Critics of the American health care system must sometimes look like raving lunatics to those who work in the health insurance industry. Determining risk, offering only very expensive policies to those most apt to become sick, denying coverage to people with preexisting conditions, finding pretexts to deny life-saving treatments to policy-holders--well, what the hell do you expect them to do? They are private insurers and mean to turn a profit. That's how it's done. Why all the crazy talk about how "immoral" and "evil" they are? No one says that about auto insurance. But what, really, is the difference between figuring out who is likely to get sick and who is likely to crash a car? Actually, it's even crazier than that. All the talk about "preexisting conditions," for example--it's as if someone could get auto insurance today to cover an accident they had last week!
Now, even Republicans are willing, or say they are willing, to make it illegal for health insurance companies to deny coverage for preexisting conditions. That too must seem strange to those who work in the industry. It's as if conservative Republicans agree with liberal Democrats but are unwilling to pursue the line of thought to its logical end. If you allow that health care does not lend itself to markets and the profit motive, then there is no reason to preserve private insurance. You want them to stay in business but refrain from certain profit-maximizing practices? Then the government might as well do it.
James Surowiecki says it better than I.
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