Paul Krugman writes:
“No. 1,” declared Mitt Romney in Wednesday’s debate, “pre-existing conditions are covered under my plan.” No, they aren’t — as Mr. Romney’s own advisers have conceded in the past, and did again after the debate.
Was Mr. Romney lying? Well, either that or he was making what amounts to a sick joke. Either way, his attempt to deceive voters on this issue was the biggest of many misleading and/or dishonest claims he made over the course of that hour and a half….
So, about that sick joke: What Mr. Romney actually proposes is that Americans with pre-existing conditions who already have health coverage be allowed to keep that coverage even if they lose their job — as long as they keep paying the premiums. As it happens, this is already the law of the land. But it’s not what anyone in real life means by having a health plan that covers pre-existing conditions, because it applies only to those who manage to land a job with health insurance in the first place (and are able to maintain their payments despite losing that job).
Krugman is right, Romney’s ideas about what should be done with health care are a sick joke. But so are Obama’s and Krugman’s. (“Obamacare”, remember, which Krugman supports, was modeled on “Romneycare”.) Take this “law of the land” he refers to under which Americans are “allowed to keep that coverage even if they lose their job”. In fact, John C. Goodman points out in this paper in Health Affairs,
the thrust of federal law is to encourage health insurance that is not portable and discourage insurance that is….
In the main, insurance obtained through an employer is not portable, whereas insurance purchased by individuals is. Strangely, the tax law heavily subsidizes the former while giving very little tax relief to the latter….
If health insurance portability is desirable and if the tax law favors employer purchase, why don’t employers purchase individually owned (and therefore portable) insurance for their employees? The answer: Federal law makes this impossible, or at least impractical.
In his book, Priceless: Curing the Healthcare Crisis, Goodman writes:
In almost every state, employers are not allowed to buy the kind of insurance employees own and can take with them from job to job and in and out of the labor market. That prohibition needs to be rescinded. Most of the time, the problem of pre-existing conditions arises precisely because health insurance isn’t portable.
So we have a problem where federal law exacerbates the problem whereby people who change jobs lose their insurance coverage and, if they have developed a medical condition since they were hired at the first job, now have a “pre-existing condition” and cannot get coverage. But instead of fixing that problem, the Patient Protection and Affordable Care Act (ACA, a.k.a., “Obamacare”) simply decided to dictate to insurance companies that they must accept everyone, regardless of pre-existing conditions, which defeats the whole purpose of insurance. Imagine if the government was to dictate to fire insurance companies that they must provide coverage to people whose homes have already burned down.
This policy, of course, has unintended but predictable consequences. It incentivizes people to not purchase an insurance policy unless and until they get sick and forces insurers to raise premiums on everybody to cover the additional costs—precisely the opposite of the government’s ostensible goal of lowering costs and insuring more people. So what was the bureaucrats’ solution to the very problem they created with all their legislative bungling? Why, the individual mandate, of course! Which happens to be unconstitutional. But never mind that. Who cares about the Constitution, anyways?
Krugman’s conclusion is:
The fact is that Mr. Romney tried to mislead the public, and he shouldn’t be allowed to get away with it.
Indeed. But when Krugman tries to suggest to his readers that under existing federal law, employer-provided insurance is already portable and Americans can take it from job to job as long as they are willing to pay for it, he is guilty of the same.
For anyone wishing to learn more about the problems with the health care system in the U.S. and some ways to help solve it, I highly recommend Goodman’s book, Priceless: Curing the Healthcare Crisis. (And I’m not just saying that because if you purchase it by clicking this link, you’ll be helping a pal out because I’ll get a referral payment from Amazon.)