Saturday, November 27, 2010

Auto insurance is NOT like Obamacare

Many make a false analogy between health insurance and auto insurance. Here are some differences between auto coverage and health coverage routinely glossed over or unacknowledged:
1) With auto insurance, the states are making the mandates not the feds. The states have that authority and the feds do not.
2) Government provides us roads to enable driving, but it does not provide us our health to enable living.
3) Using roads requires interaction, requiring some of those government protections for us from other drivers;
while someone else's poor diet, lack of exercise, bad genes or poor luck simply are not be anyone else' problem health-wise, nor should it be financially. (Let's leave public health issues aside for now.)

Group health insurance model provides the same risk pooling benefits that are often cited by Obamacare defenders. It does and addresses adverse selection, but THAT model is a big part of the reason for escalating costs. Consumers of the coverage are removed from the provider selection process and providers are encouraged to form provider networks (cartels). Both of these facts mean that providers do not have to compete on price. THAT is the main source of the cost problem.

Risk pooling does have its issues, but in and of itself it is not socialism UNTIL the government mandates or operates its own health coverage networks. Of course the federal government has done just THAT with Medicare, Medicaid and VA hospitals for at least the last 45 years, which is again part of the current cost problem. There is no free market in health care, so there is no cost containment.

Health care for the indigent should be reassigned back to the fine faith-based hospital systems like Baylor, Presbyterian and Methodist so the "public" is not stuck with the bill. Every one else should buy individual policies for major medical issues and leave everything else as fee for service.