Politics = Inertia (Let the patient be damned!)

There's a concept in healthcare insurance where all risks in a community of interest, a market, are pooled - community rating; and then there's experience rating where the healthy are advantaged in more ways then one and the sick are marginalized, paying disproportionately more into the pool just to have a seat at the table.

There's a concept in healthcare insurance where all risks in a community of interest, a market, are pooled — community rating; and then there's experience rating where the healthy are advantaged in more ways then one and the sick are marginalized, paying disproportionately more into the pool just to have a seat at the table. The latter is what we mean by 'a medical catastrophe is one step from personal bankruptcy.' It also explains Paul Krugman's recent remarks about the hit that healthcare reform took in Massachusetts:

"Suppose, for example, that Congress took the advice of those who want to ban insurance discrimination on the basis of medical history, and stopped there. What would happen next? The answer, as any health care economist will tell you, is that if Congress didn’t simultaneously require that healthy people buy insurance, there would be a 'death spiral': healthier Americans would choose not to buy insurance, leading to high premiums for those who remain, driving out more people, and so on."

Krugman P. "Do the Right Thing." NY Times Published online: January 21, 2010

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Jessie McKinley writes in the NY Times, January 22, 2010, "California Democrats Revive Universal Health Plan." That is, democrats in California revived a bill yesterday that would create a single-payer, universal healthcare system in that state.

On Jan 22, 2010, at 2:25 AM, Fredrick H (MD, PhD, Esq.) wrote:

It really can't be done right without incorporating Medicare, but it's not going to be done right at the Federal level, so it's good that the states do what they can.

It's also good that it's not a hand-off to the Insurance companies, which is the plan that so alienated the Mass. voters.

Fredrick