From the midweek edition of the Morning Jolt:
Obamacare Is ‘Bro’-ken Beyond Repair
Most Americans don’t like thinking about health insurance. If you’re thinking about it, usually it means something’s gone wrong. The best-case scenario is that you’ve gotten sick or injured, and the health insurance pays for the treatment. The worse scenario is that you’re fighting with them to get them to cover the costs of your treatment.
There’s a reason most Americans were comfortable, if not thrilled, getting health insurance through their employer: The choices are limited, and it’s easier to pick among three plans offered through your employer than the multitude of plans offered on the market. There’s a school of thought that while we like a lot of choices in theory, in practice we find too many options confusing and get paralyzed by indecision.
If I offer you a choice of two movies to watch tonight, you can pick pretty quickly. Yet if we start looking at the On Demand options, we will scroll and scroll and scroll and “how about that one? No?” and scroll and scroll and FOR GOD’S SAKE, HONEY, JUST PICK A MOVIE ALREADY I DON’T EVEN CARE ANYMORE — er, sorry, just lapsed into old habit there.
The point is that many people find making a decision more difficult when they have a lot of choices. I just plugged information into ehealthinsurance.com and found 18 plans priced from about $500 to $1500 per month. Picking a plan requires evaluating trade-offs (Do I want a higher monthly premium in exchange for a lower deductible?) and weighing a lot of unknowns (Am I going to need a lot of coverage in the future? What if I pay a lot and never need it? What if I don’t reach my deductibles most years?).
A while back, liberal blogger Kevin Drum acknowledged the emotions that drove much of the health-care debate in this country for the past decades:
Let’s be honest. What we all want is unlimited access to medical care; unlimited access to any procedure we want no matter how pricey; unlimited choice of physicians; instant availability of doctors every time we get an ear ache; and we’d like all this for free. That’s what we want. And we’re annoyed when we don’t get it.
This means that we’re always going to be annoyed no matter what kind of healthcare system we have. And guess what? That’s true. Surveys from around the world prove it. In pretty much every country, people complain about their healthcare systems. Americans generally complain more than most, which makes sense since our healthcare system is so bad, but it’s only a matter of degree. The truth is that healthcare is just a tough nut to crack and sick people are cranky. No one is ever going to be satisfied, not with the status quo or with any conceivable replacement.
Thus, to build the political momentum to pass the bill, Obama and his allies had to promise something close to the ideal of all upside and no downside. Charlie Cooke remembers:
Obamacare, recall, was sold with a specific set of political promises: The new regime, advocates insisted, would reduce the deficit, cover the needy, and reduce total health spending — all while lowering the premiums of those who were already insured. Back in 2007, when Obama was running for the Democratic nomination, he introduced what was then an embryonic proposal with the quixotic assurance that, “if you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums.” Then he adumbrated what would happen to the “amount of money” that Americans would “spend on premiums.” “That will be less,” Obama told anybody who would listen.
That is why Obamacare is truly destined to fail. It’s not just a website; it’s a series of ultimately contradictory promises. And its most nominal form of success — avoiding the death spiral — hinges on two extremely big gambles. The first is that most Americans will warmly embrace the process of comparison-shopping for health insurance.
The second is persuading young invincibles to buy insurance.
Behold, a new web ad from Colorado Consumer Health Initiative and ProgressNow Colorado Education:
Oh, and if I were setting up a system that absolutely, positively depended upon getting young people to buy insurance . . . I would not have included a provision that requires plans to cover children until they’re 26.