I generally try to stay apolitical on this blog and in my writing, but I got an unbelievably shocking e-mail from the Cato Institute this week: “Join the Anti-Universal Coverage Club!” said the subject line, exclamation point included.
According to the e-mail, and these words are verbatim:
- Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
- To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government generally does a poor job of improving quality or affordability. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.
- In a free society, people should have the right to refuse health insurance.
- If governments must subsidize, they should be free to experiment with cash subsidies, vouchers, insurance coverage, public clinics & hospitals, uncompensated care payments, and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”
The first point certainly is valid. Wide availability of quality certainly is a worthy goal. But does it mean availability to everyone who wants it?
The other points all raise questions, such as, if government intervention in healthcare is so bad, why is Medicare so sacrosanct in U.S. policy-making and why is the Veterans Health Administration held in such high esteem?
Sure, some people may lose the right to refuse health insurance under certain proposals, but that likely will end up varying state-by-state, similar to automobile insurance laws. (Here in Illinois, people have the right to refuse to wear helmets while riding motorcycles, but is that really such a great idea?)
I’m guessing that this Cato e-mail was prompted by two things: the push for universal coverage in key states like Massachusetts and California and the release of the movie “Sicko.” Well, California Gov. Arnold Schwarzenegger gave the closing keynote address to the annual meeting of America’s Health Insurance Plans the week before last, and he was warmly received since private health plans stand to benefit greatly from his flavor of universal coverage.
As for “Sicko,” the rumored appearance of Michael Moore at the AHIP meeting never materialized, but the filmmaker’s presence certainly was felt. The impending release of the movie was on the minds of a lot of attendees, and I heard an AHIP media representative on the phone, giving an impassioned defense of private insurance to an out-of-town reporter. (At the time, the film hadn’t been released, and nobody I know had seen anything more than the trailers.) Further, AHIP CEO Karen Ignani had an op-ed in USA Today last Friday, the day of the movie’s release.
I haven’t seen the movie myself yet, but I have noticed that the debate so far has delivered a deafening silence in the areas of quality and efficiency. How can any discussion of healthcare reform forget such important points?