In the US, I understand that their insurance based system of health care costs around twice as much as ours and delivers, on average, about the same result. I also understand that this average conceals a lot more variation than we would think was decent.
Notwithstanding, about half the population of the US appears to think that a solution on the European model more or less amounts to communism, which heaven forfend.
Against this background, a recent article in the NYBR had another go at explaining what Obamacare was all about. I think it succeeded.
Rule 1: health insurers are obliged to take people on without regard to any pre-existing conditions they may have.
Rule 2: people must have health insurance, otherwise they just wait until they get ill before getting it under rule 1.
Rule 3: support is available to the less well off so that they can better afford to buy insurance under rule 2.
Observation: states are supposed to set up, or have set up, (mainly online) exchanges through which people can shop around for health insurance. Getting these exchanges set up has proved troublesome, but they are getting there.
Which amounts to having a rather complicated version of the NHS by the back door, with each health insurer operating what amounts to a mini NHS. Rather an odd way to do things, and very odd for anyone in the insurance business where they like to assess premiums on the basis of risk. But be that as it may, the people who hate communists are fighting back hard.
One can also see why the embattled Democrats might have thought that doing things on the sly stood a better chance than going for it full frontal.
It seems that the communist haters lost the first round at the Supreme Court which said that Congress did have the powers to do this sort of thing (Congress being no House of Commons with more or less untrammelled power). They are now having a second round, fighting on the grounds of an obscure lack of precision in the bit of the tax code which makes support available. If they win, the support vanishes and the whole package comes tumbling down.
At least the writer in the NYRB thinks that their case, whatever its lack of merit on moral grounds, is poor. Coming up about now, so I shall have to keep an eye out.
Nearer home I read in the DT yesterday that our Health Police, having brought the smoking battle to a more or less successful conclusion, are training their guns on senior alcoholics. It seems that quite a lot of us seniors, particularly retired male civil servants, have acquired the habit of taking as much as a glass of wine every evening. Which comfortable habit is, according to the DT, doing dreadful things to their insides. Echoes of one of those Sun questionnaires on the subject - answer yes to more than three of the following ten questions and you are an alcoholic - with the every day being much worse than the quantity involved.
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