I have an op-ed today on Topix.com’s Politix page about Obamacare’s age-related rate restrictions, which require younger people to pay higher insurance premiums in order to subsidize the coverage of those older. I say in the article:
No one, presumably, would be comfortable with the idea of fleecing our children and grandchildren in order to lighten our bills. But supporters of the Affordable Care Act have taken to arguing that forcing young people to subsidize older people isn’t some new consequence of the health law—all insurance, they claim, requires some people to subsidize the expenses of others. Take fire insurance. Ten thousand people might sign up to insure their homes, but only a couple of those homes may end up burning down. The premiums paid by those whose homes did not burn down go toward rebuilding the homes of those whose did.
“That’s how insurance works,” insists health policy analyst Aaron Carroll, who concludes that the health law’s age-related rate restriction is “really not much different than how insurance is supposed to function, by transferring money from the more-healthy to the more-ill.”
But by equating traditional insurance with the health law’s age-related rate restriction, commentators like Carroll ignore a key component of insurance in a market absent government intrusion: the freedom to buy a policy that is priced according to your own risk—a policy that subsidizes no one.
Check out the whole article here. I previously addressed another argument made by proponents of this restriction, here.
(This is cross-posted from Voices for Reason.)
For those who may have missed this recent story:
The nation’s largest movie theater chain has cut the hours of thousands of employees, saying in a company memo that ObamaCare requirements are to blame.
Regal Entertainment Group, which operates more than 500 theaters in 38 states, last month rolled back shifts for non-salaried workers to 30 hours per week, putting them under the threshold at which employers are required to provide health insurance.
. . .
One Regal theater manager told FoxNews.com the move has sparked a wave of resignations from full-time managers who have seen their hours cut by 25 percent or more.
“In the last couple weeks, managers have been quitting on a daily basis from various locations to try and find full-time work,” said the manager, who asked not to be named. “Regal up until now has never restricted anyone to anything below 40 hours.”
The manager told FoxNews.com ObamaCare has had the unintended consequence of taking food off his table.
“Mandating businesses to offer health care under threat of debilitating fines does not fix a problem, it creates one,” he said. “It fosters a new business culture where 30 hours is now considered the maximum in order to avoid paying the high costs associated with this law.
“In a time where 40 hours is just getting us by, putting these kind of financial pressures on employers is a big step in a direction far beyond the reach of feasibility for not only the businesses, but for the employees who rely on their success,” he said.
The Affordable Care Act makes it illegal for most employers to hire a full-time employee without also providing him with health insurance (or paying a hefty fine.) Commanding employers to provide health insurance does not change the fact that it does not make business sense to provide it in some cases. So it should not be surprising that some employers are instead choosing to scale back employee hours.
(This is cross-posted from Voices for Reason.)
Image: Anthony22 at Wikimedia Commons
A recent editorial in the New England Journal of Medicine discusses Vermont’s single-payer health care system and makes the case that other states have a lot to learn from the Green Mountain State. What struck me was what the piece left out of its discussion.
Here are the alleged positives of socialized medicine in Vermont, according to the article:
- “Transparency” and the “engagement of all stakeholders”
- An “independent” five-member board that controls every price, every product and every medical provider
- A state-run health insurance market
- Cost savings
If you needed heart surgery and were considering where to have it, and somebody handed you this list of the benefits of Vermont’s scheme, my guess is you’d toss the list aside and ask, “But are there surgeons in Vermont who have a higher success rate for my particular surgery than those in other states? What are their protocols for reducing medical errors? Are they particularly good at dealing with complications that might arise when I’m on the table?”
There is no mention of the quality of health care in Vermont in the NEJM article, and this article is not an exception—it is all too common for discussions of greater government intrusion in health care to proceed without any consideration for what this will mean for the quality of care available.
The reason there is such little concern with the quality of care is that the leading advocates of government control over the medical field are motivated by egalitarianism—the notion that everybody should have equal health care, even if that care is equally shoddy. To learn about the quality of health care that ultimately results from such an approach, you need only listen to the recent interview I conducted with Sally Pipes, in which she discusses her harrowing firsthand experience of socialized medicine in Canada. (Though Vermont’s scheme is relatively new, there’s reason to expect the same kind of downward trend in quality.)
If advocates of increasing government control were motivated by making possible the highest quality health care, they would talk more about the indisputable fact that freedom and free markets were essential preconditions for the unprecedented human advancements of the last 150 years, including in medicine.
Image: Wikimedia Commons
On this episode of Eye to Eye, I had the opportunity to interview Sally Pipes, a leading proponent for greater freedom in health care. In discussing health care policy issues in this country, people often make comparisons to the health care systems of other nations—the Canadian system is often brought up. I discussed with Ms. Pipes her firsthand experience of socialized medicine in Canada.
One point she made that I found particularly interesting was her discussion of the factors that lead people to have a skewed view of a health care system. When you have routine medical needs (which is the category most people fall in), a health care system fraught with government intrusion may look as if it is working decently. The shortcomings of such a system often only become apparent when you experience out of the ordinary illnesses that require experimentation, innovation and state-of-the-art care. This is important to keep in mind when you hear Canadians saying, as they often do, that their government-run health care system works great.
Another subject we discussed is the frequently cited fact that Canadians spend a lower percentage of their GDP on health care than Americans (11.4% vs. 17.6%). In my view these kinds of collective statistics are dubious and misleading (given the impact of regulatory controls on costs, and the disparate quality of service from one country to another–to name just two problems).
Some of the other topics Ms. Pipes discusses in the podcast include:
- Why private health care is outlawed in Canada
- The part of the American health care system that most closely resembles Canada’s
- Where doctors and patients are going, to escape government intrusion in their medical decisions
- Why health care in Canada is getting worse
Ms. Pipes is president of the Pacific Research Institute. She writes a column for Forbes.com and is most recently the author of The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare.
We regularly hear that government needs to intervene in the market to ensure that all people have “access” to health care. But what does “access” mean? Is there some epidemic of oversized hockey goalies standing outside hospitals, blocking people from getting into the ER? Have I just missed the news that hospital walkways are booby trapped and that you can only sneak through the door if you have your own invisibility cloak?
On a free market, everyone has the same “access” to a hospital as they have to a movie theater or restaurant: they can walk in and buy what they are willing and able to pay for.
The people lamenting the lack of health care “access” don’t like that. They don’t like the fact that a person has to pay for medical care, and so rather than say, “You are entitled to have other people pay for your health care,” they use misleading language to imply that a person’s having to pay for medical services is equivalent to having someone interfere with his freedom to buy care.
There is no problem of “access” to health care. The problem today is that health care is heavily controlled and regulated: we don’t have the freedom to pursue medical care on a free market. As a result health care is more expensive, more bureaucratic, and less available than it would be if government stopped trying to promote “access.”