Reverse Stone Soup Saves Lives!

by Will Wilkinson on December 15, 2009

Julian Sanchez finds the sausage unpalatable:

As I understand the current state of play, we willstill have a mandate and a “non-discrimination” rule, which more or less abandons any pretense that insurance is about managing risk (which is to say, that it’s actually insurance).  In other words, we’re eliminating the rationale for the role private insurance companies play in our system, but insisting that it continue to revolve around them and, even better, handing them an enormous subsidy.  But we’ve eliminated the counterweight [the "public option"] designed to check costs, because that part, according to a logic I completely fail to fathom, is especiallysocialist.

What’s remarkable about this is how naked and brazen it is. That is, I can’t come up with any remotely coherent pretext for thinking this particular policy combination makes sense. Which isn’t to say the same system with the public option was much more coherent.  Contemplate how extraordinary that is: There’s almost always at least some fig leaf of an ideological principle or an economic argument strung up in front of even the most naked interest group grab.  But nobody seems to be even pretending this compromise amounts to anything but an open bribe to the very insurers whose existence it renders unjustifiable.

[...]

If there’s a coherent defense that could  be made of this particular Frankenstein—that is, a policy defense, not the obvious realpolitik explanation—I’d be curious to hear it.

Julian’s not the only one who feels this way.  Last night, Markos Moulitsas Twittered: “Insurance companies win. Time to kill this monstrosity coming out of the Senate.” But Ezra Klein disagrees. Here’s his apology for the monstrous frankensausage:

The core of this legislation is as it always was: $900 billion, give or take, so people who can’t afford health-care insurance suddenly can. Insurance regulations paired with the individual mandate, so insurers can’t discriminate against the sick and the healthy can’t make insurance unaffordable by hanging back until the moment they need medical care. The construction of health insurance exchanges so the people currently left out of the employer-based market are better served, and the many who will join them as the employer system continues to erode will have somewhere to go.

But are the benefits of this bill greater than its costs? Once one raises the question, I think it’s easy to see that the answer can be “Yes” only if one imagines that the benefits will be enormous. In that light, I think we can see more clearly why Ezra has felt it necessary to rely on the flabbergasting claim that over 100 thousand people will die in the next decade if this legislation fails. Indeed, mass theft on behalf of insurance companies does looks pretty good next to mass death.

I can offer no better summation than IOZ’s:

So I guess village blurgher Ezra Klein called Joe Lieberman a senatorial version of Dan Burros and then some other dude atThe New Republic suggested that Lieberman was a bad Jew because he couldn’t do arithematic, or something. Blog! Well, the occasion sent me skimming through Mr. Klein’s recent output, and it is striking how it tells the famous tale of stone soup in reverse . . . except somehow the moral remains the same. Basically, everyone starts out with a big pot of delicious hearty soup, and then all the residents of the village stop by and scoop out all the good stuff, and what’s left is a half-full pot of rancid water and a hunk of rock. Delicious! Or, at least,better than nothing.

Well this is the partisan rearguard’s answer to everything, isn’t it. Better than nothing!

Better than a Silverdome of uninsured corpses, eh?

  • mk
    we’re eliminating the rationale for the role private insurance companies play in our system, but insisting that it continue to revolve around them and, even better, handing them an enormous subsidy.

    Is this really so hard to understand?

    Liberals want to kick private insurers out of the health care system.
    But, private insurers have lots of money and own some senators.
    So, liberals can't quite get what they want.
    Instead they want to get there in stages. In this bill, they will make private insurance companies irrelevant via regulation.
    Someday in the future they will want to take the next step of kicking private insurers out the door for good, on the pretext that "they serve no good purpose."
    Private insurers know this is the liberals' plan, so they want to be bought out in order to agree to even a step in that direction.
  • billgardner
    Well put.
    And so terribly sad.
  • Noah Yetter
    The real trouble is Ezra only goes 1 for 4 in that little excerpt.
    1. Yes, the exchanges will probably help people in the individual market
    2. No, discriminating against sick people is not a bad thing for an INSURANCE company to do, as Julian points out. You think Progressive will insure your car that you wrecked yesterday?
    3. No, the mandate will not stop healthy people from gaming the system. The penalty can be waived who it would affect, and is otherwise far too small to be effective.
    4. No, we will not get $900 billion of health care for people who were not previously getting any. A) we will spend, much, MUCH more than that and B) a great deal of it will go to subsidize those who are already well off and well cared for.
  • "Indeed, mass theft on behalf of insurance companies does looks pretty good next to mass death. "

    Well, either that, or compared to the crap that people have to go through now - I'm sure you've heard the argument that the current of affairs is so horrendously awful, than almost anything would be better than the status quo. I think I've seen Yglesias make a claim like that once before. Or if you have felt, or known people that have gone through the worst aspects of our current healthcare system (The "view from your sickbed" series of posts over at Andrew Sullivan's illustrate this piont) it's possible to think this frankensausage is worth something at least - maybe not "enormously" better than the status quo, but still better even if only marginally because there is hope for "more change" in the future. The thinking may go something like "we didn't stop at Medicare, so we can change more in the future too." I think Ezra is one of those that thinks this bill is worth it. You know, the name "bleeding heart liberal" is there for a reason
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