A Country Divided

In the 30 years of my professional career in risk management and insurance, I have never come across an issue as divisive as the debate over National health insurance. I will admit, right up front, that I am an opponent to the idea. Categorically, I am one of those conservatives who are prone to side with Thomas Jefferson who was quoted as saying, “The role of government is to do for society what society cannot do for itself.”  Likewise, I am apt to quote what was printed in the monthly periodical of the mid-19th century entitled the “United States Magazine and Democratic Review”: “The best government is that which governs least.” So at this point, the question becomes, do we as a country need the government to be in healthcare? Some of my associates point to the “efficiencies” of Medicaid and Medicare as evidence that the government is already in healthcare and runs it very well. Yet, this is not really a fair example since these government programs have never been handled by the private sector. Therefore, we cannot see if there is a better solution apart from government. In the same way, the Federal government, by law, offers the postal service for local mail and is substantially in red ink. Where there is competition in delivery of packages, UPS& DHL keep the government system in the minority. Monopolies are illegal unless the government establishes them!

So what is the argument for the National healthcare mandate (euphemistically called the “Affordable Care Act”)? Basically, it was sold to Congress as a way to insure the 34 million people in the country who are without health insurance. Using taxes and the IRS is the means whereby the Federal government is going to mandate subscription. The simple question that I do not hear many in authority asking is, “How many of these 34M currently pay taxes?” If they do not, how will their healthcare utilization change? Those who do pay taxes are going to subsidize those who do not purchase health insurance; the math is predictable.

Another argument has been that considering the rate of inflation in health insurance premiums, the private sector has not done a very good job with healthcare. I agree that premiums go up way too fast, but that is more a function of lack of competition, unfunded government mandates and lack of cost containment. My solutions to these three problems are: 1) remove federal constraints that prevent consumers from purchasing health insurance from out-of-state insurance companies thereby increasing competition between insurers; 2) require the government to know and report the cost to consumers before mandating new health benefits; 3) many of the extra (and oft unnecessary) tests that doctors order, which run up healthcare costs, are due to doctors’ fears of malpractice suits. Limiting their liability (aka “tort reform”) would help reduce healthcare costs and our health insurance premiums.

Absent these governmental solutions (what “society cannot do for itself”), the government has proposed a new, huge bureaucratic kingdom to solve a problem it helped foster in the first place. By the time the solution is proven to be ineffective, national healthcare will already be fully implemented. The recent announcement of the government’s delay of implementation by January 1, 2015 affords time to look into alternatives other than full-blown National healthcare. It is my hope that such will be found. For further information on the timeframe for currently-proposed implementation and what this means to you, check out our website.

Brian H. Merriam, CPCU, ARM, AAI
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