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I have not heard that catastrophic coverage is banned by the bill, but the end of this sort of insurance is implied because of adverse selection. Either "insur

I have not heard that catastrophic coverage is banned by the bill, but the end of this sort of insurance is implied because of adverse selection. Either "insurers cannot refuse coverage" will have exceptions, or reduced cost/reduced benefit programs have to go. Maybe it will take a year or two before the "quality standards" get enacted, but I can't see it not happening. I don't care about the people who choose to go without health insurance to save money. I wind up paying for them when they get hit by a car, when their appendix bursts, when they have a freak aneuryism, or when they fall down their stairs. People go without health insurance because it is incredibly expensive. For a lot of people it is a crappy deal, or just flat out unaffordable. It is interesting how people who thought they couldn't afford health insurance used to be portrayed as victims. Now they're the bad guys, they broke the system for everyone else, and you don't need to care about them. What a difference two years makes.

tptacek 17y ago
I don't understand how your logic follows. There are no rules in the Senate bill that cap premiums, or establish floors for the premiums of high deductable insurance. Won't adverse selection drive down the cost of high-deductable insurance as it becomes a proxy for "insurance for 20-30 year olds unlikely to make claims"? If you can afford health insurance, and health insurance is available to you, and you decide not to buy it because you're 25 and you don't think you'll need it, you don't deserve my sympathy. If you can't afford health insurance, you deserve whatever we can do to make health insurance affordable to you. Please don't try to drag me into identity politics. This isn't a "rich vs. poor" issue.
- mattchew 17y ago
  If the rule is cannot deny coverage, high risk people will buy the cheap policy and then switch when they need the expensive benefits. For that matter low risk people will switch if they roll snake-eyes and need to schedule something expensive like reconstructive surgery. This is essentially the same adverse selection logic that justifies the mandate. * People choosing to buy or not buy insurance has gotten reframed, and I find it interesting to see how effectively the switch took place. In 2008, your hypothetical 25 year old would have been portrayed as a victim, if anything. Screwed over by the greedy health insurance companies who make it impossible to get decent coverage at a reasonable price. In 2010, he's the bad guy. It's his fault the system is broken. He is morally obligated to buy that health insurance now, and if he argues that he's getting a crappy deal for what he is paying, it's him who is being selfish and greedy. There are certainly identity politics tangled up in health care reform, but I was talking about the reframing of an issue and fickle public opinion.

tptacek 17y ago

I don't understand how your logic follows. There are no rules in the Senate bill that cap premiums, or establish floors for the premiums of high deductable insurance. Won't adverse selection drive down the cost of high-deductable insurance as it becomes a proxy for "insurance for 20-30 year olds unlikely to make claims"? If you can afford health insurance, and health insurance is available to you, and you decide not to buy it because you're 25 and you don't think you'll need it, you don't deserve my sympathy. If you can't afford health insurance, you deserve whatever we can do to make health insurance affordable to you. Please don't try to drag me into identity politics. This isn't a "rich vs. poor" issue.

mattchew 17y ago
If the rule is cannot deny coverage, high risk people will buy the cheap policy and then switch when they need the expensive benefits. For that matter low risk people will switch if they roll snake-eyes and need to schedule something expensive like reconstructive surgery. This is essentially the same adverse selection logic that justifies the mandate. * People choosing to buy or not buy insurance has gotten reframed, and I find it interesting to see how effectively the switch took place. In 2008, your hypothetical 25 year old would have been portrayed as a victim, if anything. Screwed over by the greedy health insurance companies who make it impossible to get decent coverage at a reasonable price. In 2010, he's the bad guy. It's his fault the system is broken. He is morally obligated to buy that health insurance now, and if he argues that he's getting a crappy deal for what he is paying, it's him who is being selfish and greedy. There are certainly identity politics tangled up in health care reform, but I was talking about the reframing of an issue and fickle public opinion.