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.
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