by publius
One of my hobbyhorses of late is to illustrate – at the institutional party level (i.e., the “sphere”) – that progressive policies are simply superior to conservative ones at this point in history. It’s not merely that I subjectively prefer the former, or that the dueling policy approaches present equally plausible options. It’s that recent events have vindicated progressive assumptions of the world, and illustrated why modern conservative policies are often based on factually inaccurate – or dreamworld – assumptions about how the world actually works. See, e.g., global warming, stimulus effectiveness, financial bailout, etc.
Today, let’s add high-risk pools to that list, because they illustrate this larger point perfectly. Yesterday’s WP examined Minnesota’s high-risk pool and explained why programs like these are central to McCain’s health care “policy.”
Here’s the nickel version. McCain’s proposal seeks to push more people into individual plans (rather than employer plans). The problem, however, is that lots of people would be disqualified on the individual market on the basis of, say, pre-existing conditions. In response, some states have established programs where the government subsidizes insurance companies to take on these higher-risk, high-cost individuals. McCain has made these pools a lynchpin of his larger plan – indeed, he has to, given that he’s otherwise doing literally nothing for people with pre-existing conditions. (Jonathan Cohn has a more extensive background on these programs here).
Sounds not terrible, right? Well, wrong. These high-risk pools are essentially big jokes. More precisely, the idea that high-risk pools adequately deal with the needs of the uninsurable is a joke. And it’s a joke for two reasons – (1) they have proven wretchedly deficient in practice; and (2) they are also a conceptually flawed idea. I’ll examine both after the jump. Take it to the chorus.
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