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Almost Forgotten: The Insurance Mandate Lie

The other day, I was reminded of one of the lies we’ve been fed about the Health Care Takeover the Democrats are desperately trying to pass through the Houses of Congress: The Individual Mandate, which would be just like your mandated automobile insurance. This specious line of reasoning has been almost forgotten amidst the arguments over abortion funding and the Constitutionality of reconciliation and trying to “deem” a bill passed by rule.

The individual mandate would require every American to purchase health insurance, or to pay a penalty (I call it a fine, because that’s what it really is) if they choose to go without. Proponents of this insurance mandate argue that it is like automobile insurance, where we are required to purchase liability insurance for our automobiles before we can drive them on the roads. They say that this mandate protects individuals from the financial harm of medical bills they cannot afford.

In this limited line of reasoning, they are correct, but that isn’t the whole story. This is, in fact, what insurance is really all about: Protecting us from the massive costs frequently associated with the unexpected. The individual state mandates for doctor visit coverage and other “expected” expenses is not insurance, and the sooner we separate the two concepts of insurance and payment plans the better, but I digress. The problem with comparing the health insurance mandate to the auto insurance mandate is thus: Liability insurance for automobiles covers my expense when I do damage to someone else; the health insurance mandate covers my expense when something happens to me.

To some, this may seem a triviality, but it is not. Liability insurance for automobiles not only protects me from having a large out-of-pocket expense when I am at fault, but it also protects the person that I have damaged in case I can’t afford to pay out of pocket. When I rear-ended somebody awhile back, I had two choices: Claim it against my insurance or pay for it myself. In that instance, even though I had the insurance, I chose to pay for it myself. The additional long-term cost in higher premiums wasn’t worth the relatively minor cost of the repair. The insurance was there to protect me against claims I could not afford. Had there been more damage, I might have chosen to let the owner of the other car file the claim, rather than pay for it myself. That was my choice.

The other difference between auto insurance and mandated health insurance coverage is that, in the one case, I am being required by the state to purchase liability coverage so that I can drive a car. In the other, I am being required to purchase insurance simply by existing/i>. This isn’t simply saying, “If you want to do ‘A’, then you must first purchase ‘B’.” Rather, they are saying, “You are subject to the requirement to purchase ‘B’.”

Think of the precedent this sets: If the Federal Government can fine us for not purchasing health insurance, what else can they require us to purchase? Perhaps next year, each American will be required to purchase an electric scooter to fit the President’s environmental agenda. Perhaps we will all be required to put solar cells on the roof of our home. Live in an apartment? You’ll be required to buy alternative-source electricity. Perhaps the government could compel us to fly twice per year to shore-up the airlines’ sagging balance sheets. Once the precedent for compulsion is set, what binds the government from doing it again and again and again?

One of the primary reasons given for the individual mandate is that it will increase the size of the insurance “risk pool” and thus, lower costs. This is short-sighted reasoning and ignores the economic Law of Supply and Demand. Certainly in the short term, it will lower the overall cost of premiums as more people buy insurance, but in the long-term it will have the opposite effect on total health care costs.

Think about it: When more people have health insurance, with all the statewide mandates and payment plan requirements thrown in, people will see that the cost of health care on a per-transaction basis will fall. The price tag to them becomes small: $20 for doctor visit co-pays. $125 for an ultrasound. $250 for an MRI. They have already paid their premium, and so the incremental cost of additional care is, to them, minimal. I have seen this in my own behavior: When I was not covered by insurance, I rarely saw the doctor, and only when I suffered from severe illness or injury. Now that I have health insurance coverage, an illness or injury I might have previously ignored now warrants a doctor visit. My insurance premium is a sunk cost, so as long as I have $20 co-pays, I might as well use them.

What people do not realize is that the actual cost of the care they receive is much higher, and the insurance company is paying the bulk of these costs. The $20 doctor visit was actually $150, the $125 ultrasound actually $900, the $250 MRI really $3,000. As the visible costs sharply decrease for the previously uninsured, the demand for these services increases in a similarly precipitous manner.

Without an accompanying increase in available medical resources such as doctors, nurses, equipment and the various categories of medical supplies, this rapid artificial increase in demand will drive up medical costs. It is as inevitable as the tides rising and falling or the moon waxing and waning. Doctors and hospitals will demand more medical supplies. Medical suppliers will demand more chemicals, plastics, and electronic components. Component suppliers will demand more raw materials, from metals to chemicals to other parts. Raw material suppliers will have to increase their prices to deal with the shift in demand and the increased costs in extracting those raw materials. That increase in raw material prices will be transferred back up the line to the final customer (that is, you and I), at what amount we do not yet know.

