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Bobby Jindal takes to the pages of today's Washington Post to argue that:

A majority of so-called Republican strategists believe that health care is a Democratic issue. They are wrong; health care is an American issue, and the Republican Party has an opportunity to demonstrate that conservative principles work when applied to real-world problems.

I agree with Jindal about that, but the problem with the 10 solutions he offers in his article, is that they don't really conform with conservative principles. Or more accurately, his proposals are a grab bag, with a little bit of everything but no unifying vision.

Some of his ideas, such as allowing purchasing pools, making policies portable, increasing transparency, reforming the legal system, and expanding HSAs would be aimed at creating a free market for health care in this country. Yet several of his other ideas involve more government regulation. One involves "permitting young people to stay on their parents' plans longer..." But this is nothing new, these so-called "slacker mandates" already exist in 17 states, and they involve government forcing insurers to allow adults to stay on their parents policies, in some cases as late as 30 years old. A better way to encourage younger people to get insurance is not through more mandates, but less mandates, which would allow them to purchase cheaper, more basic health insurance plans.  

A more problematic part of Jindal's article is his endorsement of a requirement forcing insurers to cover everybody with pre-existing conditions. Whatever you may say about such a requirement, it's completely inconsistent with conservative principles. The problem is that you can't enact such a policy in isolation. If the government requires insurers to cover everybody who applies, then it will also have to cap the price of insurance so that insurers can't just say, "sure, we'll cover you -- for $5,000 per month." But taken together, these two policies -- known as "guaranteed issue" and "community rating" -- have had disastrous implications at the state level. While those with pre-existing conditions can now get "affordable" insurance, the price of insurance skyrockets for healthier individuals. Given that insurers can't deny anybody coverage, people decide -- quite rationally -- that they may as well wait until they get sick to purchase insurance. The result is that healthy people exit the insurance market, and insurers flee to avoid getting stuck with disprortionately sick patients. But instead of learning their lesson, the response by policy-makers is to advocate expanding the role of government even more. Healthy people cant exit the market, policymakers argue, if they're required by law to purchase insurance or pay a tax. The result is the individual mandate. However, government can't mandate health coverage if a lot of people still can't afford it -- so the answer becomes expanding Medicaid and introducing new subsidies for people to purchase insurance. And so on. The point is that government begets more government, and you can't simply embrace one aspect of the big government health care proposals while ignoring the obvious ramifications of such a policy.

So, in his effort to come accross as a pragmatist, Jindal borrows some ideas from each side of the debate and packages them together, but in practice, the ideas are completely incoherent.

I wrote about an alternative way of covering those with pre-existing conditions here.

View all comments (5) | Leave a comment

John - TMF| 10.5.09 @ 5:58PM

1. Only the healthy blow off the need for the acceptance of pre-existing conditions. Just like the thin have no problems denying the obese coverage... Just try to be a fat man at 50 and get health insurance (or any medically rated insurance for that matter... not gonna happen).

2. The reason why this battle is being fought is precisely what Governor Jindal points out. People would NOT feel compelled to look to government for help if they could actually purchase the products for themselves.

The assertion that the acceptance of preexisting conditions would require mandatory participation of everyone is a meme asserted by the insurance industry (whose hands are not at all clean in all of this...) sort of like if we have to cut the budget, we will have to cut it across the board... no more cops or firefighters... BOO!!!

Most states require insurance companies from employee health groups to cover previously covered pre-existing conditions. Insurance is still there and still provided in some measure by most employers.

The whole thing is a crock of hitahtah. The insurance industry in variously in bed with the Dems, the health Nazis, the drug companies, and the government in general. It's like the evil Emperor in Star Wars... its playing every side against the other one so that it might triumph for the conflict.

What is really the entire issue? It isn't the cost of what is going out... at 50 I have had enough experience with completely wasteful and idiotic insurance coverage decisions that cost far more money than it would have saved to have had them just cover things. Most are merely quasi-governmental bureaucracies anyway. There just never seem to be rational answers other than clerks and low level managers reading lines in contracts.

No one is "shooting straight on this one". One thing that I can tell you, is IF a form of universally purchasable, private insurance is not reliably available to EVERYONE, THEN this demand will be renewed and Socialized medicine will once again be a national issue.

The problem is not "HAVING HEALTH CARE INSURANCE"... the problem is "NOT BEING ABLE TO HAVE HEALTH CARE INSURANCE".

Jindal is attempting to address that key fear. Dismissing him with insurance industry propaganda is not going to solve the problem.

r/The Mighty Fahvaag

Martin j smith| 10.6.09 @ 7:29AM

For me the issue is free choice. I suspect the fear that inspires the bulk of opposition to Obama Care is taking free choice away and extensive government control of the whole system. And not all of these opponents are conservatives by the way. What is needed are ground rules that are transparent to all to address those areas that are in need of correcting. I strongly suspect the majority of American voters would NOT reject health care access ( Not just and Insurance card )
for all citizens ( notice that caveat ) as long as they have the ability to maintain control of their lives. That is key.

Damian| 10.6.09 @ 9:26AM

You can't be deigned coverage for a preexisting condition currently if you are on a group policy. Whats wrong with expanding that protection to individual policies?

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More Blog Posts by Philip Klein

http://spectator.org/blog/2009/10/05/jindals-incoherence-on-health

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