Nationwide Health Insurance Mandate Would Be Bad Policy
"Requiring catastrophic coverage (our parents called it major medical) probably is smart," but a requirement that "everyone have comprehensive health insurance, covering preventive and routine care," is not "really a good idea," Betsy McCaughey, a former lieutenant governor of New York and an adjunct senior fellow at the Hudson Institute, writes in a Wall Street Journal opinion piece.
She writes, "The rationale for this mandate is not personal responsibility but 'shared responsibility,' a polite way of saying shared costs," adding, "Requiring comprehensive coverage, the argument goes, will make it affordable for the sick, by pulling the young and the healthy -- neither of whom use these health services very much -- into the insurance pool" and "will cure overcrowded emergency rooms and help tame skyrocketing health costs." However, such "arguments are based on myths, not facts," according to McCaughey.
She writes, "The first myth is that it's fair to make everyone pay the same price for health insurance" because, for "young people who rarely use health services, this is a rip-off." According to McCaughey, the "second myth behind federal mandate proposals is this: Lack of insurance forces people into the emergency room for routine health care." She writes, "Federal data ... show that the elderly are most inclined to go to the emergency room, though they are universally covered by Medicare."
The "third myth" is that the recent increase in the number of uninsured U.S. residents has resulted from a "sudden moral failure of the country of a broken health care system," McCaughey writes, adding, "Instead a major cause is immigration and cultural differences that make recent arrivals likely to be uninsured."
McCaughey writes, "These facts should point the presidential candidates and Congress toward a sounder policy on health insurance." According to the U.S. Census Bureau, of the 47 million uninsured U.S. residents, almost 10 million have household incomes of at least $75,000 and "probably can afford coverage but have chosen not to buy it," McCaughey writes. In addition, "14 million of the uninsured are already eligible for government programs," such as Medicaid and SCHIP, and "simply need to sign up," she adds.
McCaughey concludes, "That leaves about 23.7 million people -- some citizens, others newcomers -- who cannot afford coverage. It's up to the nation to decide what to do about that. One thing is clear: Mandating that everyone, including young adults, buy insurance, and then hiding a hefty, cost-sharing tax inside their premium, is an unfair solution" (McCaughey, Wall Street Journal, 1/4).