Scared Monkeys Discussion Forum

The plan before the Senate creates a set of 50 state-based insurance "exchanges" that are established as markets for health plans. Consumers must buy policies from their employers or through the exchanges — but, either way, their choice of coverage is limited to one of four basic insurance plans that the government sanctions.

Private insurers will still compete to offer policies but must model their coverage on one of these four templates. In short, the Senate bill explicitly standardizes health benefits and then establishes elaborate mechanisms (including subsidies and penalties) to pay for them.

Here's the rub: While these four plans vary from low- to high-cost options, the benefits offered under them are pretty much the same. The difference between the cheaper and pricier plans is mostly the amount of cost sharing (e.g., you pay less for insurance if your co-pays are higher).

In effect, the plan creates a single national health-insurance policy. Consumers' only real option is to trade higher co-pays for lower premiums. But we'll all get the same package of benefits established by a series of new agencies and an "insurance czar" seated in Washington.