A Stitch in Haste

Kevin Drum on Health Savings Accounts:

[A]ny healthcare proposal that's designed to appeal more to healthy people than to sick people is fundamentally flawed. After all, the whole point of healthcare is to take care of sick people.

The bottom line is that if HSAs are a better deal for healthy people, then inevitably they're a worse deal for sick people. And if you take healthcare seriously, it's sick people you should be concerned about.

This is, of course, utter nonsense.

The false premise underlying Drum's entire lament is the patently false reduction of a person's condition to either "healthy" or "sick." This is such a preposterous claim as to hardly merit rebuttal. As we all know, a person can be "perfectly healthy," except for hypertension, or high cholesterol, or excess weight, etc. A person may be "perfectly healthy" except for a family history of heart disease or breast cancer or mental illness. A woman can be, and hopefully is, "perfectly healthy" while she's pregnant. Flu shots are meant for the "perfectly healthy" and not for people who are already sick with the flu. And so on...

It seems to me that the purpose of "health care" is to maintain and improve the health of individuals, regardless of health, not just to "cure the sick." And the purpose of health insurance is not to blindly transfer money from the "healthy" to the "sick," but rather for each individual participant to plan for the contingency of becoming sick himself. A "healthy" person today may become sick tomorrow, and a "sick" person today may become healthy tomorrow. Any policy that imagines healthy people staying healthy forever and sick people staying sick forever is, to use Drum's term, "fundamentally flawed."

And since when is expanding choices a bad thing? Health Saving Accounts would be voluntary. But, as we saw with Social Security reform, nothing voluntary is ever to be tolerated by liberals. Ever.

And since when is lowering taxes in order to increase saving, especially saving for health care, a bad thing? Is it now immutable liberal dogma that taxes are always preferable to savings?

An insurance system that only works only has any chance of working if it compels people to participate against their will is also by definition "fundamentally flawed" (see also, "Social Security"). Should people without cars be forced to buy auto insurance simply to reduce premiums for people with cars? Even assuming arguendo that Drum's dubious zero-sum assertion of "if HSAs are a better deal for healthy people, then inevitably they're a worse deal for sick people" is correct, so what? Why do "healthy people" owe any duty to "sick people" to ease their healthcare financing burden any more than people without cars should be forced to ease the auto insurance burden of those who do? The purpose of a person's health insurance is to insure that person, not to engage in stealth taxation to insure his neighbor.

So now the radical liberals have gone from the abstract "hatred of the good for being the good" to the concrete "hatred of the successful for being the successful" to the absurdity-embracing "hatred of the healthy for being healthy." All in the name of "progressive compassion for the less fortunate."

Is it too late to dress up as a scary liberal for Halloween?

(Via Marginal Revolution. More thoughts at Truck and Barter.)