Pelosi's brand spanking new slogan for the recess
Pelosi provided House Democrats with talking points to take back to their districts. The headline — "Health Insurance Reform to Hold Insurance Companies Accountable" — showcased Democrats' stepped-up efforts to cast insurance companies as villains in the debate, as polls show a public increasingly wary of the health care effort.
Even a simple soul like me knows that you can't just switch on populist rhetoric like a light switch. You've got to prepare the ground in some way!
Anyhow, "holding the insurance companies accountable" is a vacuous slogan no matter what. Voters can hold their elected representatives accountable through elections, one hopes, but people can't hold insurance companies accountable through the market* because the market is broken. Krugman the economist:
There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.
This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.
This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.
The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.
You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.
Between those two factors, health care just doesn’t work as a standard market story.
Now, the argument now doubt is that the bills on offer will provide "tough regulations" for the insurance companies. But the tip-off is the weakness of the ombudsmen in the bill; they have no conflict resolution powers. So how and to whom do patients appeal?
So, prepare yourselves for reams of "progressive" bloviation on the Democrat's new found spine, etc. Yay!
NOTE * An odd locution anyhow....