A Misguided Argument Against Universal Health Care

An oped in the NY Times claims the quest for universal health care is misguided. Ramesh Ponnuru’s arguments, McCain revisited, are notable for what they don’t say.

” For people with pre-existing health problems, for example, direct subsidies would probably be more efficient than rigging insurance markets to make sure they are covered.”

Medicynical note: Sooner or later everyone will have a health problem. At that point the insurer will be “free” to increase the patient’s premiums and force those unable to afford the new higher rate out of the policy. Imagine a health insurance system demoniacally rigged to protect the insurer not the beneficiary. Guess who would provide the direct subsidy? A solution that solves nothing. Brilliant!

He follows immediately with

“As Michael Cannon, a health policy analyst at the Cato Institute, has written, “There is no evidence that a dollar spent on universal coverage will save more lives than a dollar spent on clinics, or reducing medical errors, or nutrition, or fighting poverty, or even improving education.” And if universal coverage generally reduces the quality of care or retards medical innovation, it could end up being bad for everyone, including the poor.”

Medicynical note: This is irrelevant to the argument preceding. It should be noted that our friends at Cato have not shown much enthusiasm for any of the mention interventions–nutrition, fighting poverty or improving education.

He then argues for a non-employer based system without any protections that the coverage will meet minimum needs:

“The existing tax break for employer-provided insurance could be replaced with a tax credit that applies to insurance purchased either inside or outside the workplace. At the same time, state mandates that require insurers to cover certain conditions, which make it expensive to offer individual policies, could be removed”

Medicynical note: Private health insurers salivate at the idea that they would be allowed to offer policies to the healthy that do not meet the needs of those with illnesses. What better way to force high cost patients out of their system. This is not health insurance it’s highway robbery.

In Ponnuuu’s world the employer’s current contribution to health insurance disappears into the employer’s profits. Employees are offered the sop of a tax credit to pay for new coverage obtained in a “not so free market.” No mention is made of the insurer’s ability to increase rates on individuals with chronic illness, cancer, heart disease, you name it. The market is not at all free to those with illness or without savings. The superficiality of the proposal is amazing.

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