1. Freedom to choose what’s in your plan: Fortune & NRO worry that you’ll be forced to pay for a better, or worse, health plan than you want. First and foremost, that’s not right — any private plan you’re currently using would survive the creation of the “public option,” so it’s not clear how a government alternative would alter that. But as it stands now, most Americans get insurance through their employers, who offer between 1 and 3 plans at the beginning of employment. How much meaningful choice do you have, today, over the content of those plans?
2. Freedom to be rewarded for healthy living, or pay your real costs: apparently, several states set a range of possible charges for insurance plans, such that an ill person can’t be charged much more than a healthy person for insurance. We’re told this is evil — but isn’t it just the basic definition of insurance? Risk spreading? And few plans today, anyways, will give breaks to low-cost insureds who maintain a healthy lifestyle. Healthy policyholders are how insurance companies make money, making savings lost minimal.
3. Freedom to choose high-deductible coverage: This freedom may matter to richer people; but many Americans lack the freedom to enroll in any plan, at all. It’s true that the healthy and the reckless won’t be able to enroll in certain ultra-bare bones plans, but when these plans fail, it’s society that bears the cost, and is this such a loss, set against the gain of the many uninsured Americans who benefit from the option?
4. Freedom to keep your existing plan: NRO notwithstanding, under the health care bill, you can keep your old plan. S 102(a)(1)(A) preserves old plans effective when the bill is passed, as is, and affects subsequent private plans only by requiring them to meet minimum standards. Further, the mandatory improvements to care are sensible and helpful. Section 111, for example, bans discrimination against “pre-existing conditions.” This may not matter to some, but for those of us with even modest chronic conditions, this provisions makes a real difference. The “pre-existing condition” rule is the most commonly used weapon in the insurer’s arsenal: companies frequently try to deny coverage on its basis, even when a condition occurs within coverage.
To the extent that the bill would modify existing ERISA plans, too, NRO/CNN fail to mention that ERISA, like the public option, is a scheme that mandates minimum standards for employee plans. Government upwards modification of ERISA minima doesn’t preempt private schemes; it changes existing government standards, no private control lost.
5. Freedom to choose your doctors: here’s the kicker. No-one who has anything less than a “Cadillac” plan has the complete freedom to choose their doctors.
American health care is broken. It’s a deception to hold up the state of modern care as an ideal that stands to be broken.