Ramesh Ponnuru, like many conservatives, would like to rid health care of state insurance mandates. These mandates demand that insurance plans do crazy things like cover maternity care and bone marrow transplants and colon cancer screening (fuller list here). In their absence, some insurers would still cover those things. And some wouldn't. The question, of course, is whether consumers would know which insurers were which. Fairly few folks, after all, remember to ask if there's bone marrow transplant coverage in the unlikely event that they unexpectedly develop multiple myeloma. To this concern, Ponnuru responds, "it is hard to believe that the market would evolve in a way that consumers were asked procedure-by-procedure, condition-by-condition what they wanted covered. There would probably be various standard packages offered by insurers, resources such as Consumer Reports and word-of-mouth, etc." That's all a bit hand-wavy, I think. It's possible that the market would provide relevant information. But for whom? Consumer Reports has a circulation of about 4,000,000 a month (and, as anyone in the magazine business will shamefacedly tell you, circulation numbers always vastly inflate actual readership). Word of mouth has its advantages when you're trying to decide on a restaurant but it's poorly suited to assessing your health risks over a period of decades. I have no doubt that well-educated, affluent customers could access relevant information. But that doesn't describe most customers.Take an easier market, like televisions. There's a lot of good consumer information out there about televisions. There are magazines and web sites and Amazon reviews. Even so, plenty of people still purchase crummy televisions. They don't do their research or they don't know how to assess the various reviews they find. They buy their television under time constraints (the old one broke and the game is this weekend) or they think they're getting a deal. Happily, buying a bad television doesn't much matter. Buying bad health insurance does.All that said, I think there's a good case that health insurance comprehensiveness should be federally regulated rather than the product of 50 different state legislatures. But that's not the same thing as getting rid of those regulations altogether.Related: The behavioral economics implications.• The realities of the individual insurance market. CAN CONSUMER REPORTS SAVE HEALTH INSURANCE?
Ramesh Ponnuru, like many conservatives, would like to rid health care of state insurance mandates. These mandates demand that insurance plans do crazy things like cover maternity care and bone marrow transplants and colon cancer screening (fuller list here). In their absence, some insurers would still cover those things. And some wouldn't. The question, of course, is whether consumers would know which insurers were which. Fairly few folks, after all, remember to ask if there's bone marrow transplant coverage in the unlikely event that they unexpectedly develop multiple myeloma. To this concern, Ponnuru responds, "it is hard to believe that the market would evolve in a way that consumers were asked procedure-by-procedure, condition-by-condition what they wanted covered. There would probably be various standard packages offered by insurers, resources such as Consumer Reports and word-of-mouth, etc." That's all a bit hand-wavy, I think. It's possible that the market would provide relevant information. But for whom? Consumer Reports has a circulation of about 4,000,000 a month (and, as anyone in the magazine business will shamefacedly tell you, circulation numbers always vastly inflate actual readership). Word of mouth has its advantages when you're trying to decide on a restaurant but it's poorly suited to assessing your health risks over a period of decades. I have no doubt that well-educated, affluent customers could access relevant information. But that doesn't describe most customers.Take an easier market, like televisions. There's a lot of good consumer information out there about televisions. There are magazines and web sites and Amazon reviews. Even so, plenty of people still purchase crummy televisions. They don't do their research or they don't know how to assess the various reviews they find. They buy their television under time constraints (the old one broke and the game is this weekend) or they think they're getting a deal. Happily, buying a bad television doesn't much matter. Buying bad health insurance does.All that said, I think there's a good case that health insurance comprehensiveness should be federally regulated rather than the product of 50 different state legislatures. But that's not the same thing as getting rid of those regulations altogether.Related: The behavioral economics implications.• The realities of the individual insurance market. 
