Tag: medical insurance

Categories
free trade & free markets too much government

Heap Bad Medicine

Could medical insurance — insurance for “health care” — itself act like a drug?

Are we addicts?

Third-​party (“insurance”) payments sure are super-​convenient. But their convenience comes at a cost: insurance (and other third-​party payers) that remunerate doctors and hospitals directly is what’s driving much of the price inflation in this sector.

Automobile insurance policies overwhelmingly pay the insured, not the mechanics, and we have no automobile repair crisis.

This was related with utmost clarity by Jeffrey A. Singer in his recent Wall Street Journal commentary “The Man Who Was Treated for $17,000 Less.” A patient got an astoundingly better price for a surgery by simply setting aside his insurance program and paying in cash. Singer explains why:

  1. “Hospitals and other providers make their ‘list’ prices as high as possible when negotiating contracts with health plans and Medicare regulators. No one is ever expected to pay the list price.”
  2. “[M]ost people these days don’t have health ‘insurance.’ They have prepaid health plans. They pay premiums to take advantage of a pre-​negotiated fee schedule arranged for and administered by a third party.”
  3. “It is the third-​party payment system that interferes with true price competition, so ‘market clearing prices’ can’t develop.”

Singer reminds us that specialty services like Lasik eye surgery, which tend not to be covered by insurance policies, have improved in quality and gone down in price.

Alas, as he laments, the United States is “headed in the exact opposite direction” from a real, cost-​reducing solution. To a nation addicted to third-​party payers in medicine, Obamacare is nothing more than upping the dose of the same old drug.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets national politics & policies too much government

A Fraudulent Pill to Swallow

If you’re like me, you often rub up against common opinion and find little sense in it — or, as I like to put it, popular opinion with the common sense bled out of it.

On Monday I reported on an anti-​Obamacare lawsuit against the federal government for mandating the purchase of medical insurance that included “free” contraceptive drugs (including “morning after pills”). I took on the obvious problems, but neglected to mention that it’s not insurance.

I guess you can call turnips “rainbows” and politicians “angels,” but, based on accepted meanings of terms, it is not “insurance” when benefits include regular maintenance or common preventive (“prophylactic”) products.

One doesn’t insure against dandruff by buying a policy that provides you with “free” shampoo or against sunburn by purchasing a policy that offers free SPF50 sunscreen. One doesn’t insure against obesity with insurance that provides “free” healthy foods according to This Diet or That Diet.

For instance, it would be absurd to have an insurance policy to pay for one’s vitamins.

In a sense, the vitamins are the insurance. Think of them as a separate, medicinal form of insurance, which you pay for at purchase.

Same for contraception.

One buys insurance for unexpected and irregular needs. Calling Obamacare’s “contraception benefit” mandate “insurance” is a fib.

Much of what we think of as insurance actually amounts to confused (and confusing) methods of savings (at best) or a confidence game to get some people to pay for the regular goods and services other folks use (at worst). By force and fraud.

The force is the government mandate. The fraud is calling this whole program “insurance.”

This is Common Sense. I’m Paul Jacob.

Categories
First Amendment rights free trade & free markets general freedom ideological culture

A Nickel’s Worth of Freedom

“If we are going to pay for your contraceptives,” said Rush Limbaugh on air, referring to Ms. Sandra Fluke’s congressional testimony, “and thus pay for you to have sex, we want something for it. We want you to post the videos online so we can all watch.”

In my Townhall column this weekend, “’Tis a Pity He’s a Boor,” I responded with a “No, thanks.” But I did defend what I took to be the point Rush was trying to make: “The issue isn’t about contraceptives, but the right to choose … on your own nickel.”

The flak Rush received became an avalanche of advertiser pull-​outs from his show. And an apology.

And this all points to something interesting about freedom.

Rush has freedom of speech. He would still have it if every advertiser in the world refused to touch him and he took to blogging. His freedom requires no one to support him. Free speech doesn’t force anyone to listen – or advertise.

Similarly, Ms. Fluke has freedom of association, sexually and otherwise, including her relationships with the university in question and its contracted insurance company. But such freedom doesn’t obligate her school or insurance company or other consumers (through passed-​on costs) to pay for her contraceptives. We all have freedom.