And this doesn’t even touch the increase in demand for the time of doctors, nurses and other medical professionals.

This is High School level macro economics. A mandate for health insurance coverage will increase the demand for health care (that is, “shift the demand curve to the right”). This artificial demand shift will cause an increase in health care prices (“raise the equilibrium price”) as surely as the rising sun causes the cock to crow. The rising costs will force health insurance companies to increase premiums, giving the Democrats every excuse they need to come back to the American People with their Public Option™ to “save” the system from itself.

This, I think, is the real reason for the mandate: It has nothing to do with covering more people, or ensuring that people don’t game the system when pre-existing conditions are no longer an obstacle to obtaining insurance (that’s a whole other diatribe). In fact, the mandate is intended to break the system. When the mandate is enacted it will, after a fashion, cause the price of health insurance to skyrocket making health insurance affordable to fewer people. These skyrocketing prices will be blamed on those uncaring, inhuman insurance companies and their evil, greedy, profit-hungry corporate managers. We are already being conditioned to think this way about insurance companies by the media and the Democrats. Then, when Americans demand a solution, the Democrats can step in with their Public Option™, explaining how it “works” so well in Europe, Canada and elsewhere (as they have tried to do each time they propose it here).

The Democrats have taken the long-term view on this: They understand that once this legislation is enacted, it will be virtually impossible to repeal or even curtail. They take pieces out of their legislation but never consider adding free-market alternatives, because they know each piece added from their agenda inexorably leads to higher costs and greater demands that the government “DO SOMETHING!” about those costs. They want to break the system so that they can take it over, and they know that once they control our health care, they control us.

This bill has to be stopped. It has to be stopped now. Not in November. Not in 2012. Now. Today.

Call your Congressman. I know you’re burned out, but call him anyway. Do it now, whether you’re at your office or a home computer or in a coffee shop reading this on your phone. Do it even if you think your congressman is sure to vote “No”. Tell them you don’t want higher costs. Tell them you don’t want government mandates. Tell them you don’t want this monstrosity that is the Senate bill. Tell them your vote in November depends on theirs today.

Cross-posted at The Minority Report.

COMMENTS

  • http://hillbillypolitics.com Steph C

    You’d think one might suddenly realize that’s the purpose of 2300+ page bills. When one bomb gets exposed and people are focused on it, all the other bombs are lying around unnoticed.

    Or should it be called a mine field? If this mine doesn’t blow you up, then next one will if you’re foolhardy enough to navigate the field blind.

    • acat

      I think “barbed nets” are a better analogy – the goal of law is to trap, like a net, and the barbs are used to encourage the prey – us – to stay trapped.

      For every barb in a net we see, there are others .. and it’s not just in the legislature although they’re the most prolific.

      I’m reminded of the theory (that I think was later confirmed) that one of the Justices on the Supreme Court would insert language into findings – especially majority findings – that would have an impact not on the current case before the court, but on cases in lower courts that he wanted to influence.

      Mew

  • Menlo

    There is no penalty if you fail to pay the penalty. It is a very important detail I think is crucial to acknowledge.

    We must remain united in refusing to buy or accept any coverage when this bill “passes.” To do otherwise would, I believe, acknowledge acceptance and support of the bill.

    • acat

      Because I’m not quite sure how else to read this…

      Mew

      • Menlo

        We all need to refuse to buy, or accept anything called “health insurance.”

        No one’s current coverage (current meaning March 2010 with same benefits and rates) is going to still be around by then.

        • acat

          I have a condition that, while not life-threatening, makes insurance a bit tough to get. I also have seen what my medical bills without insurance look like. One of the things that insurance does is to give me access to negotiated rates.

          What you’re proposing I do instead is .. what?

          Mew

          • Menlo

            In that case, maybe you are among those who will benefit from the bill and should be supporting it?

            If not, I suppose you could negotiate rates yourself. That’s what I’d plan to do since insurance insurance would not likely save you money once this system is implemented.

          • acat

            I would benefit from the Republican ideas including tort reform (so my doctors can quit running test after test after test to protect themselves from my hypothetical lawyers) and crossing state lines (increasing the pool size, reducing the cost per pool member) …

            Negotiating rates with doctors, by the way, is possible because insurance companies can assure ‘em that they’ll get paid on time, every time. For me to negotiate this, I’d have to take my time and call all the various billing departments – time I’m not spending earning money – and proving my ability to pay on time – the easiest way being to put my money into an escrow or bond of some sort.

            None of this makes your request that I stop buying insurance any more rational, and sounds like more work for less gain. Just like this bill.

