Health-care for the poor, those with pre-existing conditions, vital to solving problem

The debate about health insurance has really gotten silly. It is time to cut to the chase and tell it like it is. Full disclosure, I am a conservative, lifelong Republican.

First, in order to provide health insurance to the millions of people who cannot afford it, a massive government program is necessary — i.e., an expansion of the welfare state. There is no other way to spin it.

Second, you cannot insure people with pre-existing conditions. That is not insurance, it is another government-funded subsidy. “Insuring” people with pre-existing conditions is like allowing people to go without automobile insurance until they have an accident and then letting them call an insurance company and say, “OK, I want to buy insurance.” That is not insurance, and no for-profit insurance company can survive such a law without large public subsidies.

If we in the United States value life as much as we say we do, then these programs must be subsidized by some government, either federal, state or both. It is simply actuarially impossible to continue to insure these two populations of people and at the same time cut the cost of government subsidies. Obamacare tried to pay for these programs by making healthy people buy insurance or pay a fine. Millions of people opted to pay the fine — and, hence, insurance companies did not get the premiums from healthy people necessary to pay the costs of insuring unhealthy people. Premiums skyrocketed and access to medical care decreased.

Let’s call a spade a spade. These two objectives — insurance for the poor and coverage for pre-existing conditions — are essential if we want to continue to be a caring country. Therefore, we must expand the welfare state for these programs and perhaps cut the welfare state where it is being abused by lots of other folks, some of whom have been on welfare for three generations.