I see the idea of “absolute” net neutrality going away at some point. Eric Schmidt made an important point at Web 2.0 Summit: There are two concepts of net neutrality. One is you can’t discriminate against any particular company or any particular application. But on the other hand you can discriminate against classes of applications. You could prioritize video lower than voice, or a bulk download of data lower than something that requires real-time communication. Prioritization will be contentious, but capacity limitations will make it clear why it’s necessary.
Suppose there were groups of secularists at hospitals who went round the terminally ill and urged them to adopt atheism: ‘Don’t be a mug all your life. Make your last days the best ones.’ People might suppose this was in poor taste.
In truth, the law is quite moderate. It is more conservative than President Bill Clinton’s 1993 plan or President Richard Nixon’s 1974 plan (in which the federal government would have covered anyone who wasn’t insured through an employer). It’s much more conservative than expanding Medicare to cover everyone. It is clearly one of the least radical ways for the United States to end its status as the only rich country with millions and millions of uninsured.
But the law depends to a significant degree on the mandate. Without it, some healthy people will wait to buy coverage until they get sick — which, of course, is not an insurance system at all. It’s free-riding.
Without the mandate, the cost of insurance in the individual market would rise, perhaps sharply, because some healthy people would not be paying their share. Just look at Massachusetts. In 1996, it barred insurers from setting rates based on a person’s health but did not mandate that individuals sign up for insurance. Premiums then spiked. Since the state added a mandate in 2006, more people have signed up, and premiums have dropped an average of 40 percent.