An Analogy With Holes Like...

>> Tuesday, September 08, 2009

Matt may well be right that whatever bill that emerges from Congress will be enough of an improvement over the status quo to be worth supporting. His claim, however, that the Baucus bill "would create something comparable to the situation that currently prevails in Switzerland" is deeply problematic. There are, first of all, questions about whether the regulatory controls on private insurance would be comparable, which can't be answered until we see the final bill, but I'm not terribly optimistic. Even more important, however, is the fact that the Swiss system bans for-profit insurance carriers from participating in the basic system. This is really a difference in kind, not degree: obviously, if you take most of the no-value-added corporate looting out of American health care a mandate-subsidize-and-regulate private system would be a massive improvement, but to put it mildly this would not be the result of the Baucus bill. (Indeed, depending on the details the corporate looting could well get worse.) Although worse than single-payer countries, the overhead costs in Swizterland aren't outrageous -- "administrative and profit-margins account for about 5 percent of premiums." A Baucus system, however better than the status quo, really wouldn't be much like the Swiss system.


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