As a follow-up to the post below, let me repeat an old point: Liberals pay too much attention to the insurance industry. I have a couple of hypotheses on why this is. The malign elements of the insurers' business model -- namely, denying specific people with sympathetic stories concrete care -- are more forthrightly cruel than anything mustered up by the other players. The insurance industry was responsible for the Harry and Louise ads, which became iconic after the defeat of the Clinton plan. The private insurance industry is the sector of the system that it's easiest to see how we live without. But when you're dealing with health care reform, the insurance industry is actually one of the easiest to buy off, or evade entirely. They're much more fearful than the other sectors: You need doctors because everyone likes them, and you need hospitals because you don't want to bleed on the carpet, and you need pharmaceutical companies because you need drugs. You don't really need insurers. It's just that they're here now, and very hard to get rid of. Relying on the status quo bias of the electorate is a pretty good strategy, but it's by no means perfect, particularly not if we entered into some period of crisis. And it's all the worse for insurers, who are incredibly unpopular, and much more so now, post-managed care, than they were in the early-90s. It's entirely possible that some level of insurer opposition could be turned into a public relations coup for a reform plan.
