Here's my latest, sent to my senators and to the members of the Senate Finance Committee:
I am disturbed about some features of the emerging possible compromise on health care legislation. I read that this compromise is likely to include mandatory insurance for individuals, as well as requirements that insurance companies cover those who are already known to need continual expensive care.
There is something fundamentally un-American – not to mention unconstitutional – about the federal government telling people that they must purchase an expensive product for their own use that they do not believe they need. The comparison to auto insurance misses the mark, as that requirement is: (1) a feature of state, not federal law; (2) confined to those who choose to drive; and (3) mainly designed to ensure that the driver can pay for injuries or property damage his driving inflicts on others.
As for requiring insurers to cover all pre-existing conditions, this further distorts the already strained meaning of “insurance”. Insurance is a form of hedging one’s bets, protecting against unlikely events (e.g. fire, accident). Where known medical conditions will require extensive future medical care, “insurance” is a misnomer. Placing the costs of such care on insurers is a kind of tax, which will be passed on to all the insurers’ customers in the form of higher premiums. Such higher premiums are one of several reasons that people currently satisfied with their insurance cannot count on their employers’ retaining such insurance.
The question of how to help Americans pay for chronic health conditions is a difficult one, and we need a great deal more brainstorming on the subject. Greatly expanding the federal bureaucracy, either expanding or imitating existing bureaucracies that are financially imperiled and administratively lackluster, cannot be the best answer available.
There are good ideas already out there for addressing many other aspects of health care. By letting Americans use pre-tax dollars to pay for both health care and health insurance, we can disconnect health care from employment and let people be cost-conscious health care consumers. Health insurance could then fill its more appropriate role, instead of being used for predictable everyday health care. Allowing insurance companies to compete nationwide would greatly reduce cost and expand choice.
Please do not allow the push for a bipartisan solution [replaced in some emails with: the demands of party leaders] to obscure the merits of the issue.
Karen A. Wyle
UPDATE: Holy cow! My readership just jumped substantially. Hello and welcome, new folks! Please feel free to comment.