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Cease Fire! Ezra Klein Agrees with Jane Hamsher!

There’s been a basic disagreement over progressive strategy on health reform in dealing with an overly compromising Administration. But what’s driving that is a debate over whether the resulting health reform bill is likely to end up being something that’s worse than having nothing.

On that point, it looks like Ezra Klein is (finally!) starting to see things the way Jane Hamsher does.

Jane’s arugment is that the continuously compromised bill without a public option alternative will force low- and moderate-income Americans to purchase unaffordable, "junk" insurance. But there will be no means to pressure the private insurance companies to improve their products or control the relentless rise in premiums.

Judging from this Klein post, it seems he’s reaching a similar conclusion, given that the Administration is reported to be looking for ways to substantially reduce the "costs" [narrowly defined as federal budget impacts] of the subsidies:

The most likely way is to reduce the subsidies so that the individual mandate isn’t really affordable. That seems to be happening even as we speak. At that point, reformers have two options, both of them bad.

The first option is to reduce the value of the minimum insurance policy such that buying something the government considers insurance isn’t very expensive. This means policies with high deductibles and co-pays, or policies that don’t cover very much. But asking someone with a relatively low income to purchase a policy with a $1,500 deductible and significant co-pays is asking them to purchase something they can’t really afford to use. So we’re making them spend $7,000 or $8,000 a year on something they don’t necessarily want and can’t really take advantage of. That’s a recipe for a huge backlash.

The second option is to drop the individual mandate altogether. Obama, who didn’t have a mandate in his campaign plan, might be amenable to this approach. But here, too, there are problems. The young, healthy risks will hang back from the system while the older, sicker risks will flood in to take advantage of subsidies and new regulations that stop insurers from discriminating against them. The risk pool will reflect that, and health-care insurance will become even more unaffordable for the people who need it. And because it’s less affordable because of the presence of the sick, it will become even less attractive to the healthy.

So isn’t he saying Jane’s right? Ezra says the WH seems to be moving towards forcing low- to middle-income to buy "junk" insurance that, even if they had it, they couldn’t afford to use it, because they couldn’t handle the deductibles/co-pays.

That means the likely result is a huge transfer of wealth — from over $1.3 trillion in new premiums — to the private insurers, as masaccio has described, with payment enhanced by federal subsdies, but without any guarantee that the newly "insured" folks get insurance worth paying for. Why should the country support that?

Ezra then gives us some "happy news." He says we could afford to pay for adequate subsidies, but unfortunately the WH and the "centrists" in Congress (for whom the bill is being compromised) are pushing for expenditure levels far below what would be needed for adequate subsidies. This is the "happy" news?

Welcome to our view of reality, Ezra.

More
:
Even David Brooks thinks the White House isn’t seriously pursuing fundamental reform. "If you’ve lost David Brooks . . ."
On the debate about progressive strategy . . .

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Cease Fire! Ezra Klein Agrees with Jane Hamsher!

There’s been a basic disagreement over progressive strategy on health reform in dealing with an overly compromising Administration. But what’s driving that is a debate over whether the resulting health reform bill is likely to end up being something that’s worse than having nothing.

On that point, it looks like Ezra Klein is (finally!) starting to see things the way Jane Hamsher does.

Jane’s argument is that the continuously compromised bill without a public option alternative will force low- and moderate-income Americans to purchase unaffordable, "junk" insurance. But there will be no means to pressure the private insurance companies to improve their products or control the relentless rise in premiums.

Judging from this Klein post, it seems he’s reaching a similar conclusion, given that the Administration is reported to be looking for ways to substantially reduce the "costs" [narrowly defined as federal budget impacts] of the subsidies:

The most likely way is to reduce the subsidies so that the individual mandate isn’t really affordable. That seems to be happening even as we speak. At that point, reformers have two options, both of them bad.

The first option is to reduce the value of the minimum insurance policy such that buying something the government considers insurance isn’t very expensive. This means policies with high deductibles and co-pays, or policies that don’t cover very much. But asking someone with a relatively low income to purchase a policy with a $1,500 deductible and significant co-pays is asking them to purchase something they can’t really afford to use. So we’re making them spend $7,000 or $8,000 a year on something they don’t necessarily want and can’t really take advantage of. That’s a recipe for a huge backlash.

The second option is to drop the individual mandate altogether. Obama, who didn’t have a mandate in his campaign plan, might be amenable to this approach. But here, too, there are problems. The young, healthy risks will hang back from the system while the older, sicker risks will flood in to take advantage of subsidies and new regulations that stop insurers from discriminating against them. The risk pool will reflect that, and health-care insurance will become even more unaffordable for the people who need it. And because it’s less affordable because of the presence of the sick, it will become even less attractive to the healthy.

So isn’t he saying Jane’s right? Ezra says the WH seems to be moving towards forcing low- to middle-income to buy "junk" insurance that, even if they had it, they couldn’t afford to use it, because they couldn’t handle the deductibles/co-pays.

That means the likely result is a huge transfer of wealth — from over $1.3 trillion in new premiums — to the private insurers, as masaccio has described, with payment enhanced by federal subsdies, but without any guarantee that the newly "insured" folks get insurance worth paying for. Why should the country support that?

Ezra then gives us some "happy news." He says we could afford to pay for adequate subsidies, but unfortunately the WH and the "centrists" in Congress (for whom the bill is being compromised) are pushing for expenditure levels far below what would be needed for adequate subsidies. This is the "happy" news?

Welcome to our view of reality, Ezra.

More
:
Jordan Rau/KHN (h/t Yglesias), Health Bills Might Not Protect Some . . .
Even David Brooks thinks the White House isn’t seriously pursuing fundamental reform. "If you’ve lost David Brooks . . ."
On the debate about progressive strategy . . .

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John has been writing for Firedoglake since 2006 or so, on whatever interests him. He has a law degree, worked as legal counsel and energy policy adviser for a state energy agency for 20 years and then as a consultant on electricity systems and markets. He's now retired, living in Massachusetts.

You can follow John on twitter: @JohnChandley