Serving the High Plains
Serving the High Plains
Ordinarily, free markets based on choice are the best test of whether a product or service is sustainable. Healthcare may be an exception to this rule.
The Republicans fumbled the ball last week to enact healthcare reform, but the pause gives us time for reflection.
The debate over health insurance is about whether a right to healthcare is more important than freedom of choice.
The Affordable Care Act’s intent was to make health insurance, and reasonably priced healthcare, a right and a duty by requiring everyone to be insured.
But the opposition asserted if you don’t want it, you shouldn’t have to buy it, a worthy stand for freedom of choice.
As healthcare costs continue to rise, however, an uninsured healthcare consumer increasingly must make a choice equivalent to whether to buy a Cadillac or no car at all.
Healthy young people are the ones least likely to buy health insurance in the absence of a mandate, because they are the least likely to require healthcare.
Without them, health insurance is no longer insurance, which is designed to cover unlikely events that could be catastrophic.
Without the “healthies,” buying health insurance is more like making payments on a car that you know you’ll need soon, and the closer the need, the higher the premium.
When the uninsured do get sick, however, they often can’t pay the Cadillac prices, and that adds to the burden of those who do choose to insure.
I will venture that it might be better if health insurance remains both a right and a duty.
From the humanitarian view, it alleviates suffering and prolongs life.
Economically, it protects the productivity of the workforce.
When healthcare needs get serious, the supply side of the healthcare provider “market” rules. The demand side has no power.
To protect the health of you and your family, you’ll pay $60,000 for a helicopter ride from Tucumcari to Albuquerque, or as much of it as you can or must.
You’ll pay prescription drug prices that are arbitrarily increased by 10 to 100 times overnight to preserve the bloat in a company’s bottom line and hospital charges of $10 for an aspirin.
Or for as much as you can, one way or another.
Until this market becomes responsive to the demand side’s ability to pay, health insurance will continue to be a necessity.
One way to reduce healthcare costs may be to increase the power of the health insurers to enforce limits on how much should be covered.
To do that, and make the healthcare provider market a real one again, health insurance will have to remain as real insurance. That is, as a well-heeled hedge against unlikely events made more unlikely by including those least likely to need it.
For that, sadly, we may need to preserve the individual mandate.
Steve Hansen writes about our life and times from his perspective of a retired Tucumcari journalist. Contact him at: [email protected]