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An Inch of Snow

I just got this e-mail from the President. In it, he accuses me of being part of an “avalanche” of misinformation and scare tactics. Funny, sounds a little like his health care promises. In any case, here are the 8 things he promises to deliver, Santa Claus should be so kind.

  1. No discrimination for pre-existing conditions
  2. No exorbitant out-of-pocket expenses, deductibles or co-pays
  3. No cost-sharing for preventive care
  4. No dropping of coverage if you become seriously ill
  5. No gender discrimination
  6. No annual or lifetime caps on coverage
  7. Extended coverage for young adults
  8. Guaranteed insurance renewal so long as premiums are paid

Let’s take them in turn:

1. No discrimination for pre-existing conditions

  • So now we have a President that is mandating a company to serve a customer even if it does not want to. But think of this simply – why should a particular company, just because they are in the business of offering insurance protection, be forced to subsidize the known expenses of a person? It is certainly unfortunate if someone was born with a disability, or develops one before purchasing insurance, but it is an extremely hard argument to make that a particular company is now responsible for taking care of this person? If “we as a society” feel like such persons are deserving of help, then “we as a society” should be prepared to take care of this person – and not to concentrate this “charity” on a few companies. Note, that this is certainly NOT a defense of the insurance companies – they will be logrolling on this one – but it is an alert to those who believe that arbitrary laws are not part of a responsible democracy.
  • Why is health care special? Are there pre-existing conditions preventing customers in other industries from being served? Until very recently, there were not many golf clubs made for left-handed individuals. These folks were born left-handed through no fault of their own – should sporting good stores be forced to offer affordable left-handed clubs to them? You should note that today these clubs are widely available in all models and styles. Or how about folks with various food allergies? Some have a pre-existing allergy to eggs. Should a breakfast diner be forced to add items to the menu that cater to those with food allergies? The list of things where we have pre-existing conditions is endless

2. No exorbitant out-of-pocket expenses, deductibles or co-pays

  • This is a good one. How do you propose we define “exorbitant” Mr. President? Is it something that only you could afford? Is it the same way we define “jobs created“? I happen to like my current insurance package – it is a high deductible policy that will cover me generously for unforeseen, large insurable expenses. I thought you campaigned on the principle that people who like what they have will be allowed to keep it. I guess the Commissars thought better on that promise? And despite my serious reservations that consumer drive health care can work under the current institutional and regulatory framework, you are basically outlawing any proposals that move us in that direction. If anyone has been hammered for calling you a socialist in the past, perhaps they were going too far. Be here you have put in print one of the core principles of that doctrine. And it stinks
  • Why is health care special? Do you plan on rewarding all of us hoi polloi similar gifts when it comes to our home owners insurance or car insurance or life insurance or personal property insurance?

3. No cost-sharing for preventive care

  • Again, you are telling health insurance companies that they should be forced to make you pay little or nothing for doing things that are part of the normal and expected routine for health care. If people are too “irrational” (as you often claim they are) to engage in preventive care would they be any more inclined to get preventive care if it is free? The economists who believe in rationality would argue yes, but then you would seem to be a walking contradiction. When are we irrational?
  • Why is health care special? When I get my oil changed, I pay full price for that. When I replace the filters in my home HVAC system, I pay full price for that. Will you make supermarkets provide me with free yogurt, low-fat bagels, fruit and other healthy eating items? Will you force health clubs to provide memberships free of charge? Will you buy me a new sea-kayak or road bike?

4. No dropping of coverage if you become seriously ill

  • This might be profitable as a one time affair, but let me ask you a question. Why do restaurants not cheap out on their meals? Why does your grocery store not poison you or try to sell you milk that is 10% water? Why don’t cell phone companies eliminate service to some areas after that have hooked you into a two-year contract? Why don’t the lawn-care folks take my money and run before coming to finish the scheduled 4 treatments?
  • Why is health care different? Oh yeah, because there is no real competition and because it is largely tied to employment. You see what happens to Wegmans if it starts short-changing its customers, or to Jiffy Lube if it stops putting oil in your car when they promise you that they would.

5. No gender discrimination

  • So, should women be forced to purchase insurance that covers them for the misfortune of getting testicular cancer?
  • Why is health care different? Should beauty salons that cater to doing women’s hair be forced to have male customers? Should an all-boys high school be forced to install women’s rest rooms?

