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A Stitch in Haste

A Stitch in Time Saves Nine...But Haste Makes Waste

A collection of real-world libertarian, individualist and laissez-faire rants on law, economics, politics, culture and other current events
by an average, everyday lawyer & investment banker and part-time pop scholar.

Massachusetts' False Insurance Analogy
The Massachusetts Legislature has passed a bill that would make health insurance compulsory in that state:
Gov. Mitt Romney (R) supports the proposal, which would require all uninsured adults in the state to purchase some kind of insurance policy by July 1, 2007, or face a fine.
...
Romney said the bill, modeled on the state's policy of requiring auto insurance, is intended to end an era in which 550,000 people go without insurance and their hospital and doctor visits are paid for in part with public funds. "We insist that everybody who drives a car has insurance," Romney said in an interview. "And cars are a lot less expensive than people."
This is, of course, utter nonsense.

The states that require auto insurance require liability insurance, in case you harm others. Health insurance by definition is to provide coverage for yourself. Health insurance and auto insurance are actually polar opposites.

The proper analogy to the Massachusetts proposal is not liability insurance, but collision insurance — which, to the best of my knowledge, no state requires. If you want to take your chances with your vehicle, then that's your choice. Why should the government force you to do otherwise? What's not your choice is taking chances with my vehicle if you collide with it. You are required to have insurance to protect me, not yourself. (So-called "no-fault" insurance doesn't change the underlying analytical framework either — the point of auto insurance is to reimburse for damage you cause to others, even in a no-fault regime.)

So should it be with health insurance. Insurance for your body should be strictly voluntary, just like collision insurance is for your vehicle.

The externalities you impose on me by crashing into my car are your own doing. The externalities the government creates by the current swamp of publicly-subsidized health care is the government's own doing — exactly the opposite of the auto insurance paradigm. And now the Massachusetts government is "coming to the rescue" by making people pay through premiums for what they're already paying for through taxes, to correct a gap that the government itself created? This is somehow a noble, efficient or brilliant central-planner solution? Why doesn't the Massachusetts Legislature simply outlaw diseases and be done with it?

Any legitimate attempt at health care finance reform has to start at the beginning — the perverse practice of giving favorable tax treatment for health expenditures to employers rather than to employees. Get employers out of the health care benefits business altogether, raise worker pay by the value of the benefits now provided, make all healthcare expenditures — whether directly to providers or indirectly to insurance companies — tax deductible or perhaps even tax exempt. And then have health insurers start directly competing for policyholder dollars (rather than competing indirectly for employer dollars). That last point is, perhaps ironically, the real way that health insurance should be "just like auto insurance."

More thoughts from Coyote Blog, Rolling Doughnut, Below the Beltway, Marginal Revolution.

Related Posts (on one page):

  1. Schwarzenegger's War on Physicians
  2. Massachusetts' False Insurance Analogy
Posted by Kip on 5 April 2006.
Schwarzenegger's War on Physicians
Some people think that it's unfair to characterize socialized medicine as "enslaving doctors."

They are wrong:
Gov. Arnold Schwarzenegger on Monday proposed extending health coverage to California's 6.5 million uninsured residents, promising to spread the cost among businesses, individuals, hospitals, insurers and the government.
...
The governor said savings created by his plan would offset new fees he is asking doctors and hospitals to pay — 4 percent of revenue for hospitals and 2 percent for doctors.
How insane does one have to be in order to believe that the way to increase the supply of a scarce resource is by taxing the very people who are providing it?

Apparently Schwarzenegger is borrowing a page from the Michael Bloomberg book and hoping that living in California is so irresistible (i.e., that demand is so inelastic) that physicians, nurses and other health care professionals won't simply pack up and leave the state, no matter how impossible the health care socialists make it to function there. Recent evidence suggests otherwise.

It is true that Schwarzenegger's proposal would increase reimbursement rates under California's existing plan, MediCal. But that can never offset the lunacy of the underlying concept: tax the people providing what you claim to want more of.

The economically inclined might also note that, if the demand for health care is inelastic, then physicians and hospitals can simply "pass on" the tax to patients. Which would mean that Schwarzenegger's idea of helping his constituents is by imposing an indirect tax on them.

Hopefully all this nonsense will be promptly targeted for termination.

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The rest of Schwarzenegger's proposal is basically just the Massachusetts plan reheated in the microwave — see my previous post.

Related Posts (on one page):

  1. Schwarzenegger's War on Physicians
  2. Massachusetts' False Insurance Analogy
Posted by Kip on 8 January 2007.