There’s been so much shouting about health care, but little real talk about specific problems that desperately need attention.
For instance, if a child is born with a serious medical problem or develops a chronic ailment as a kid, he or she can find the door shut at adulthood when it comes to insurance. This can mean financial ruin on top of sickness.
I find this morally wrong. I want reform on this point, not just because I fear my kids could ultimately be affected, but I also hate to think of anyone’s children in that predicament.
But excluding people for pre-existing conditions is economically sensible for insurance companies. Why would any company accept such a bad investment? The new, unhealthy adult will cost your company a fortune over the years. Sammy will need considerable care to manage that heart problem. Julie will need too many doctors’ visits to keep that diabetes in check. The risk of complications and major surgeries is very real. The price is enormous. Instead, it makes more sense — at least from the insurance company’s perspective — for Sammy and Julie to get those bills from the hospital and stuff them in some dusty drawer. How could they write such checks? Of course, when they stiff the hospital, somebody pays, just as somebody pays any time the uninsured get care. And the costs go up and up. We worry rightly about the cost of reform. But too many ignore the exorbitant cost of no reform, which is incredibly steep, given the inflation we’ve seen over the past decade and the growing pool of uninsured.
Meanwhile, many say a government mandate on everyone to purchase insurance will kill the free market. But those who champion our free market health care system miss an important point: this is not a free market. If it were indeed free, people wanting to purchase insurance wouldn’t be locked out. In a free market, people are free to purchase what they need. Nobody is stopping you from buying the meal you want. No restaurant tells you to go away, that you’re not wanted. That’s a free market. With insurance, it’s different. You can get sick through no fault of your own and then be locked out of the market, financially ruined. I’m sorry, that’s not a free market.
Likewise, in a free market, you are free not to purchase anything at all. So, a mandate does, in fact, go counter to the notion of a free market in that respect. There’s no way to deny that point. But you also can’t deny that you are already not free to avoid health care services. Pretty much everyone is eventually a health care consumer.
For instance, the fellow who collapses on the Best Buy floor is going to be taken to the hospital, even if he has avoided buying insurance because he’s free to do so. So, he has been thrust into a health care market without making any choice on his own. This is not like the purchase of a TV, where he could simply walk out of Best Buy. No, he’s had a stroke. He’s now an unwilling health care consumer. So this can’t be called a “free market,” but he is indeed the recipient of an expensive service, even though he’s offered none of the prepayment the insured fork over for such services.
Should I have to pay more in insurance premiums because he was unwilling to be responsible enough to get at least catastrophic insurance coverage? Everyone faces the possibility of catastrophe, whether in our cars or in our chests. To think we’re free from that possibility is personally irresponsible and a freeloader way of thinking that I find very troubling.
The reason insurance companies have pre-existing condition clauses is very appropriate. They want to combat this freeloader effect, people buying insurance only when they need it. So insurance companies have said it’s unfair to force them to eliminate pre-existing condition clauses, unless everyone has to purchase insurance. They’re right.
The irony of this whole “socialism vs. free market” health care debate is that the government mandate on personal health insurance was initially a Republican idea that was pushed during the Clinton attempt to overhaul health care. Four current Republican senators: Orrin Hatch, Charles Grassley of Iowa, Robert Bennett of Utah and Christopher Bond of Missouri supported the GOP-proposed government mandate, which was a response to Clinton’s more ambitious plans.
“We called this responsible national health insurance,” says Mark Pauly, a conservative health economist at the University of Pennsylvania’s Wharton School, who helped come up with the proposal. “There was a kind of an ethical and moral support for the notion that people shouldn’t be allowed to free-ride on the charity of fellow citizens.”
Those GOP senators who once supported the government mandate are opposed to it, now that Democrats have embraced the idea. The notion of mandating some personal accountability for health care was once fashionable in the GOP. Of course, the for-it-before-I-was-against-it credo is the Washington way. Political victory is always more important than national health. I wonder, should we also drop car insurance requirements in the name of freedom over socialism? Isn’t mandatory car insurance also an infringement on my right to ride free from government hassle?
You say that’s different. Driving is a privilege, not a right.
True. But if you’re living, you’re on a type of road, too. Being on that road without at least some form of liability insurance means you expect others to cover the bill when your body has a wreck.
I know those folks in suits and ties, those elected men and women of blue and red, met in Washington to discuss health care recently.
But I’m not holding out much hope.
Health reform may be on life support, but given all the dysfunction I’ve seen, I can’t help but feel our country’s legislative system is already dead. I desperately want to feel something positive, not this disillusionment. I’m not a tea partier, but when it comes to health insurance, I’m every bit as angry.
Zach Mitcham is editor of The Madison County Journal.
FINALLY!! Someone with common sense who puts what's good for the people above what they have been fed by the Republican Party. Thanks for the well written, well informed, and truthful article. Thanks, also, for the guts to step up to the plate and stand up for what you believe.