Health care commission wants to punish you

This Web only Speakout has not been edited.

Brian Schwartz

Thursday, February 7, 2008

Remember grade school, when teachers would punish the whole class for the actions of just a few troublemakers? This is collective punishment, which is typically practiced during wartime or under martial law.

Collective punishment has now arrived with compulsory medical insurance. Known as an “individual mandate,” it’s the law in Massachusetts, and California’s State Assembly has approved it. In Colorado, it is central to the “Blue Ribbon” Commission’s recommendations, which commissioners will present to the General Assembly on January 31.

Politicians peddle compulsory insurance under the guise of eliminating the “cost shift from the uninsured” by making people “responsible.” The story is that the uninsured get medical care without paying, which increases premium costs for the insured. So why not simply force everyone to buy insurance? Because it scapegoats the victim and empowers the true perpetrators of our insurance mess: politicians.

According to the Commission’s “Baseline Coverage and Spending” report, the cost shift attributable to increased premiums is around $200 million annually. This “free from provider” cost is just $85 per privately-insured resident, or one percent of an average premium.

But the Commission’s proposed billion-dollar “cure” is itself a huge cost shift. To encourage compliance with mandated insurance, the Commission’s plan includes tax-subsidized premiums and Medicaid expansion. Per privately-insured Colorado resident, the tax increase would cost about $400. Worse yet, Medicaid itself increases insurance premiums by short-changing doctors.

And why expect *this* government bureaucracy to stay within budget? The Boston Globe reports that to contain costs, Massachusetts medical authorities will “probably cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients have to pay.”

Second, holding people “responsible” would mean punishing freeloaders themselves and allowing providers to prevent freeloading. Compulsory insurance is the opposite: it forces the innocent to buy insurance determined by political interests, rather than their own needs. That’s collective punishment.

What if we applied the Commission’s rationale to freeloaders who leave restaurants without paying the bill? This certainly increases prices, but forcing all citizens to buy “diner’s insurance” punishes the innocent.

Third, government controls already punish the innocent – insured and uninsured alike – by making medical care and insurance prohibitively expensive.

Federal tax policy deeply discounts employer-provided insurance. This chains us to our jobs and employer insurance options. Insurance companies need not please us — they know we must change jobs to buy a competitor’s product. Shall we further pamper insurance companies by forcing everyone to buy their products?

Since income is taxed but premiums are not, consumers end up buying “insurance” that is really prepaid medical care. Insulated from medical costs, patients spend like business travelers on a company expense account, so medical providers need not compete on price.

On the state level, medical providers and disease constituencies lobby to force insurance to include benefits that many customers do not need. For example, Colorado law compels widowed wives to pay higher premiums for prostate screening, maternity, and marital therapy. How’s that for a cost shift?

These and other mandates increase Colorado premiums by 21 to 54 percent. This dwarfs the one-percent increase attributable to the uninsured. Colorado’s Chief Medical Officer told the Washington Post that 2,500 Coloradans lose insurance for every one percent increase in premiums.

When government controls increase insurance costs, the young and healthy drop coverage first. Those remaining have a higher medical risk, so premiums rise again, which again drives out the healthiest remaining customers.

Reformers have some nerve to support policies that make insurance prohibitively expensive, and then make criminals of those who do not buy it.

Compulsory insurance is based on collective punishment, a perverted form of justice found where troops patrol streets and spitballs go splat. It punishes both the insured and uninsured for the misdeeds of politicians. Colorado legislators should not scapegoat the uninsured for the mess they’ve perpetuated. They should repeal legislation that inhibits the free market from delivering affordable high-quality medical care.

Brian Schwartz is a resident of Boulder. The author’s free-market proposal to the Blue Ribbon Commission is at WhoOwnsYou.org.

• February 7, 2008

  3:29 a.m.

  Suggest removal

  mrfxx writes:

  Fine, Mr. Schwartz - I understand your arguement; however, doesn't this mean that if Dick or Jane chooses not to be insured that they should be denied medical care at an emergency room if they cannot prove means of payment? Aren't we all paying those "hidden costs" of health care when hospitals pass those costs on to the insured? Why expect the rest of us to pay for uninsured parents' children's health care if they choose not to have insurance (especially if they choose to have such niceties, but unnecessary items as cable TV - and shouldn't not carrying health insurance on one's children be considered a form of neglect?).

  Perhaps Mr. Schwartz chooses to ignore the fact that while some uninsured folks are that way by choice (naive folks who believe that "nothing bad can happen to me" - ignoring facts like many drivers don't have full coverage or that cancer can strike even those who live so-called healthy lifestyles), most folks who have no medical coverage simply cannot afford it. It is interesting to me that health cost increases, usually impacted more by profits for so-called "health" insurance companies than anything else, invariably run several points ahead of the cost of living. Anyone who argues that a single payer system of some sort would be worse than the existing system is simply ignoring the fact that ALL insurance companies are in the business for the profit - their job is to pay out less money than they take in - regardless of whether that is in the best interest of the insured. How could a single payer system be worse for one's health?

  By the way - those companies which argue that benefits including insurance is why the US "can't compete" with overseas corporations have neglected to mention that virtually all of those countries have some form of universal health care - limiting what the corporations have to pay.

• February 7, 2008

  8:30 a.m.

  Suggest removal

  SASQUATCH writes:

  All the dems (HRC and Ritter) are calling for mandatory healthcare that would be enforced by severe financial penalties. The HEALTH NAZIS would then follow-up forced membership with a system of rationing in order to keep costs down. And for Colorado, taxpayers, we would have to pick up the tab for some 200,000-250,000 uninsured illegals. Ritter isn't telling you this, but the illegal component of the estimated total uninsured of some 790,000 would cost you, the taxpayer, some $250-$300 million annually.

  Gov. Ritter, why not just send a $300 million check annually directly to Mexico and skip the HEALTH NAZI fandango?

• February 7, 2008

  9:12 a.m.

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  kathyM writes:

  If everyone is forced to buy health insurance, guess who won't buy it? Those who can't afford it--the SAME people who can't afford it now!

  Duh.

• February 8, 2008

  7:16 p.m.

  Suggest removal

  Annoyed writes:

  QUOTE Fine, Mr. Schwartz - I understand your arguement; however, doesn't this mean that if Dick or Jane chooses not to be insured that they should be denied medical care at an emergency room if they cannot prove means of payment?
  END QUOTE

  I can't say if they should be denied medical treatment or not, that is up to the hospital and the doctor involved.

  I do say however that the hospital and doctor should not be required BY LAW to provide health care to anyone that claims they cannot/won't pay.

  I hear all the whining about medical care costs, but in the final analysis, we are responsible for ourselves only, I am not my brothers keeper or his slave.

  I would like to see all the whiners not complain if they were forced to work for free for anyone demanding they do.