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America Doesn’t Need a Health Insurance ‘Czar’

Americans are not serfs. We value our health and our freedom.

by
Paul Hsieh

Bio

January 18, 2010 - 12:00 am

The Wall Street Journal warns us that under ObamaCare, we may see yet another “czar” — this time, in charge of our mandatory health insurance. This would be in addition to the long list of czars President Obama has already appointed for “green jobs,” executive pay, domestic violence, international climate change, and the auto industry.

Under any system of mandatory insurance, the government must necessarily determine what constitutes an “acceptable” plan. The health insurance czar would be in charge of a new bureaucracy called the “Health Choice Administration,” which would regulate what prices insurance companies could charge for policies, who they must cover, and what benefits they must offer.

If you’d rather purchase a low-cost “catastrophic-only” policy, but the czar determines that all health plans must include benefits such as in vitro fertilization, blood lead poisoning treatment, and chiropractor services (as some states like Massachusetts already require), then too bad. You won’t be allowed to spend your own money based on a rational assessment of your needs and circumstances. Instead, Washington will tell you how you must spend your own money.

To add insult to injury, President Obama has repeatedly promised:

If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.

It turns out what he really meant was: “If you like your health care plan, you will be able to keep it — but only if my czar lets you.”

After a five-year grace period, large employers who offered health insurance to their workers would have to abide by all the rules set by the czar as to what counts as a “qualified” plan.  Small employers offering health insurance could be subject to the new rules even sooner.

The only argument between the president and Congress on this point is whether your limited range of mandatory insurance choices would be determined by a single national-level czar (which the president and the House Democrats prefer) or 50 state-level czars (which the Senate Democrats prefer).

Furthermore, Fox News reports that the planned system of mandatory insurance would amount to a massive transfer of wealth from the young to the old. Most young healthy people would do best with a low-cost catastrophic-only health insurance plan to cover major emergencies, and a health savings account to cover small routine expenses. But under ObamaCare, they would be forced to pay a disproportionate share of others’ medical expenses:

“If you charge people a fair price, then a 50-to-60-year-old should pay about six times as much as a 20-year-old,” said John Goodman, president of the National Center for Policy Analysis. But he noted that the Senate bill says older people can be charged only three times as much; the House bill says they can be charged two times as much. “So we’re going to penalize low-income young people in order to lower the premiums for older wealthier people.”

Young adults who are healthy would be the most unjustly affected by mandatory insurance. They consume the fewest medical resources. Under mandatory insurance, they would most heavily subsidize the costs of the older, more-frequently-ill patients.

Mandatory insurance thus robs them of money they could use for their own goals, such as saving to buy a first house or to start a business or a family. In other words, the insurance czar would force them to sacrifice their lives and futures for the sake of the collective.

When an insurance czar requires everyone to purchase health insurance, then sets the prices and benefits independent of a free market, it turns insurance from a system of voluntarily shared risk into a thinly disguised form of government welfare.

Trying to solve the problem of the uninsured by forcing everyone to purchase government-administered insurance would be like trying to solve the problem of homelessness by forcing everyone to buy a unit in a government-run housing project.

Instead of yet another presidential czar to make our insurance purchasing decisions for us, we need genuine free-market reforms.

Patients should be allowed to purchase insurance across state lines and use health savings accounts for routine expenses. Insurers should be allowed to sell inexpensive, catastrophic-only policies to cover rare but expensive events. States should repeal laws that force insurers to offer (and patients to purchase) unwanted mandatory benefits such as in vitro fertilization coverage.

Such reforms could reduce insurance costs over 50% — making insurance available to millions who cannot currently afford it, while respecting our freedoms.

Americans are not serfs in need of a czar. If we value our health and our freedom, we should reject both the idea of mandatory insurance and a health insurance “czar.”

Paul Hsieh, MD, is a member of the Colorado chapter of Docs4PatientCare (www.Docs4PatientCare.org) and co-founder of Freedom and Individual Rights in Medicine (www.WeStandFIRM.org).
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