The same freedom of contract that allows advertisers to drop Rush’s show also allows businesses to choose employee benefit plans, workers to choose where they will work, and insurance companies to decide what terms they will offer.

Or it should. And in the specific case of contraception coverage did, until the Obama Administration dictated otherwise.

Several nasty words ago, that’s what started this brouhaha.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets national politics & policies

Competition Works Even With Limited Info

Few of us understand all our options when we shop for homeowners’ insurance. 

The New York Times’s Paul Krugman riffed on this, arguing that “When people call for ‘consumer choice’ in health care, what this mainly comes down to isn’t comparison shopping on actual care … but rather comparison shopping on insurance policies. And that’s basically impossible even for home insurance, which is a lot simpler than medical insurance.”

Krugman calls a free market in medical insurance “fantasy.”

Yet the illusions involved in buying insurance also apply to non-​market medical coverage. 

Consider: Most people with low-​price insurance like their coverage at least so long as they don’t have to make many claims against it. That’s because insurance is one of those things you buy hoping not to have an occasion to require it. 

Something similar happens in single-​payer medicine. Some Europeans (especially the young and healthy) praise their state systems that cost them next to nothing out of pocket, patching up their scrapes, mending their bones “for free.”

But wait till they are old and really sick, and on a multiple-​month waiting list for an MRI or cancer treatment. Rationing-​by-​waiting can be a killer.

Bottom-​line this: In a competitive insurance market, on learning of poor performance by your carrier, you can drop your insurer like a hot potato. In single-​payer systems, you’re stuck. In line. Hoping not to get something too taxing on the system.

But you do have a choice in coffins.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets general freedom national politics & policies too much government

Commerce, Compulsion and the Constitution

Every once in a while a judge attends to the Constitution, and freedom lovers cheer wildly as if this were very strange, even wondrous. I guess it is, considered in light of the sweep of human history.

Should the Democrats’ “health care reform” package kick in fully, it would compel people to purchase medical insurance by punishing abstainers with a steep, extra tax. So hurray for Judge Henry Hudson of the federal district court in Richmond, according to whose recent decision the Commerce Clause of the Constitution does not empower Congress to point a gun to our heads and force us to buy health insurance.

If the Constitution could be honestly read that way, it would mean that the Founding Fathers had fought to replace British tyranny with an even worse home-​grown one. But no, no Founder thought that giving the federal government power to smooth trade relations among the states equaled authorization for universal, compulsory purchase of books, booze, bobby pins — or whatever Congress-​Approved “health care” delivery system some future central planners might concoct. Nor does it.

We’re not out of danger yet, obviously. There are many more battles to come, many other provisions of “Obamacare” that have yet to be challenged and quashed in courts or in Congress. But in any tough job, you need to accomplish the first step. 

Judge Hudson’s common-​sense conclusion sounds like a great first step to me.

This is Common Sense. I’m Paul Jacob.

Categories
free trade & free markets national politics & policies too much government

Over 50 and for Freedom

Say you’re a senior citizen. You’re concerned about the rising costs of medical services, but are not ready to surrender your care to well-​meaning but naive advocates of ever-​greater government. What to do?

Many seniors belong to AARP, a kind of combination consumer group and political lobbyist association for people age 50 and over. Fifty seems kind of youngish to me to be a senior citi — ow! crick in my back! — but okay.

Members get discounts and also get AARP spokesmen pretending to represent them on political questions. AARP supports a big-​government overhaul of medical services. However, they’ve discovered that the issue is touchy. So they have taken pains to dispute President Obama’s recent claim that AARP endorses any particular bill.

Some AARP members fear that Medicare benefits are at risk. Other AARP members and former members just like their freedom.

Thank goodness AARP has competition. There’s a group called 60 Plus, and now a new outfit, the American Seniors Association, is offering a special deal to all seniors who submits a torn-​up AARP card with their application. 

ASA’s president, Stuart Barton, is blunt: “President Obama must think the American people are idiots.…” if he thinks they’ll buy “the idea that health care rationing, restrictions and regulations being debated in Congress will save money and result in better preventative medicine.”

You know what? I’m not even going to wait until I turn fifty. Sign me up.

This is Common Sense. I’m Paul Jacob.