            Mew

          • Menlo

            You obviously think you’ll still have some advantage with insurance after 2014. So you can’t think the bill is TOO terrible.

            Regardless, I’d just as soon either go into debt or do without what I could not afford. It’s worth the sacrifice to make this rotten system unsustainable.

          • Menlo

            If a doctor refused to see me on the basis that he did not trust that I would pay him on time, I wouldn’t think he is a very good doctor.

            Personally, I think doctors should be prohibited from negotiating special rates with insurers (or anyone if not based on a patient’s income), but that’s another matter altogether.

          • acat

            Every buyer and seller of a good or service negotiates the price of that good or service. Why forbid that for doctors?

            I’ve been trying to understand your point of view, where you could be coming from to be making the statements like “everybody should just give up insurance”. This doesn’t hurt Obama, it doesn’t hurt the Dems, it doesn’t do anything but cause insurance companies to go out of business faster, with the result that government will be “forced” even further in to fill the gap.

            This statement, that doctors should not be allowed to set their own rates, clears it all right up. You may be intelligent, but you’re lacking in wisdom.

            Mew

          • Menlo

            Doctors should set their own prices. They should charge patients and publicly disclose rates in advance rather than making deals with insurance companies. An insurance company should not be allowed to get a special rate. Period.

            If the insurance companies who comply with the new federal system go out of business, that would be wonderful! If the reason were well-known (people’s refusing the mandate), I suspect the government would be more than likely to undo some of the provisions in this bill than to only get more involved. But as John Shadegg said, even a single-payer system that eliminated the whole health insurance industry would be better than this monstrosity.

            Whether it helps anything or not, I will maintain that those of us who see it for the evil that it is should openly and publicly refuse to comply with anything in this bill.

          • acat

            In one post, you want doctors to set their own prices, but you insist insurance companies can’t get special deals while in the previous post you explicitly state “doctors should be prohibited…”.

            It doesn’t matter which is “forbidden” from negotiating – in either case, it is not capitalism.

            Let’s try this. Should WalMart pay the same for a case of toothpaste as a local mom-and-pop grocery store? Is it fair that, in some cases, WalMart can *retail* a tube of toothpaste for less than the mom-and-pop can get it *wholesale* ?

            The answer to the second is that it is not “fair”, but the answer to the first part is that it’s between WalMart and the manufacturer, fair doesn’t even enter into the discussion. Period.

            I don’t have a problem with a doctors’ office having a rate chart on the wall, just like McDonalds. I do have a problem with saying that *nobody* can question those rates.

            Shadegg, by the way, is apparently buying into the entire “evil insurance company” idea. A single-payer system is a nightmare because at least with insurance companies there’s some competition, some opportunity for change. Single-payer defeats that, reducing doctors to slaves – they have to accept whatever the single-payer will give them or go out of business .. for as long as that’s allowed.

            Mew

          • Menlo

            If that makes me anti-capitalist, so be it. Either way, health care cannot even begin to be compared to toothpaste. It’s really not very relevant to my point though.

            Of course as the original diary points out here, why buy the cow when the milk is free? If you do have a problem after 2014, you can always get “health insurance” without the pre-existing condition restrictions. For that reason alone, I can’t understand why any healthy or functioning individual would buy “health insurance” after 2014. It would be the most incredibly stupid thing in the world if a person only did so because some law “mandates” it. Obviously, the latter is not your position; so while I understand your concerns, I do disagree.

            I would prefer this system fail no matter how dire the consequences! If a “refuse to buy insurance” campaign does so, and it’s the only hope I could imagine, that’s fine by me. If not, at least I’m standing up for my individual rights.

          • acat

            Toothpaste and WalMart is a nice, simple analogy. Toss it if you like, doesn’t really matter.

            Why would I buy insurance after 2014? Perhaps because of what Walgreens did today, turning away any new medicaid patients. I doubt Walgreens did this because they “hate the poor”, although I expect we’ll hear that’s the case – more like they want to stay in business.

            You seem to believe that the cow will continue to give milk once it’s free. I don’t see that happening.

            If private insurance reimbursements actually let Walgreens make a profit, and lets me open a new account should I relocate, that’s one reason to keep buying insurance.

            I don’t expect Walgreens to be the last outfit to say “We don’t accept Obamacare”. As we’ve discussed, doctors are free today to set their own rates, insurance companies are free to negotiate. So is Medicare. Many doctors won’t accept it because, unlike insurance companies, Medicare payouts don’t cover costs – doctors end up losing money on their Medicare patients.

            Again, I’ll be evaluating this come 2014.