6. No annual or lifetime caps on coverage

  • Do you not see the imcompatibility of this provision with 1, 2 or 3? So, there can be no cost sharing, there must be free care at the front end, but then there can be no caps at the back end. But such a provision just goes to demonstrate that health insurance is not insurance. The purpose of insurance is to insure people from the possibility of very high uncertain expenses. Fairly priced policies would charge premiums to make sure that there is NOT a cap on coverage – that is the reason we all want insurance for anything else in the first place. Otherwise, what health insurance is … is a subsidy for getting medical care at the expense of people who do not use much medical care.
  • Why is health care different? If I wished to purchase a warranty for my vehicle that covers only particular parts and repairs for a particular period of time, am I not permitted to do so? What if we forced auto companies who offered warranties that they had to replace engine belts in a car forever … no matter what? And the same thing for transmissions, and all other moving parts?

7. Extended coverage for young adults

  • If there were more evidence needed that we want to look more like Europe, here it is. This provision calls for extension of a family’s coverage to “children” up to age 26. Why 26? And has anyone thought through the implications of this on an insurer’s willingness and ability to provide family coverage? You do realize that it is not inconceivable that singles and couples without children heavily subsidize the insurance costs of families.
  • Why is health care different? What is next, mandating that all parents maintain rooms in their homes for their children to live in long after they fled the nest? Are couples with grown children morally responsible for not downsizing their homes While we are at it, perhaps we can make sure that summer camps remain open to all “children” up to 26? I am sure my daughter would love her “Discovering Dinosaurs” camp to have some more mature children in it. While we are at it, why not raise the age limit on when “children” can work from 16 to 26?

8. Guaranteed insurance renewal so long as premiums are paid

  • Cool – so now that I have paid a year of premiums, I can take up smoking, I can eat Big Mac dinners every night for the rest of my life, and I can pursue my dream of being an artistic sky-diver … and the rest of you poor slobs have to subsidize this lifestyle. Awesome!
  • Why is health care different? I can see this one down the road … so long as a worker shows up to work every day for a year, they are guaranteed to have their jobs renewed – even if they work at a place that makes these things, for instance.

We know why such a pronouncement was made. Not many voters can look behind the immediate consequences of the offering of such gifts. They like guarantees. They like peace of mind. They like thinking they don’t have to pay to get more. And when someone even scratches the surface to reveal that there are unintended consequences of these policies, they are accused of being misleading and partisan. If such is the case, then I am as misleading and partisan as they come.

Update: more from Arnold Kling:

In contrast, there is a lot of room to move health care in the other direction–toward free markets. The only real health care reformers are those of us on the libertarian fringe. The two major parties are just posturing. That’s why I haven’t written much about the day-to-day debate on “reform.” It is not clear to me that defeating the Democrats’ legislation is something I should root for. We’re still nowhere near considering real reform.

9 Responses to “An Inch of Snow”

  1. Speedmaster says:

    Slam-dunk post!!! I got the same email today. Truly an amazing bit of political cr@p. 😉

  2. Chris Gerrib says:

    So, your question is “why is health care special?” In other words, why don’t we treat health care like, say ordering a meal in a restaurant.

    Well, part of the answer is called rescission. This is where you pay your premiums, get sick, and then get dropped for an undiagnosed or unknown pre-existing condition. It’s the equivalent of walking into a restaurant, ordering and paying for a meal, getting the soup, but then not getting the main course. And not getting a refund! Sorry you’re still sick hungry – not our fault.

    The more fundamental answer is that a lot of our health is out of our control. There is no way to prevent gallstones. I had melanoma a few years ago. Maybe if I hadn’t spent my youth standing on the bridge of a frigate in Florida – or maybe not. My father and his brother both had prostate cancer in their mid-50s, vastly increasing my risk. Other than picking different parents, what am I supposed to do about that?

    Attempting to financially encourage people to be healthy is a great idea. Unfortunately, there are real limits to how much control we have over our health. Penalizing people for matters over which they have no control is fundamentally un-American. Except that’s exactly what our current health care system does.

  3. Chris Gerrib says:

    WellPoint’s Blue Cross of California subsidiary and two other insurers saved more than $300 million in medical claims by canceling more than 20,000 sick policyholders over a five-year period. More results like this can be found by Googling “recission.”

    And once again, I would like to know how “American” it is for people to point a gun at me and demand that I become responsible for taking care of their medical expenses Well, first off, we already do that – it’s called “Medicare,” and “the VA” and “Medicaid.” Second, this includes your care, unforeseen and otherwise. Third, since we’re not in the habit of letting people die in the street, you’re already paying for other people’s care. Who do you think pays for the uninsured folks in the emergency room? Or when they get admitted for serious conditions? Or the public hospitals, like Cook County General here in Chicago?

