Dr. Paul Hsieh: Mafia-style health insurance: An offer you can't refuse
By: Dr. Paul Hsieh
OpEd Contributor
November 16, 2009
Suppose the mafia came to your town and forced everyone to purchase all their meals at mob-approved restaurants. The mafia would also select the menu items.
If you liked broccoli but their vegetable choice was spinach, then tough luck. Everyone would also have to purchase dessert, whether they wanted it or not. And if some customers couldn't afford the high-priced meals, the mafia would force you to "contribute" to cover their bills.
Most Americans would be outraged at such violations of their basic rights. But this is precisely what the president and Congress want to do with health insurance.
The recently passed Pelosi plan is essentially a national version of the failing Massachusetts system of mandatory health insurance -- a plan that has led to skyrocketing costs and worsening health care.
Under any system of mandatory insurance, the government must necessarily determine what constitutes an "acceptable" plan. Hence, this creates a magnet for special interests seeking to include their pet benefits on the required insurance menu.
Massachusetts residents must purchase numerous benefits that they may neither need nor want, such as in vitro fertilization, drug abuse therapy and chiropractor services. If you'd rather purchase low-cost catastrophic-only insurance without those options, tough luck. Mandatory insurance thus violates the individual's right to spend his own money for his benefit according to his best judgment.
Since the plan's inception in 2006, insurance premiums in Massachusetts have risen by 8 percent to 10 percent each year, nearly twice the national average. Because the mandatory insurance is so expensive, the state must also subsidize the costs for low-income residents. In response, the state has raised taxes and cut payments to doctors and hospitals.
Many frustrated doctors now lose money on each state Medicaid patient. The Massachusetts Medical Society reports that 40 percent of family practice doctors and 56 percent of internal medicine physicians no longer accept new patients -- "the highest percentages of primary care practices closed to new patients ... ever recorded."
Similarly, average waiting times in Boston to see a specialist have increased to seven weeks, whereas in other states it has fallen to three weeks. Massachusetts patients may have theoretical "coverage," but that's not the same as actual medical care.
To add insult to injury, the president has called the Congress' plan a "moral imperative" that will promote "choice and competition."
If Obama truly wanted to promote choice and competition, he would propose fewer government controls -- not more. State governments should eliminate mandatory benefits.
Insurers should be allowed to offer low-cost catastrophic plans and to sell policies across state lines. Individuals should be allowed to use Health Savings Accounts for routine expenses. Such free-market reforms would greatly lower insurance costs for millions of Americans.
Free-market reforms would also be a political winner. According to CNN, eight of every 10 Americans are happy with their current health care, but concerned about rising costs. Polls also show a majority of Americans opposed to Congress' plan. Free-market reforms that lowered costs while respecting individual rights would be smart politics.
Where would meals be better and cheaper? A city where customers could choose between restaurants competing in a free market? Or a city where everyone was forced to buy all their meals at a few mafia-controlled restaurants?
Like the mafia, Congress wants to make you an offer you can't refuse. At least the mafia doesn't pretend that it's acting for your own good.
Dr. Paul Hsieh is co-founder of Freedom and Individual Rights in Medicine (FIRM) at
http://www.WeStandFIRM.org .
