Ezra Klein: President Obama should not apologize

Posted by AzBlueMeanie:

All this faux outrage from the conservative media entertainment complex and Tea-Publican politicians over insurance cancellation notices is a disgusting spectacle to behold.

Essentially what the right-wing is arguing for is continuation of the status quo of a health insurance market that was completely broken. One where people were at the mercy of unscrupulous insurance companies who would sell you a crappy health insurance policy with a low premium, but with high out-of-pocket costs and no coverage for serious illness or medical procedures, preexisting condition exclusions, annual limits — and frequently cancelled after its term of one year expired. Consumers with a pre-exisitng condition were uninsurable at any price.

In essence, the right-wing is defending health insurance consumer fraud and victimizing consumers. The fact that some people are happy with being victimized by insurers with a crappy health insurance policy and no coverage speaks more to their shortcomings — "please take my money for nothing in return, i love throwing my money away!" These are not the kind of people who should determine sound public policy.

Ezra Klein argues Obama shouldn’t apologize for blowing up the terrible individual market:

NBC's Chuck Todd asked President Obama about the people losing their
health insurance despite his promise that "anyone who likes their plan
can keep it." (See the video and read the transcript here.)

"I am sorry that they are finding themselves in this situation based on assurances they got from me," Obama replied.

The answer is a bit of a dodge. People aren't finding themselves in
this situation based on the president's promises. They're finding
themselves in this situation based on his policy. And Obama isn't
apologizing for the policy.

"Before the law was passed, a lot of these plans, people thought they
had insurance coverage," he said. "And then they'd find out that they
had huge out of pocket expenses. Or women were being charged more than
men. If you had preexisting conditions, you just couldn't get it at
all."

Obama was wrong to promise that everyone who liked their insurance
could keep it. For a small minority of Americans, that flatly isn't
true. But the real sin would've been leaving the individual insurance
market alone.

The individual market — which serves five percent of the population,
and which is where the disruptions are happening — is a horror show.
It's a market where healthy people benefit from systematic
discrimination against the sick, where young people benefit from
systematic discrimination against the old, where men benefit from
systematic discrimination against women, and where insurers benefit from
systematic discrimination against the uninformed.

The result, all too often, is a market where the people who need
insurance most can't get it, and the people who do get insurance find it
doesn't cover them when it's most necessary. All that is why the
individual market shows much lower levels of satisfaction than, well,
every other insurance market.

Those numbers, of course, don't include the people who couldn't get
insurance because they were deemed too sick. Consumer Reports put it unusually bluntly:

Individual insurance is a nightmare for consumers: more
costly than the equivalent job-based coverage, and for those in
less-than-perfect health, unaffordable at best and unavailable at worst.
Moreover, the lack of effective consumer protections in most states
allows insurers to sell plans with ‘affordable’ premiums whose skimpy
coverage can leave people who get very sick with the added burden of
ruinous medical debt.

This is the status quo that Tea-Publicans want to continue. They want insurers to be able to continue to victimize consumers.

This is a market that desperately needs to be fixed. And Obamacare
goes a way toward fixing it. It basically makes the individual market
more like the group markets. That means that the sick don't get charged
more than the well, and the old aren't charged more than three times as
much as the young, and women aren't charged more than men, and insurance
plans that don't actually cover you when you get sick no longer exist.
But the transition disrupts today's arrangements.

(Interestingly, recent Republican plans
have focused on disrupting the employer market by ending, limiting, or
restructuring the tax exclusion for employer-based plans. There's an
extremely good case to be made that that needs to be done, but it means
much more disruption for a much larger number of people. Obamacare's
focus on disrupting the individual market — and only the individual
market — is a more modest approach to health-care reform.)

There's been an outpouring of sympathy for the people in the
individual market who will see their plans changed. As well there should
be. Some of them will be better off, but some won't be.

But, worryingly, the impassioned defense of the beneficiaries of the
status quo isn't leavened with sympathy for the people suffering now.
The people who can't buy health insurance for any price, or can't get it
at a price they can afford, or do get it only to find themselves
bankrupted by medical expenses anyway have been left out of the sudden
outpouring of concern.

If people have a better way to fix the individual market — one that
has no losers — then it's time for them to propose it. But it's very
strange to sympathize with the people who've benefited from the noxious
practices of the individual market while dismissing the sick people
who've been victimized by it.

Obama is rightly taking flack for making a promise he wasn't going to
keep, and he's right to apologize for it. But he shouldn't apologize
for blowing up the individual market. It needed to be done.

What gets lost in the media hysteria is that health insurance policies are for a term of one year, and in the individual market they are a unilateral contracts, the terms of which are exclusively determined by the insurer — there is no negotiation and a meeting of the minds in a bilateral agreement. It's take it or leave it. And that insurance policy and/or rates changes every year. The private market is subject to "churn," there is no guarantee of continuity. That is why President Obama should not have said "anyone who likes their plan
can keep it." Any reasonably informed consumer knew this was not possible — so they had no reasonable expectation of reliance on this statement.

The conversation that we should be having today is the need for more insurance regulation and more effective enforcement against unscrupulous insurers who have long engaged in consumer fraud victimizing consumers. State insurance department regulations and regulators are weak and ineffective. State attorney generals rarely pursue consumer fraud claims against insurers.

Instead, we are subjected to this spectacle of media villagers turning this insurance reform argument on its head, and who are defending the status quo of health insurance consumer fraud and victimizing consumers. Ask yourself whose side these media villagers are on — certainly not yours as an insurance consumer.