Better Health Care Questions

The ongoing debate over how many people would wind up without health insurance under Barack Obama's proposals is interesting, but by its nature it's bound to be inconclusive.

What I'd like to see a clearer explanation of from the Jon Cohns and Ezra Kleins and Paul Krugmans and so forth of the world is a more detailed account of who's supposed to worse off under Obama's plan. After all, I could unveil the following Matt Yglesias Health Care Plan -- let's make an individual mandate to buy health insurance at least as good as what congress gets -- and then run around town slamming Barack Obama as a foe of the uninsured for leaving millions without coverage. But that'd be dumb. My hypothetical plan is only a "universal health care plan" in a vacuous sense. It wouldn't do anything to actually help people who currently lack insurance.

Clinton's plan isn't like that. It does do things to help people buy insurance. As a general matter, though, the things it does are the same -- subsidies for those of modest means, regulations preventing insurance companies from discriminating against those with pre-existing conditions, etc. -- as the things Obama's plan does to help people buy insurance. In terms of specific details, neither campaign has released much in the way of specific details. And what's more, everyone acknowledges that any specific details the campaigns might release will likely be changed during the legislative process anyway. So what's the deal? Instead of guessing how many people might or might not buy insurance in Obamaland, I'd like to know what kind of people will wind up uninsured in Obamaland and how they'd be differently situated in Hillaryworld. In particularly, would they actually be better off in Hillaryworld? My sense is that mandate advocates are trying to obscure the fact that most of the people who wouldn't have comprehensive insurance after the proposed Obama reforms are people who'd be screwed-over by a mandate.

UPDATE: I should have added that these are people who arguably should be screwed over. The goal of national health care policy should be to support the needs of the poor and the sick, and the individual mandate is a clumsy way of doing that by making the prosperous and healthy cross-subsidize their insurance premiums.