Saturday, February 23, 2008

Clinton vs. Obama on Health Care

I was listening to the Clinton/Obama debate last night and was struck by their slight difference on health care policy. The key difference seems to be that Obama does not have a mandate for everyone to purchase insurance while Clinton would.

Couple issues here. First, I just cannot understand why people would think that mandating health care coverage is such a great thing. I can understand a desire to subsidize it, a la Obama, but if someone doesn't want to spend their money on health insurance, why should we force them to? (By the way, what will the penalty be? Will we incarcerate someone for not buying health insurance?)

There could be "reasonable" arguments here, but I don't think any of them explain Clinton's position. One, we could fear our own self-control, so that if an uninsured person gets sick, we will not let them go without care but would pay for it. I don't think this is a reasonable argument and I don't think it is why the mandate idea appeals to so many people. Second, one could raise an adverse selection argument, saying that if people can opt out, then the healthy will opt out leaving only the least healthy in the pool, causing a classic "lemons" problem that can cascade and cause the insurance market to not function. This story has no support from the working of health insurance markets generally, and again, I don't think it is what explains the support for mandates.

I think what explains the support for mandates is the usual liberal belief that people do not make good decisions and need to be protected from themselves, along with an embarrassment that liberals feel when talking to Canadians and Europeans who tout their universal health coverage. "How can you live in a country where some people do not have health coverage?" Gosh, that is almost as bad as living in a country that lets people carry guns for self defense.

1 comment:

Doreen said...

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