Thursday, April 7, 2011

Predicting behavior under ACA

Not easy, as the case of high risk pools attests.

14 comments:

Patrick_L said...

It's interesting to note that high-risk insurance pools are a conservative policy idea, since it's the only way they can provide some form of health insurance to sick people without violating their opposition to several other policy ideas like an individual mandate. For instance, Peter Ferrara, who Professor Eismeier quoted earlier today on the blog, argued at a conservative health care conference I attended today that high-risk pools are one of several health policies conservatives should be pushing. (Ferrara has been associated with a variety of conservative think tanks throughout his career, including Cato and Heritage.)Liberals prefer alternatives to high-risk pools because of all the problems they have, which explains why PPACA only includes them until the exchanges are fully operational.

I think high-risk pools in PPACA show just how inclusive health care reform tried to be with conservative ideas, how flexible it is in achieving its many goals, and why current state policies like their own high-risk policies are unnaceptable long-term options. American health care needs serious reform.

TJE said...

Still, doesn't this spectacular failure to predict behavior give you pause about the obamacare technocracy?

Patrick_L said...

All it does is demonstrate that there is a great deal of uncertainty to any projections and predictions of this nature. There is a huge possible range of variation around what experts think is most likely to occur. This cuts both ways- some things are likely to turn out worse than predicted, while other things will likely turn out better.

TJE said...

Big gamble.

Patrick_L said...

And our current system isn't a big gamble? Our costs are growing fasther than other nations', while our system already costs nearly twice as much as our peer nations. Our systemwide health care costs make our economy uncompetitive as we dispense large portions of our national income on health care instead of more useful investments in infrastructure or human capital. Do you like our current system where tens of millions of Americans go without health insurance? Aren't you the one gambling that some miracle is going to occur that will dramatically change the trajectory of our nation's health care system?

TJE said...

After we make this $1 trillion gamble, won't we still have millions of uninsured?

Great uncertainty and lack of information is where we need incrementalism, the science of muddling through.

Patrick_L said...
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Patrick_L said...

Health insurance coverage under PPACA would rise from 82% to 95%- a huge increase.

The ranks of the uninsured are increasing rapidly each year. Try all the incremental changes you want- you won't stop that trend.

TJE said...

Over time, incrementalism can produce big changes. The difference is its modesty in the face uncertainty and lack of information.

TJE said...

http://www.urban.org/health_policy/uninsured/index.cfm

Patrick_L said...

I'm not sure why you'd cite the Urban Institute, when they put out studies arguing that the "National health reform will expand insurance coverage by about 30 million people, reducing the number of uninsured by more than half."

And incrementalism would not work- every level (individual, provider, insurer, medical technology/drugs/devicies etc.) is broken and slowly disintegrating. Incrementalism would be an ineffective strategy because it would just push problems from one level and sector to the next.

TJE said...

Mr. L, you are misunderstanding the science of muddling through.

TJE said...

Again, Mr. L, I cited Urban Institute to be fair and balanced. PPACA will, at great cost, insure many millions. It will leave many millions uninsured.

I suppose my point is a simple one: Those with a boundless faith in technocracy and central planning may be disappointed to find that PPACA is not the greatest thing since sliced bread.

Patrick_L said...

Luckily no one with a brain above room temperature has boundless faith in technocracy and central planning, so no one is going to be disappointed when PPACA fails to be the greatest thing since sliced bread.