Hiltzik column: Of healthcare mandates and loopholes

Followers of America's healthcare mess know that its outstanding feature is the loophole. Insurance companies exploit loopholes to deny coverage to those they fear might develop, you know, an illness, and to rescind coverage purchased by those whose illnesses threaten the carrier's dime.

As my Thursday column states, the key to effective reform is to close every loophole -- mandate that insurers sell coverage to all buyers, for example, and mandate that every American be a buyer. That way, the insurers are deprived of the incentive to drive away more costly customers while keeping the young and the hale.

The reform bill passed by the Senate Finance Committee this week under the guidance of Sen. Max Baucus (D-Mont.), incorporates the individual mandate. But the question is whether it has created a gaping loophole by soft-pedaling enforcement. Specificially, are the penalties for evading the insurance requirement so light as to be ineffective? Many economists believe so. Herewith an analysis, along with a caution about what the consequencies might be of a weak mandate. The column starts here:

Healthcare reformers tell a wry joke about one of their number who, called to heaven, is given the opportunity to pose a single question to God.

“Will we ever have universal health coverage in the United States?” the reformer asks.

“Yes,” comes the answer from on high, “but not in my lifetime.”

The simple truth implicit in this joke is underscored by the landmark healthcare bill passed this week by the Senate Finance Committee: America is walking up the driveway of universal coverage, but hasn’t yet made it through the door.
 

Read the whole column.

-- Michael Hiltzik

Comments

[Tab Cocovillea]

Universal coverage can only result in one thing, higher costs for everyone, which is a fool's game, Any time government mandates anything, there will be new methods devised to circumvent the mandates. One way is for the companies "forced" to offer coverage is to raise prices, another is to deny services to all equally. Every action has a reaction, and I'm pretty sure the people wanting everything for free and without a fight are going to be rudely surprised by the reaction to their simple-mindedness. Open, free markets work, not the Gordian knot that's being tied for us.

[Bob from Berkeley]

I believe that Health care reform is a major component of economic reform. The two should not be separated. When families are being bankrupted by health care costs, then how can anyone say that economics and health care are separate? They aren't. When entrepreneurs are scared from starting new businesses because of health care costs, then how can anyone say that economics and healthcare are separate? When people are denied wage increases...? When people cannot get care and are less able to work...? When people are dying...?

We have to face this problem as a country. I don't make much money, but I am always willing to pay into real universal healthcare for this country. I'd rather give it to our government, which represents all of us, than corporations out to make profit from the sick and dying

A Canadian wrote that it benefits his entire society that its citizens have access to universal care. By making preventative medicine freely available, it lowers the cost of chronic illness. By making early diagnosis possible, it prevents many diseases from reaching a fatal stage. By making mental health care and medication available to those who need it (and who are often unemployable), it avoids the American system where many such people are abandoned to the streets or to the care of their overtaxed families.

No health care plan should cost more than the total amount Americans are paying for health care now. Anyone who says differently either doesn't know anything about finance and healthcare, or they are deliberately trying to squeeze American taxpayers to line their own pockets.

How can we help push through change when the very people responsible for change are being paid off by the people who need to be changed?

[js]

This is no place for Hiltzik's op-ed columns.

Notwithstanding my disagreement with Hiltzik, this is Petruno's space, and he handles it well with a mid-point view.

[Mark Graybill]

Why do you villanize all healthcare insurance companies? Will a government program be any less costly or less corrupt? Will a government program make the healthcare industry better? If you think so, then you don't know much about Medicare.

We cannot legislate the world to be safe - it not only will never happen but we risk tossing out liberties as legislation heads down that path. Thus, prudent bipartisan deliberation with an ear to America’s voices is warranted for every policy decision - not one side's solution against the other side's regardless of what opinions Americans are voicing. The latter is unbecoming a democracy - despite what their advertising campaigns promise.

I don't see either party rising to this challenge - it is politics as usual, ad nauseam.

My adult children had initially decided against purchasing healthcare coverage for whatever reason they felt free from having to share with me. Perhaps they declined because they were in good health and wished to gamble, and spend that money on other things. My oldest still doesn't have coverage even though he and his wife could purchase coverage with their cigarette money if they stopped smoking.

A couple of my adult children decided to finally grow up and be responsible. During high school I gave them all a choice - a choice to have a social life and extracurricular activities, or straight-A grades to go after scholarships with. They chose the former and now are finding it difficult to go to and pay for college and have a life. So after some struggles, they looked at some options and found the Air force Reserves. Not only do they now have help with college, but they have great healthcare coverage available to them (still have to purchase it and have a choice to purchase it). They also have a part-time career they can retire from someday regardless of what they become as a civilian (my daughter wants to be a surgeon and my son an engineer).

My point is they had a choice that should not be taken away from them, that the hard knocks of life compelled them of their own free will to find a solution. However, not all are willing to find their own solutions; they want others to find solutions for them.

I have a colleague whose son refuses to be responsible because, says his son, "There is always a program to take care of me." He is hoping for change to make his life better despite his dad's pleas to make his own life better by utilizing the ability we all have been endowed with through evolution.
Now it is tempting to force these individuals to purchase coverage. In fact, why not force everyone who is alive in America to purchase coverage? Solves several problems, right? But where is the proof it will solve our healthcare woes and not create other maybe even bigger problems? Moreover, try to ask those questions and you're quickly dismissed for reasons typically ad hominem. How does this make for good policy?

Sometimes an argument for a solution fails to be given the same principled consideration as other arguments regardless of whether they share relevant principle s. Moreover, sometimes the solution that makes the most sense may not be the best solution. When something makes sense, your brain chemistry changes in a way it likes. Nothing however has ever been established attributing as true something making sense.

Now, how is it right for such brain chemistry of some to force life changes on others?

Here's a question: what do we do with the 'criminals' who don't buy coverage after such law is passed? Not all libertarian arguments are valid, but many are worth listening to.