some money to anyone who pays less than $2500 (single) or $5000 (married) in taxes total currently but who buys their own insurance and wouldn't be on Medicaid. Everyone else it would just show up as lower taxes on their tax returns. This would replace the tax deduction for businesses. Personally, I could live with a subsidy for the working poor to buy their own insurance instead of being on Medicare.

    LeeJoe, you mention that you're in the Armed Forces. Is paying your salary and your health care illegitimate "plunder" as well?

  • ||

    I'll take Job B all else being equal.



    Well, a lot of people make that tradeoff in a marriage, with one partner taking the outside consultant job with no benefits, and the other taking the job with benefits.

  • ||

    "There is NO reason the employer should be involved in a family's health insurance. None."

    Freedom of association? Choice?

  • ||

    I love this new deal about sneering at the Constitution and the idea of limited government. Yeah. Just what do you people think protects us from tyranny? Authoritarian governments have been the norm in history. We (including other liberal nations existing today) are the freakin' exception.

  • LeeJoe Cruz||

    My salary overseas, was of course legal plunder. Borrowing money to build billion dollar bases so that million dollar planes can drop 100,000.00 bombs on mud and earth houses and kill goat herders is not legitimate defense. The Entire DOD in it's existance is not Constitutional either. So yes, it's plunder. The Federal Government will use coercive force to extract wealth from the citizenry to pay for "National Defense."

  • ||

    While I know the Constitution "Blows," it in no means gives the Federal Government the right to regulate Healthcare.

    General Welfare clause. Commerce clause. Necessary and proper clause. 16th amendment.

    These are the things that let the federal government do damned near whatever it wants.


    Fine. So by your argument Nick, there's no problem with eliminating the special tax break for employer-insurance then, or treating individual-bought insurance the same?

    How about just a tax break that does not involve incentives to do what the government wants you to? With tax incentives people who want to participate are rewarded and those who do not are punished. This is the tax break scam.

  • ||

    I love this new deal about sneering at the Constitution and the idea of limited government. Yeah. Just what do you people think protects us from tyranny?

    That's cute.

  • Gunboat Diplomacy||

    A voucher? Are you kidding me? Every day I watch idiots who can't even pay their bus fare without staining their minds to the brink of implosion and you want to give them a voucher for their healthcare?

    Good luck with that.

  • kilroy||

    "Freedom of association? Choice?

    I included the quote in that message for the context. Maybe you should read it again.

    Freedom of association? You mean like employers being allowed (and subsidy encouraged) to pool employees into associations to leverage insurance purchases while that same freedom is denied in general?

    Choice You mean the choice of taking what your employer gives you or paying much more on the open market where it's not subsidized? Or the "choice" of staying with your employer because your pre-existing condition won't transfer to a new insurer at a new job?

    I'm all for freedom of association and choice. For everyone not just employers.

  • ||

    Yes, kilroy and John Thacker. I do not want special tax benefits for an employer. I would love to see the tax breaks for everyone. I'm just saying there's no reason to prohibit an employer from giving you anything you agree to accept, which is how some people are making it sound.

    Or maybe my reading comp sucks.

  • Fletch||

    mark (and others)

    Here is a site where you can compare the various health bills before Congress (I like HR 3400/Rep Tom Price).

  • ||

    A number of people here questioned the need for vouchers versus just having people pay for insurance outright. I'm guessing here, but I believe the idea is to prevent people from spending the money on something else and then still bitching about how they don't have health insurance and demanding that ***someone*** pay their medical bills.

  • ||

    Here's a question: Is unlimited government bad if the Republicans are calling the shots?

  • ||

    "I do not want special tax benefits for an employer. I would love to see the tax breaks for everyone. I'm just saying there's no reason to prohibit an employer from giving you anything you agree to accept"

    Nick,

    I think that's the same stance most people here have. I would also add that getting health insurance from your employer is probably not a good choice (once the playing field is evened) for reasons of tying your health insurance to your current employer, but I see no reason to disallow/penalize further.

  • ||

    I do not want special tax benefits for an employer. I would love to see the tax breaks for everyone. I'm just saying there's no reason to prohibit an employer from giving you anything you agree to accept, which is how some people are making it sound.



    Great, we all agree then. Good to hear.

  • mark||

    I think we should just ban insurance, and force hospitals to offer "benefit plans" to patients. Same as insurance but more competition. Not sure how to solve the problem of moving to a competitor once you come down with an expensive condition.

    As an aside, a friend of mine got an x-ray from a guy who runs a "mobile x-ray" service out of his van. He waived the charge but she still had to get a prescription from a doctor for $90. Not fair.

  • ||

    I think we should breed a race of clone slaves, train them in medicine, then give each family a clone slave doctor of their very own. Yes, you'd have to feed, clothe, and house him, but that would be cheaper than maintaining health insurance. We'd still have to pay for the equipment and medicine, but I think that would be manageable if we had millions of clone slave doctors.

    Oh, and when the clone slave doctors aren't treating you, they can clean and cook. Man, there's just nothing wrong with this idea, is there?

  • ||

    I think we should breed a race of clone slaves, train them in medicine, then give each family a clone slave doctor of their very own. Yes, you'd have to feed, clothe, and house him, but that would be cheaper than maintaining health insurance. We'd still have to pay for the equipment and medicine, but I think that would be manageable if we had millions of clone slave doctors.

    Oh, and when the clone slave doctors aren't treating you, they can clean and cook. Man, there's just nothing wrong with this idea, is there?


    One improvement - clone slave neanderthal doctors.

  • alice bowie||

    Mark
    I think we should just ban insurance, and

    We would then have to bail out the insurance industry

  • ||

    Good idea. 'Cause we know we can kick Neanderthal ass in the event of a slave rebellion. We made 'em extinct last time, after all.

  • ||

    I would prefer not to be cloned thanks, unless you supply a corresponding supply of Raquel Welch and Barbara Bach clones.

    And a corresponding number of clubs :-)

  • ||

    Second "supply" shoud be "number"

    UG! Gieco lied....ARRRRGH (smash)!!!!!

  • ||

    And I don't do windows either (broken window fallacy).

GET REASON MAGAZINE

Get Reason's print or digital edition before it’s posted online

  • Progressive Puritans: From e-cigs to sex classifieds, the once transgressive left wants to criminalize fun.
  • Port Authoritarians: Chris Christie’s Bridgegate scandal
  • The Menace of Secret Government: Obama’s proposed intelligence reforms don’t safeguard civil liberties

SUBSCRIBE

advertisement