Paul Krugman: Afflicting the Afflicted

http://www.nytimes.com/2010/02/26/opinion/26krugman.html

If we’re lucky, Thursday’s summit will turn out to have been the last act in the great health reform debate, the prologue to passage of an imperfect but nonetheless history-making bill. If so, the debate will have ended as it began: with Democrats offering moderate plans that draw heavily on past Republican ideas, and Republicans responding with slander and misdirection.

(snip)
What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.

(snip)
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.

(snip)
But Democrats can have the last laugh. All they have to do — and they have the power to do it — is finish the job, and enact health reform.

If, for some strange reason, farmers weren't allowed to sell food to other states, the fear of competitive deregulation would be perfectly valid - but the best solution wouldn't be to maintain the status quo. The best solution would be to allow them to sell across state lines AND create federal food safety regulations that make sure farmers don't break below whatever the minimum necessary standards are. I mean, hell, the FDA didn't always exist, and I don't think anyone ever said, "You know, there are some snake oil salesmen out there committing fraud. We should end their ability to sell their products in other states." They said, "Hey, we should establish some drug standards that are applied everywhere."

They're trying to create insurance regulation standards as part of this health care reform bill, but Republicans oppose them. Obama has said it's fine if we open up sales across state lines, but we've got to have regulation to make sure companies don't set up shop in a state with no regulation and sell people crap. Which is exactly what the Republicans want.

But without the exchange, each individual in one state might be suspectable to laws of another state....that's why the Republican way of doing this doesn't make sense, and the way the Democrats are doing it, via the exchange, makes perfect sense.

The President discussed that at length today. Did you watch? :shrug: