Mary Beth Schneider, writing for the Indianapolis Star, has an article entitled Health coverage bill is still kicking on the subject of SB 503 which is a bill designed to provide health insurance for the working poor. Mike Sylvester is not happy with this latest advance of big government.
The bill passed the House Public Health Committee 11 to 1. The reprinted bill and/or the House Committee report weren’t immediately available on the General Assembly’s website, so I don’t know how extensive the House’s changes were to the original Senate Bill. Ms. Schneider’s report says they were extensive “including expanding coverage to include mental health services, drug addiction and family planning services and adding a sliding premium scale so that poorer people pay less;” expanding coverage for pregnant women and children, allowing dependent children to stay on their parents’ health insurance to age 24, and adding a tax credit for employers that offer wellness programs.
The revised bill apparently leaves out one minor detail. How to pay for it. Gov. Daniels proposed cigarette tax increase died in the House earlier this session, but it still might be resurrected during the conference committee process. Senator Miller, who heads up the Senate Health committee, says Senate Republicans have concerns about some of the changes to the bill. In particular, she wants family services defined to ensure that they don’t include abortion.
As I mentioned, Mike Sylvester has concerns about more big government. His general proposition is basically unassailable. This looks like government assuming yet a greater role in our lives. I guess it depends on the details, but I’m not as certain that his specific concerns are as well founded. He suggests that, because the average family health care plan costs $11,000 per year and because under this bill a family with an income of $41,000 would only have to pay $1,230, the rest of us will be left to make up the difference. Furthermore, he argues, the infusion of government money into the health care market will force health prices higher and higher. Certainly if health care were anything like a rational market, his points would be well taken. But, the fact is the health care market isn’t rational. Consumers are often forced to make choices at what amounts to gunpoint — “your money or your life.” Pricing isn’t anything like transparent. Cross subsidies are legion. So, it’s not at all clear to me that the normal market rules apply.
I suspect his concern about the rest of us footing the bill is perfectly valid, but that the price tag won’t be nearly as stiff as that almost $10,000 differential would suggest. And I don’t suspect that the infusion of government cash in this instance will raise prices. I think that a lot of the folks who will be able to take advantage of these programs are the people receiving a lot of emergency room services currently but then not being able to pay for them.
[tags]SB503-2007, health care[/tags]
I had a lot of concerns about the previous bill, that was to use higher cigarette taxes to fund personal health accounts. I don’t know about the revised version. In general, I’m very uneasy because the people who come up with “solutions” almost never ask the people who might qualify for health programs what they want, what would serve their needs.
Money and health insurance are important, but they are only part of the issue. I work with “underserved populations.” Transportation, fear of the health care system, poor past experiences, local clinics and labs that have M-F, 8 to 5 schedules, cultural values, and lack of education are also important reasons that people don’t seek and don’t receive proper medical care and preventive screenings.
I’m not sure where your concept of a “rational market” comes from, but it’s meaningless.
ALL markets are subject to the same natural laws–black markets, legal markets, etc. And Mr. Sylvester is right in his assessment of the economic consequences of this scheme. If you doubt the validity of the theory behind this, look at the history of health care costs. Health care spending as a proportion of GDP remained relatively stable throughout US history up until FDR’s reign of terror, other than during wars and epidemics. It was only when Roosevelt instituted wage freezes that health care costs began to rise.
To continue to be competitive in the labor market in the face of a wage freeze, companies began offering what we today call “fringe benefits”. Among these was health insurance. And as more and more people became shielded from the costs of their health care, they sought treatment when it was not really necessary, and when in the past they wouldn’t have even considered it. All this drove the cost of health care up. This in turn resulted in higher insurance prices, which made people even more inclined to seek “frivolous” treatment (since they were now paying more, they figured they may as well get more out of it), raising health care prices even more, etc., etc., etc. It’s a vicious circle.
This scheme will only exacerbate the situation.
And this doesn’t even take into account the infinitely more important moral argument against this–the individual is an end in himself, and should not be compelled to provide for another against his will.
