January 4, 2010 by D Stack
It’s been pretty heavily reported in the blogosphere – Rush Limbaugh needed emergency medical care in Hawaii last week. At a press conference he said that from what he can see in Hawaii, “there is nothing wrong with the American health care system. I received no special treatment.”
As many have noted out there, Hawaii mandates, with very few exceptions, that employers in Hawaii provide health insurance to employees working more than 20 hours a week. I first read about this in an article by Paul Abrams at the Huffington Post.
An advantage to systems like Hawaii’s and, to a lesser extent, those like Massachusetts’ (which mandates obtaining coverage but doesn’t put as much onus on employers) is that the cost of health insurance gets spread out in a far larger pool. And this pool includes lots of healthy people who don’t have very high health care costs.
Why is this good? Like any insurance program, it spreads the risk. For every person with an expensive, life-threatening illness, there will be lots of people with minimal health care costs. If people can opt-in to a system only when they need it, the costs become astronomical. This is the whole reason for insurers wanting to keep out people with preexisting conditions – or assess them a much higher premium.
Why not just go to a free market system? I’ve seen it suggested (for example on the January 4, 2010 Rush Limbaugh Show by guest host Mark Steyn) that we should just get rid of insurance and you pay for what you get. This probably would have the effect of lowering doctor’s costs. After all, a large part of their expenses currently go to insurance companies. Of course people who couldn’t meet these costs would just have to die if they couldn’t afford them. Which brings us to the whole reason for having insurance in the first place. Spread out the risk. Buying a house is the biggest purchase most people make, typically spread out over a thirty year mortgage. You don’t expect your house to burn down in a fire, but if it does you almost certainly couldn’t afford to have it rebuilt. Hence the reason mortgage holders almost always require homeowner’s insurance. They want to minimize the risk on their investment – the mortgage. If your house burns down and you can’t afford to rebuild it, odds are pretty good you’ll just walk away and tell the bank the charred ruin is all theirs.
So I hope health insurance seems reasonable. Now you have to decide as a society if everyone has a right to it. Yes, no mention of a health care as a right appears directly in the United States Constitution, though the Declaration of Independence does enumerate “life” as one of our inalienable rights. As to whether it is constitutional – the argument for it is that one of congress’s specifically enumerated powers is to “promote the general welfare”. Social security has endured constitutional challenges so it is reasonable to assume a government requirement of health care would.
For purposes of argument, assume such a mandate would survive a challenge. Is it something desirable? Or put differently, should it be a right? I assert that it should. I believe it is wholly consistent with the guarantee of “life, liberty, and the pursuit of happiness”. It seems to me the alternative is to allow people to suffer and/or die when they need not. I’m not talking about difficult end of life decisions as to the timing of death. I’m talking about a person who contracts a treatable disease but has no means of paying for that treatment. Or not giving preventive care which could detect such diseases at their earliest stages. Of not providing treatment to crippling mental illnesses.
If that is socialism, sign me up.