The complexity of the recent health care legislation is a pre-existing condition. Unfortunately there is no mandated insurance policy to protect the citizen against unforseen threats to his/her health by this legislation. Rather than enabling a smooth transition to a state controlled system, it is likely to ignite a sudden upheaval in the health care system. The resulting political firestorm is likely to singe everybody.
Thousands of analysts are reading and trying to understand the implications and costs of the legislation. No doubt, dozens of potential disruptions will be revealed that will call the viability of the bill into question. The hedgehog likes to keep things simple. With private insurance coverage guaranteed for pre-existing conditions, why shouldn't everyone under the age of, say, 50 (or maybe under the age of death), simply cancel their health care insurance? Why shouldn't every employer with under 50 employees (or maybe every employer) simply drop coverage?
The glib response is..."We anticipitated that and included a fine for failure of responsible parties to procure insurance." But at this point political realities intervene. 1) Initial fines are much lower than the cost of insurance. If they were higher, resistance by lower paid workers would be intense. 2) Basic policies are going to be comprehensive and expensive. Persons making less than $50,000 per year can't afford them, and the proposed subsidies are unlikely to offset the choice of no health insurance. 3) As participation in private insurance collapses, only sick people remain in private insurance. Suddenly, private insurance premiums soar.
We already the see the possible effects of selecting out the young and healthy from insurance pools. The Recession has caused the layoff of many young workers. They previously paid health insurance premiums (or their employer provided insurance), and needed little or no health care. Health insurance companies are already asking state regulatory agencies for huge premium increases. It is economically rational, because their premium collections are lower and their costs are more or less constant. When universal healthcare is implemented, the young and healthy will select themselves out of private health insurance. Private health insurance will simply disappear.
Some opponents of healthcare say that this is the intended design of the universal healthcare legislation. Proponents may or may not agree. No matter, the health bureaucracy is completely unequipped to respond to this amount of change. Should private insurance collapse in a short period of time, the results could be catastrophic.
It is instructive to read reports on the effectiveness of the home loan modication program, and the "weatherization" of houses programs of early 2009. They have been complelely ineffective. Very few loans have been modified and very few houses have been weatherized. Rats gather around government cheese, so regulation and rules must be airtight to prevent corruption. Unfortunately, bureaucracies are slow and cumbersome, and the people that need these programs simply cannot access them. This would be uncool if it happened in healthcare.