Mimsy Were the Borogoves

Editorials: Where I rant to the wall about politics. And sometimes the wall rants back.

The Democrat’s anti-health health-care plan

Jerry Stratton, June 9, 2009

The new Democratic health care bill sounds like an anti-health care plan. It sounds as though it is designed to increase individual costs, increase overall costs, and reduce the quality, of health care. It’s our current system on steroids: health care that is disconnected from the patient, and answerable only to the government and the employer.

  1. It requires employers to offer health insurance to their employees. Instead of just subsidizing employer-based insurance over individualized insurance, employers will be penalized if they don’t provde health insurance. This is even worse than our current system. Employer-based health insurance puts the employer between the insurance company and the patient. The employer’s needs are rarely the needs of the patient.

    1. Health insurance companies will cater to the needs of employers, not the needs of the patient.
    2. Personal insurance prices will rise even higher, because most insurance will be sold en masse to employers.
    3. Individuals will be able to choose from one or at best a handful of plans, unless they want to pay exorbitant prices and not get health care through their employers.
    4. Wages will drop, jobs will drop, and/or prices will rise, because every employer must now pay someone to manage their health care plans. Every employer must add a health care benefits specialist to their payroll to ensure compliance.
  2. It requires a minimum level of coverage that covers non-emergency, wellness, and prescription drug coverage. This means that if you are willing to cover non-emergency care yourself to reduce your premium, you can’t do it. You can’t just buy emergency or catastrophic health insurance, and pay for minor costs out of pocket.

    Imagine if you could only buy car insurance that covered every tune-up. Your car insurance itself would be catastrophic. That’s the only health insurance available under this plan. So even though the plan superficially looks like individuals are choosing their own coverage, in fact that coverage is determined to the letter by the federal government.

  3. It either negates or doesn’t allow for lowering your health care costs by changing your habits or situation. If you promise to use a seat belt, if you buy a car with an air bag, etc., you can lower your car insurance costs. But if you stop smoking, stop boxing, or otherwise promise to act in a safer manner, your health insurance will be the same. Either the insurance company can’t offer you a reduced rate, or the increased rate that they charge others for risky behaviors will be covered by the government. Whether it’s through your taxes or your premium, you’ll pay more; and what you pay will be out of your control.

Because health care plans under this system are micromanaged by the federal government, there is no room for competing plans that cater to individual needs. We’re not going to see a market full of companies all vying for our business. Complying with rules costs money. The level of micromanagement described in the bill—the mass of rules that will be created on the whim of the Medical Advisory Council—will form a barrier to entry that blocks smaller, more customer-focussed companies.

And it isn’t only the mass of rules but that the rules change on the whim of the MAC. This doesn’t just invite corruption, it virtually ensures it. Because the rules will change regularly, mere survival will require lobbying the MAC to create favorable rules and remove unfavorable rules. And it will inevitably create an environment where larger corporations lobby to create rules that are unfavorable to their competitors. Only large companies will be able to compete. Companies that can’t afford to lobby, or that choose to focus on health care rather than on lobbying, will fail.

We will end up with one to three giant HMO-like companies dominating health care.

Further, this ends up creating another huge federal/state bureaucracy tasked with enforcement. Individuals must verify their coverage. There will be fines for non-compliance, and the rules will be complex and the bureaucracy faceless. The MAC will be an IRS for our health.

Real reform would reduce our dependence on employer-based insurance and it would increase the options available to us to choose our own level of insurance. It would remove all barriers between the patient and the doctor except those that patients themselves choose. Instead of making the employer be the health care customer or the federal government be the health care customer, the patients themselves would be the health care customer. That’s the only way to make health care actually care about the patient.

This bill sounds like a disaster for people who want to manage their health care costs and who want personalized care. It will create the kind of faceless, maze-like system you see in dystopian science fiction movies.

June 23, 2009: Updated point three for clarity.

  1. <- No criticism of spending
  2. Resistance to media bias ->