Does this mean that it is a moral imperative to abolish taxation entirely? Must we rely on voluntary donations to fund any and all government functions, including, but not limited to, the military, the police, and the courts?
Yup.
That’s one possibility…there are others: seizure of the assets of convicted criminals (since they are the ones whose actions necessitate government, other than the military), for instance.
There are practical problems with that, certainly–such as the case of someone whose case is overturned on appeal or is otherwise exonerated, or who dies before he exhausts his appeals, etc.–but it’s worth looking into.
I detect a note of John Galt in that last paragraph as well. I’ve always sort of wondered how Randian Ubermensch justified using something as socialistic as a court of law to enforce their otherwise worthless paper contracts and currency? (Not to mention that abomination to individuality – the corporation which, among other things explicitly shields the individual from liability for his or her actions.)
Without stable courts and currency, the economy would creep along in a sort of barter system, requiring immediate payment for services rendered.
I was a fan of Rand in my younger days. Then I progressed to a more nuanced Lockean perspective. Now, I fear I might be descending into a Hobbesian cynicism.
Not necessarily. People like convenience–it’s not at all inconceivable that, by common agreement, some token or certificate would come to be recognized as a store of value. It’d be chaotic in the beginning, but eventually one would reach a critical mass (kind of like Betamax vs. VHS, or the more recent DVD-R format wars) and would just snowball after that. Is it inevitable? Of course not–nothing in history is inevitable (I direct you to Popper’s “The Open Society and Its Enemies”). But I posit that it’s at least possible, and frankly quite likely–and even if it doesn’t happen, well, so what?
I can’t say I’ve read any of their works in any depth–I’m thoroughly unfamiliar with much of the substance of their arguments, though I understand the general course of their thinking based on third-party accounts (which, of course, may be tainted by the judgments of their respective reviewers). I’m just now getting started on Francis Bacon, so Hobbes and Locke are not far off, though I won’t come to Rand until much later. But I am interested in what precisely you mean by “nuanced”. It has been my experience that that word is a substitute for argument–basically, saying “you won’t understand” (or even “I don’t understand myself so I’m just going to accept what this person says uncritically since he’s a ‘philosopher'”). Rejecting the notion that the world is black-and-white is fine, except that I have yet to see an actual argument as to why it’s not.
In this case, I’m using “nuanced” to simply mean that I’m less idealistic.
In what sense?
I’m no longer convinced that the rights of the individual are inviolable and that it’s all right to let the Devil take the hindmost.
If you view society as a collective agreement where any individual is free to opt out at any time, then you have a significant free-rider problem.
Let’s just suppose a village where most of the members of the community organize to fight off wolves. They contribute resources to the effort; they contribute time by patroling at night; and they contribute by sacrificing time for laboring when they’re sleeping off their night shifts. A handful of citizens can opt out and still fully benefit from their wolf-free environment without paying their way. What’s the remedy? Jail the citizen who declines to contribute? Banishment?
Perhaps the same community has a lot of members who won’t contribute to the wolf patrol. Then you have a village that’s overrun by wolves.
Or, you force contributions through, say, taxation. That compromises individual liberty; but, under the right circumstances, I’m o.k. with that.
The proper question is not “who benefits from the act?” but rather “who makes the decision to act?” If you and I are neighbors, and I remodel my house, you may benefit (you’ll probably be able to get a higher price when you sell), but it’s absurd to say that you are therefore somehow obligated to pay me. Why? Because you didn’t choose to take on the expense. In fact, if it had been up to you perhaps you would have decided that the potential gain was less than what your share of the expense would have been.
I go into this in more depth at http://blog.outwardhosting.com/?p=9
I was talking to an older fellow of my acquaintance about the best interest of the community versus the rights of the individual, particularly when thinking in terms of outside threats.
He suggested to me that:
“If men were angels, no government would be necessary.
If angels were to govern men, neither external nor internal controls on government would be necessary.
In framing a government which is to be administered by men over men, the great difficulty lies in this: You must first enable the government to control the governed; and in the next place, oblige it to control itself.”