A Poor Richardâs News reader asks:
I totally agree that the fact they are forcing you to buy something is immoral. But what about the fact that you CANNOT be denied coverage if you have a pre-existing condition?
There is a central principle that I think we agree on here. People with pre-existing conditions should be able to get treatment. However, mandating insurance coverage forces private companies to enter into legally binding contracts, something I donât believe the government should have the power to do. At that juncture, what youâre talking about is no longer insurance. Itâs something else entirely. After all, you canât go get collision coverage for your car AFTER somebody rear-ended you. You canât get a home-owners insurance policy for a house with a leaky roof and a cracked foundation. However, Obamacare essentially forces this to happen in the medical field, but there are better solutions to the problem of pre-existing conditions than government mandates.
How did we wind up with our employer-based insurance system?
It is valuable to remember where our system of health insurance (particularly provided by employers) started in the first place. During WWII, the Federal government placed caps on the salaries of workers in the United States. President Franklin D. Roosevelt (a Democrat and a progressive) wanted to prevent the private sector from using higher wages to lure workers away from the government during the war. As a workaround the wage caps, businesses began offering health insurance as a bonus on top of a salary. WWII is long over, but today our tax code still promotes an environment where medical benefits are favored over higher salaries and self-insurance.
So, the entire reason we now have health insurance entangled in the jobs market is because the private sector responded to Federal anti-competition regulations (as it always does). Now, with Obamacare, the Federal government is once again issuing regulations that prevent employers from offering competitive benefits to employees (by nixing âCadillacâ plans and catastrophic plans and mandating all employers provide the same cookie-cutter plans.)
Already, weâve begun to see the private sector respond to these new government intrusions by finding work-arounds. Some businesses are hiring only part-time employees. Some are hiring only 49 employees instead of 50 (these businesses have earned the nickname â49ersâ). Many top hospitals will no longer accept patients who carry Obamacareâs plans. Doctors are leaving the field in large numbers because instead of making their jobs more affordable, itâs making medicine unworkable.
What could we do differently?
First off, I believe charitable hospitals are the front line in treating pre-existing conditions. But instead of making charity easier and more affordable, Obamacare actually puts additional regulations, red tape, and fines on charitable hospitals that give free treatment to poor people. Until recently, the vast majority of new hospitals built in this country were charitable organizations started by churches and private foundations. Even today, the Southern Baptist Convention, the Catholic Church, and other religious institutions provide state of the art medical care to countries around the world. Mercy Ships, for example, sails a cruise ship hospital all over the world to treat people in impoverished countries. However, here in the US, it is becoming more and more difficult for charities to provide essential health services. Remember, the government doesnât like competition!
Secondly, I believe that the Federal government could positively motivate insurance companies to take on customers with pre-existing conditions by allowing more customizable plans, but Obamacare mandates cookie-cutter plans that offer almost no flexibility whatsoever. For example, if a skin cancer patient is receiving free treatment from a charitable hospital but wants to get health insurance to cover other things like broken bones or bacterial infections, he canât. The government wonât allow it. Obamacareâs âminimum essential coverageâ requires all health insurance plans to cover things like maternity (even if youâre a male) and prostate exams (even if youâre a woman). Naturally, this doesnât make insurance more affordable for anyone.
Thirdly, the Federal government has an arbitrary ban on selling health insurance across state lines, thus artificially preventing competition. As you know, competition brings prices down. I can buy car insurance from a gecko in Chevy Chase, MD, but I canât buy health insurance from a neighboring state. Through regulations like these, the Federal government artificially keeps the cost of insurance higher than a freer market would.
These are just three simple ideas, and a vibrant free market would bring our health care system many more.
Our sad reality and the way out.
Sadly, the US health care system has not been a free market for a very long time. In trying to clean up a mess that it started in WWII, the Federal Government is making an even bigger mess of the health care system. The days when local doctors routinely made house-calls to sick neighbors are all but gone. In its place, the Federal government has set up a vast web of bureaucracy, crony-capitalism, and welfare. We can do better than this, but not until government gets out of the way.
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Obamacare: yet another of endless examples where government creates a problem. Then tries to fix it by making the problem even worse and more expensive.