March 13, 2010
The Big Lie of Health Care ReformBy Robert Gelinas
One-sixth of the U.S. economy is threatened with a takeover by the federal government on the erroneous rationale that "tens of millions of people in the U.S. are without health care insurance, and therefore are being denied access to adequate health care." Unjust! Unfair!
This is, of course, an absolute lie. Nor does some large number of people "die every day from lack of health insurance coverage." That too is a lie.
Access to the health care providers (professional services) and medicine (products) of the best health care system in the world is already universal and available to every U.S. citizen, legal resident, illegal alien, prisoner, detainee, or visitor -- regardless of whether anyone is covered by any insurance policy or health plan. For heaven's sake, even the illegal aliens have figured out that anyone who walks into an emergency room is required by law (EMTALA) to be treated, regardless of the person's ability to pay.
The Big Lie: Without health care insurance, there is no access to health care.
Health care insurance coverage is but one method of paying for health care products and services. Doctors and hospitals are quite open to accepting cash, checks, or credit cards for their services rendered and have no problem with getting paid directly -- meaning they get their money right away, don't have to fill out and file mounds of bureaucratic paperwork with insurance companies, don't have to worry about what treatments are approved and reimbursable by the insurance companies, etc.
In fact, when health care is directly paid for by a patient, then issues like preexisting conditions, escalating premium rates, denied claims, dropped policies, and all of the regularly lamented shortcomings of the health insurance industry become moot. Case in point: Elective surgery such as breast augmentation is a medical procedure that isn't covered by any health insurance, but somehow, there doesn't seem to be any access issues to the procedure or lack of them occurring.
And yet most people are led to believe that they simply can't afford to pay for their own health services directly. That's why they purchase health insurance, or their employer purchases it for them as an employee benefit. Actually, this too is a great misunderstanding of the problems with respect to health insurance coverage, which are completely distinct issues from access to actual health care services.
Any form of insurance (home, car, flood, health care, etc.) is nothing more than a financial instrument used to mitigate an unacceptable potential financial risk. Insurance doesn't work unless more people are paying into a common pool than are taking money out of it. The whole idea of insurance coverage is to spread financial risk among many people so that any one member isn't hit with some catastrophic expense should a major need occur. But in many respects, most health insurance coverage has been expanded in scope to become some kind of "Health Services Subscription Club" that pays for many services that really don't represent unacceptable financial risks by themselves.
Indeed, overpaying beyond an individual's actual needs via insurance premiums is a viable means to avoid getting hit with major medical expenses. However, that's why they invented Catastrophic Insurance Policies -- i.e. those cheaper, high-deductible plans that don't kick in until direct expenses go over a few thousand dollars.
Regardless, even without any kind of health insurance policy whatsoever or ObamaCare, if someone gets in a car wreck, the ambulance will still respond and take the injured to the emergency room, where he or she will be treated regardless of ability to pay. It's already the law.
The whole ObamaCare health care reform debate isn't really about people who already have health insurance; rather, it's being crafted supposedly for the benefit of all those who are without coverage and who need it, but can't afford it. Nevertheless, if tomorrow the government bought health insurance policies for everyone who doesn't have one, that wouldn't make access to health care services any more available than it already is.
To the contrary, the law of supply and demand dictates that if 30 million or more new customers are added to a marketplace (the demand) and there is no proportional increase in the number of service providers (the supply), then prices will go up as service availability goes down -- which means that the whole system gets worse for everyone, not better.
The real issue is that there are those who wish to argue that despite all the adverse (if not catastrophic) consequences of ObamaCare to the system, health care is a "basic human right" and therefore the basis for a massive new government entitlement program. But health care isn't an "inalienable right" -- it's a basic human necessity, just like food, clothing, and shelter. All of these basic human necessities are bought and sold every day in the free market in the context of the goods and services that they really are.
The simple reality is this: There are those in our society who can afford these necessities, and there are those in our society who can't. For those who can't afford the basic human necessity of proper health care -- just like food, clothing, and shelter -- that need becomes the basis of voluntary charity and aid.
Conversely, the government version of involuntary charity via taxation is called "welfare." So whether it's private charity or a government welfare program that helps people buy something they otherwise couldn't afford but need, that's fine. Just recognize that that's the issue -- not an entitled right, not an access or availability problem, not a lack of insurance policies.
Now, if making health care more affordable for everyone is really the goal -- to thereby lower the threshold of who can readily pay for it directly and/or indirectly via an insurance policy, and thus reduce the necessity of charity and/or welfare for those who need assistance -- then free-market business forces and scientific and technological advances, along with increased competition -- not intrusive government forces -- are the answers.
Consider one mathematical fact: The purchase of 30 million new insurance policies that cost $5,000 each is only $150 billion, which is a fraction of the real price tag of ObamaCare.
One can therefore reasonably conclude that ObamaCare isn't really about making health care more available or affordable to those who need it and can't afford it. It isn't about lowering insurance costs or reducing the federal deficit. What has been proposed achieves none of these objectives.
ObamaCare is simply a leviathan of a lie, whose only practical impact for generations to come will be increased welfare-state dependency on government, greater government intrusion and control over people's personal lives and privacy, reduced availability of health care providers as more of them are driven from their professions -- all of which translates to higher and higher costs, which only accelerates the country's financial death spiral.
But that's to be expected: Most grandiose plans predicated on lies don't end well.