  4. Stephen R says:

    “My father and his brother both had prostate cancer in their mid-50s, vastly increasing my risk. Other than picking different parents, what am I supposed to do about that?

    “…Penalizing people for matters over which they have no control is fundamentally un-American.”

    If you get prostate cancer, it may not be your fault, but how the hell is it MY fault??? It is not “penalizing” someone to *not* give them something that is *not* theirs.

    I may have been born with a high metabolism and have to eat more food than the average person, but that would not give me a claim of being “penalized” because my food bill is higher.

    You are responsible for taking care of you. Part of that is buying (or growing) food you need. Part of that is paying rent or a mortgage so you have a place to live. Part of that is paying for your own health care, or otherwise providing for such (e.g. insurance). Demanding that other people provide you with these things (or cry that you are being “penalized” when they do not) is wrong. It’s nonsense.

  5. Chris Gerrib says:

    First, I am not demanding that other people provide me something. I am perfectly willing to pay my share, and considering I am in a high income bracket, I will be paying.

    Second, you are now making a fundamentally moral argument. It’s the essential argument of libertarianism, which is “let them die” if they (whoever “they” are) can’t fend for themselves.

    It’s certainly your right to make that argument, and I won’t attempt to dissuade you. But please don’t pretend it’s an economic argument, or an argument based on logic.

  6. Chris Gerrib says:

    Ask yourself why the super market doesn’t sell you watered down milk? Seriously? Ever hear of Upton Sinclair? Adulterated food was a major issue until the establishment of the FDA. What prevents rescission in virtually any other area of your life? Usually laws and regulations.

    My (potential) illness is not your fault. It may not be my fault. Much like, say, having your house wiped out by a tornado, bad things may happen that are nobody’s fault. Except in the tornado case, not only do homeowners buy insurance, we (society) also send in the National Guard (at *your* expense) and provide other disaster aid.

    Regarding the ad hominem attack, I am carrying libertarian thought to the logical extreme. If I have an obligation to feed myself, then food stamps are wrong. At some point, society steps in and decides that we don’t want to let people suffer, even due to their own fault. The whole point of civilization is to live in conditions that are better then that of raw nature.

  7. Harry says:

    The email from Obama (Rahm Emmanuel?) evokes Goebles (sp? never bothered to learn spelling his name) communicating to his fellow Nazis, repeating lies often, electronically this time.

    One of their errors was to believe that HillaryCare died because of bad political tactics, thus the race to pass it quickly. Arlen Specter said this today before an angry crowd in Philadelphia, with Kathleen Sebelius present to receive the hurled tomatoes. “We’ve worked so hard on this bill,” they both said, but added that “the final bill has not yet been written.” Arlen assured the crowd that each segment was read by his staff.

    If I were Pat Toomey, I would summarize the session as, “Rahm tees up Specter for a nice drive on the first hole.”

  8. Stephen R says:

    “Much like, say, having your house wiped out by a tornado, bad things may happen that are nobody’s fault. Except in the tornado case, not only do homeowners buy insurance, we (society) also send in the National Guard (at *your* expense) and provide other disaster aid.”

    Very true, and we already HAVE that in terms of health care. In an emergency, any person can go to an emergency room and by law they will receive care regardless of their ability to pay for it.

    To follow your comparison, Obamacare is like saying that the government should pay for someone to come over to clean my gutters and mow my lawn. Caring for my house and yard is *society’s* responsibility. We’re not talking emergency care here; and thus yours is a false comparison.

  9. David says:

    Very nice post, I wish it could be read aloud on a news outlet.

    Commenter Chris made a good point about rescission being an issue, which he is right to a certain extent, I know because this actually happened to my aunt. However, what Chris is really pointing at is the need for real actual reform of the healthcare companies towards the free market without government intervention. Healthcare contracts need to be more clear cut and understandable by non-lawyers (i.e. you shouldn’t have to hire a lawyer just to find out what’s in your coverage) and also it should be easier to bring claims to court when situations like rescission arise.

    Putting together a couple of aspects, like Obamacare, ACORN, the BP Spill and Obama’s lack of economic action, there’s mounting evidence that he’s employing the Cloward-Piven Strategy, developed by two professors at Columbia who taught while Obama was attending school there. The plan is to crush the markets by creating and/or failing to properly react to disasters, over-spending and perpetually bad economic decisions until much of it becomes nonfunctional and the government can step in and take over.

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