            As for the system failing “no matter how dire the consequences”, I’m still not clear if you mean the hypothetical government system that – even if the Dems pull off their Hail Mary play on Sunday and pass it – will be tied up in courts for the next decade, or if you’re buying into the “evil insurance companies” lie.

            You’re encouraged to stand up for your rights. Just make sure you take care of your own responsibilities. The latter get a lot less coverage, but are far more important. You’re responsible to make the right decision for yourself come 2014. So am I.

            Mew

          • acat

            Just like I will analyze it in 2013, and 2012, and 2011. That’s part of owning a small company and having to decide what benefits mix to offer myself and a few others.

            I suppose I could just close things up and live off savings for a year or two, more if I choose a diet of ramen and living in my car, but that seems just as unreasonable to ask – today.

            Mew

    • http://hillbillypolitics.com Steph C

      If that’s changed, it’s news to me, but then I have not wade all the way through 2309 pages, yet, either. At one time it involved fines and/or jail time.

      Of course, it’s a mandate I would deem unenforceable if enough people resolved to civil disobedience, but that wouldn’t stop the Democratic Congress one whit.

      They can count on conservatives to honor the rule of law better than their own base. It’s been our strength and our weakness for a very long time whereas the liberal will break it whenever it is convenient to do so in their own self interest.

      • Menlo

        That’s the one the senate passed and that the house is going to “pass.” The house version did tie it in with regular income tax enforcement.

        To comply only for the purpose of “honoring the rule of law” I believe would be incredibly stupid, especially for those who say it is unconstitutional (and thus not law). No one who opposes this measure should do it.

        • http://hillbillypolitics.com Steph C

          but it’s what we do; have done. Otherwise, why are we at this crossroads now?

          • Menlo

            And I’m saying it’s what “we” had better NOT do if we want to be taken seriously.

            As for the past, perhaps that is one reason conservatives are so seldom taken seriously when it comes to matters of law, particularly the Constitution. Fear of punishment is one thing. However, something unconstitutional cannot be law by definition, so how is obeying it anyway obeying the law?

            Regardless of constitutionality, this “mandate” needs to be defied by enough people to make the program unsustainable. And it needs to be part of a large movement. On this particular matter, we cannot put any hope whatsoever in elected or appointed officials.

          • http://hillbillypolitics.com Steph C
  • Common_Cents

    In addition to your info, mandated auto insurance does not incent you to have more wrecks. Mandated health insurance will incent tremendous increase in usage, probably overwhelming the system and driving up costs dramatically.

    Who doesn’t eat much much more at an you can eat buffet? That is the proper comparison to mandated coverage. If they force me to pay for health insurance I might as well get my moneys worth. You don’t go out and have more accidents to get your moneys worth from auto insurance. Car wrecks hurt. All you can consume health care buffets do not.

    But you will try and get your moneys worth when forced to pay for the obamaocare buffet.

  • Menlo

    I could not agree more.

    • http://seekingliberty.wordpress.com fmaidment

      …of this diary was that the mandate leads to Single Payer because the costs get so out-of-whack that the system breaks down and the government comes in to “save” us.

      If you want Single Payer, you’re just as guilty as those who want the mandate. If you prefer single payer to individual mandate, you clearly don’t understand that both are equally bad.

      Medicine is a resource. Like all resources, it is limited. Limited resources must be exchanged for other limited resources in a free society. That is basic, high-school level economics.

      This means

      1) Doctors can make deals with insurance companies if they want.
      2) Insurance companies can set their benefit and premium levels as needed.
      3) If you don’t want insurance, fine, but don’t argue to force the insurance companies out of business for those of us who like insurance.
      4) Doctors can refuse to offer care if they choose, since their knowledge and skills are a limited resource and (therefore) their personal property. Yes, I realize some states don’t actually allow this.

      In any event, it takes all kinds to make the world go ’round. This bill is intended to force us all into just a few kinds, with the eventual goal of making us all one kind (government health care customers, that is).

  • http://dreamsfrommyforefathers.com RoguePolitics

    I don’t see the auto insurance mandate as constitutional either.
    We are not children to be managed by our masters.

    btw, states that do not have mandatory auto insurance have premiums at half the cost of the other states.

    • http://seekingliberty.wordpress.com fmaidment

      And I’m not necessarily arguing that the auto insurance mandate is Kosher, either. I stated that the comparison was invalid, and attempted to illustrate why.

      Rather than argue about the validity of auto mandates, I simply explained the logic behind them.

      • http://dreamsfrommyforefathers.com RoguePolitics
  • E Pluribus Unum

    You got that right, friend!