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.
