Casting doubt on mandated health care
Over at Businessweek, Glen Whitman criticizes the "health insurance like auto insurance" plans that many candidates (Hillary Clinton among them) are touting:
As anyone who has ever driven above 55 mph knows, mandating something is not the same as making it happen. Some people will not comply: 47 states require drivers to buy liability auto insurance, yet the median percentage of uninsured drivers in those states is 12%. Granted, that number might be even higher without the mandates. The point, however, is that any amount of noncompliance reduces the efficacy of the mandate.
None of this means the uninsured are not a problem. Yet the true issue isn't that they cost the rest of us too much. It's that they simply get less care than most people (one reason uncompensated care is such a small fraction of health-care spending). And if the real concern is making health insurance and health care available to those in need, we should focus on reducing health-care prices and insurance premiums. The individual mandate is, at best, a distraction from that goal.
Whitman concludes that the best way to bring health insurance to the uninsured is to have governments remove many of the current mandates for benefits, a move which he says will open the way for low-priced catastrophic coverage plans.
(Via Marginal Revolution, which today includes a post on the "nanny state" and some quality comments.)
-Greg Dahlmann
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So many issues, so little time. We have to begin somewhere because the health care system is fraying at the edges, slipping in the middle and like the bridge in Minnesota, if something isn't done, it will fall down.
Onehealthpro
- by Onehealthpro on Oct 9, 2007 at 10:48 AM | link
I don't understand the comparison between mandating health insurance and mandating auto insurance.
Isn't mandatory auto insurance supposed to prevent other people from damaging your car in a wreck and then having insufficient insurance to get it fixed for you? Not to prevent them from tearing up their own car and not being able to get it fixed.
I can kind of see a comparison in the field of public health, where if person A doesn't go to the doctor, he may help spread a disease that affects person B. Or if health insurance coverage cleared non-emergencies out of emergency rooms. I'm not convinced that health insurance coverage makes the difference in those areas, though.
To be clear, I'm talking about people who choose not to get coverage through their job b/c they don't expect ever to get sick and they don't want to pay their share of the premiums. I have worked with people who expressed that to me. Not "couldn't afford" but "didn't want to". I think that's a short-sighted decision but I'm not sure that making these people have health insurance is any of my business. I don't think I'm affected by their decision not to have health coverage in the same way I would be if they chose not to have auto insurance and were at fault in a wreck with my car.
- by Laura(southernxyl) on Oct 9, 2007 at 6:35 PM | link
Laura: The "health insurance like auto insurance" idea has been used by supporters of these mandate plans to make insurance required by the government seem less foreign. The New America Foundation has been circulating this idea for a number years. And as it turns out, the author of that linked essay is now one of Hillary Clinton's top aides.
I think you're right, though, that after you get past the mandate part of all this the comparison starts to breakdown a bit. What these plans are really about is getting as many people as possible (including younger, healthy people less likely to use health care) into the insurance pool in order to reduce the average premium. Of course, if that happened (almost) everyone would also have some sort of health care coverage. Or, at least, that's the thinking behind all this.
- by Greg on Oct 10, 2007 at 11:31 AM | link
Better yet, the failure of mandated auto insurance led the Texas legislature to pass a law that now allows correlation of drivers, auto tags, and the insurance data bank. Car 54 can run your license plate at a red light or while you're driving down the highway and then cite you if you're uninsured - or your car is.
- by Beverly Nuckols on Oct 11, 2007 at 6:37 PM | link