There’s a way to get health insurance for tens of millions of uninsured Americans, at virtually no cost to taxpayers. Let’s pull back from the precipice, and compromise. Democrats in Congress are careening toward a massively expensive government takeover of health care which would be very difficult to repeal in the future, while Republicans have not yet embraced any plan that would make a big dent in the number of uninsured Americans. It would only take one Democratic U.S. Senator to force a compromise.
Here’s how it could be done. Adopt a plan that only expands "catastrophic" health insurance coverage to more people, rather than expanding routine and preventive insurance coverage to more people. Catastrophic policies are much cheaper, and people can always choose to supplement the catastrophic policies, or instead pay for preventive and routine care out of pocket. The way to finance the expanded catastrophic health insurance coverage for tens of millions of Americans is simple: require each uninsured person to find and buy a catastrophic policy he or she likes and can afford. In this way, much can be accomplished without any subsidies, vouchers, taxes, or the like --- all of which should be removed from the legislation.
As a society, we already have individual mandates that require people to buy a lot of stuff. For example, people have to buy car insurance to go driving, and even have to buy clothes to go walking around in public. Telling uninsured people to get basic catastrophic health insurance is not a big leap, and would reduce the societal cost of treating uninsured people who suddenly need health care. Moreover, since the catastrophic policies are relatively cheap, the individual mandate can be applied to millions more people.
Some constitutional scholars have questioned whether the federal government really has legitimate power to impose an individual mandate like the one that is already in the Democratic legislation. But virtually no one disputes that the individual states have that kind of power, and so Congress could propose an interstate agreement to get this done. Neither the states nor the federal government would have to lay out any money, except for minor administrative costs. And if some states are reluctant to go along with such an agreement, well, Congress has experience persuading and incentivizing states to do things that they might not otherwise do.
Health insurance is a complicated issue, but there are some simple solutions, and this is one of them. Best of all, it’s cheap, and the present state of our economy cannot really withstand anything more. Since we already have a Medicare program for the elderly and a Medicaid program for the poor, it’s doubtful that American taxpayers would really want to do much more even if the economy were thriving.
While requiring coverage of pre-existing conditions is well-intentioned, it would have unintended effects. For instance, people who now have expensive health plans might simply drop them, secure in the knowledge that they could always sign up again after a sickness or injury strikes. Many other provisions in the current legislation would also have unintended effects. Let's just make the plan simple and affordable, and postpone debate about Democrats' loftier goals until the economy has recovered, and unemployment is half what it is now.