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August 19 2010

Let's Talk About "The Mandate"

Hadley Heath

I read in the Kansas City Star that the best thing about the Patient Protection and Affordable Care Act is the mandate that individual Americans buy health insurance.  Never mind that this part of health care reform is at the center of the more than 20 district court challenges to the constitutionality of the PPACA... The Kansas City Star says the mandate is what makes the reform great.  Then the article ends this way:

"Those who oppose an insurance mandate should tell us how they would get healthy consumers into the pool."



Okay, well, I'm here to tell you.

Americans, like humans everywhere, act in their self-interest.  If something becomes more costly, we will avoid it.  If something becomes more affordable, we will purchase more of it.  Unfortunately, politicians in Washington misnamed the "Patient Protection and Affordable Care Act" because, as implementation of the law moves forward, we see that it can neither protect patients nor make care more affordable.

If you want to "get healthy consumers into the pool," you have two options.  You can do it Obama's way and exceed the powers of the government under the Commerce Clause.  Or, you can repeal the PPACA, deregulate the health insurance market, and watch prices decrease.  When insurance plans are tailored to individual needs and insurers compete for customers, the affordability of health insurance will appeal to more Americans - in sickness and in health. 

There is another side to this story, too.  The fact is the "healthy consumers" mentioned in the KCS article are really no cause for concern until they become unhealthy consumers.  Then they will frantically enter the health insurance market to protect themselves from catastrophic hospital bills.  But sometimes it is too late.  Sometimes the car accident, drug overdose, or unexpected visit to the hospital comes too fast for consumers to buy health insurance.  Maybe a situation like this would be more frightening if our health care system wasn't already partly socialized.  No one will be denied care at a hospital in the United States, regardless of whether they have insurance or the money to pay the bill.  The costs will simply be passed along to those who can pay.

I'm not suggesting we stop caring for patients simply because they are uninsured or impoverished.  It's important that our society care for the needy, especially through private vehicles that can charitably meet the needs of the sick and hurting.  But we are moving toward a no-consequences mentality in our society, where, unfortunately, many Americans consider the federal government to be a parent or family member who can always help if they mess up.  This is not healthy for anyone, because to have no consequences is simply against the laws of nature.  There will be consequences, even if they are not immediate and even if they fall on the shoulders of others. 

So, to answer your question, Kansas City Star:  Healthy consumers don't want to be in a pool where everything is rigged against them.  Insurance contracts are like a gamble.  We pay in, until one day; we hope to see the insurance company pay out if we get sick.  Healthy people may pay in more than they see paid out.  Sick people may pay in less.  But when the government tries to create a one-size-fits-all program to manage the health insurance of everyone, there's no room for plans that suit the individual needs of people.  Inequalities already exist in the world of health because nature largely controls who gets sick, but a government-run insurance system will only exacerbate those inequalities by inefficiently redistributing resources and access to care.

Healthy consumers want to be in a pool that is fair, where prices are affordable, and the insurance sold to them meets their individual needs.  This will only happen naturally in a free market.  But Obama and his followers can make it happen another way, with the mandate.  That is, at least until October 18, when the Commonwealth of Virginia has its summary judgment hearing on the constitutionality of this move.  Does that clear things up for you, Kansas City Star?

Independent Women’s Forum’s mission is to improve the lives of Americans by increasing the number of women who value free markets and personal liberty. Sister organization of Independent Women’s Voice.
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