Posted by
Andrews on Tuesday, November 03, 2009 9:38:03 PM
It appears that the public option is a thing of the past. At least it seems likely that the Democrats have decided to sacrifice it in an attempt to keep medical reform alive. And, understandably, conservatives are happy to see it go. But does that mean that all our worries are over? Far from it.
The problem is that the Democrats, while not pushing actual government insurance, are still pushing for mandatory coverage, which likely will mean government funding. And, as someone once remarked, the Soviet Union was nothing but universal government funding. Once the government becomes the primary source of income, or even a significant source of money, the government effectively establishes control. Just look at how much influence the government has over how insurance billing is handled, just because of medicare and medicaid. Or how much they determine policies of universities thanks tot heir role in providing financial aid. Or read my posts on vouchers ("
You Don't Drown in a Glass of Water - Vouchers Revisited", "
Why Vouchers are not the Answer", "
Never Ascribe To Evil, A Discussion of Education"), as my main objection to vouchers is how much control it would give the state over education, public and private.
Even if there were no subsidy, simply forcing universal coverage would, in itself, change medicine. First, for many of the same reasons public funding would. To qualify as "insurance", meeting the requirement that everyone have insurance,t he policy would likely have to provide certain defined services, and so every insurer would effectively be required to provide those. Be they twice yearly checkups, prenatal coverage, or "gender reassignment surgery", whatever the federal government says must be included for insurance to meet the mandatory coverage requirement would have to be in every policy. Simply by changing this definition the government could effectively dictate insurance policy for the entire nation.("
Preexisting Conditions")
Second, by making insurance universal the government would insure the "health care crisis" will worsen. It likely isn't their intent, but that is the outcome. As I discussed in "
The Absurdity of Mandatory Insurance", "
A Potential Problem With Universal Insurance" and "
A Potential Problem With Universal Insurance" universal insurance would create ever fewer reasons for providers to engage in cost competition. (See also "
High Cost of Medical Care","
Medical Reform, An Overview", "
The Insurance Sham", "
Redefining Insurance... To Actually BE Insurance", "
Why Health Insurance Isn't Insurance and Related Topics".) With cost competition a thing of the past, and every customer relying upon insurers, costs would continue to rise, and with the government easily able to expand coverage by changing definitions in legislation, the costs would soar and the price of private insurance will skyrocket. With people mandated to buy insurance, likely the poor will be bankrupted, even with some government assistance for their required insurance purchases. As a result the clamor for a public option, or outright takeover will probably grow stronger. And the government, having avoided the public option, will likely declare the "free market" (which they will claim this solution to be) has failed, and once again blame the market for a fiasco caused by intervention. (See "
How To Blame the Free Market", "
Greed Versus Evil", "
The Inherent Disappointment of Authoritarianism". And for a related problem "
An Interesting Question Under ObamaCare".)
All of which means we must not rejoice too much at the death of the public option, as the remaining choices are still dangerous and just as likely to push us toward full nationalization, be it de facto or de jure. Just as there is no need for explicit nationalization, the public option will work just a swell, there is also no need for the public option, mandated universal coverage will have the same result. At best, if we dodge the public option, dodge public funding, but still get saddled with mandatory universal coverage, we are looking at a few years of quiet, while costs quietly soar and conditions worsen until we once again hear calls for government intervention. Then again, if the Democrats pass nothing, we are still not out of the woods. The current situation is the outcome of our present system, and ti won't get better. We definitely do not need the Democrats' reform, but we do need reform.
Unfortunately, I seriously doubt we will see the free market solution we really need. (See "
My Health Care Plan", "
Clarification of My Argument for a Free Market in Medicine", "
The Insurance Sham", "
Redefining Insurance... To Actually BE Insurance".)
POSTSCRIPT
This is not quite the post I intended when I wrote a blurb in "
Upcoming Posts". Nor is it my last word on the matter. Think of this as sort of an introduction, pulling together a few old posts, setting the scene and presenting opening arguments. Each of the points I raise here deserve a post in themselves, and will be receiving it in the near future. However, for the moment, I wanted to at least mention the problems we are still facing, so I wrote this to get my cards on the table and let readers know what to expect. And, having done so, I will soon be returning to these topics and discussing them in greater detail.