Letting the uninsured hang out to dry

April 24, 2007 in Healthcare

by Jay Stevens

There’s a new, gentler libertarian stalking the virtual corridors of Montana’s blogosphere: Montana Liberty Project. It’s been a pleasure reading his blog and his perspective.

That said, I admit I don’t agree with everything he says, and I especially don’t agree with his latest post on health care. In it, he quotes Michael Cannon on the health-care market:

There’s a lesson here for those who want to cover the uninsured: focus on the incentives facing the 250 million Americans who have health insurance, not on the estimated 47 million who don’t. If the federal government stopped encouraging people with health insurance to be less careful consumers, then coverage would be more affordable, the number of people without coverage would shrink, and the quality of care would improve.

It’s this kind of abstract theorizing that can drive me nuts about libertarians.

First, health care “products” aren’t like different kinds of paper towels found on a supermarket shelf. You don’t just idly walk buy and see how much each costs, how much each brand is per roll, etc. Thanks to the insurance industry’s Byzantine pricing, it’s almost impossible to get accurate quotes on something like prescription drugs – which, in theory should be the easiest to shop for. (That is, you know the drug you need; you could just call around and see who sells it for the cheapest.) And this Byzantine pricing structure is intentional – the insurance industry created it in order to discourage claims. And that’s not to mention that the consumer probably shouldn’t be making the decisions on what drugs and medical procedures they should consume. (Actually, I wrote a little one-act play about this the last time a Montana libertarian claimed applying “free market” principles would “solve” our health-care woes.)

Second, people are already becoming “more careful” consumers of health insurance. That is, in order to avoid high deductibles and insurance paperwork, people are simply not going to the doctor. For the consumer, that’s an economically illogical action to take: avoiding the doctor now increases the likelihood of a costlier procedure later. That is, by saving a little now, the consumer pays more later. Unfortunately that’s human nature.

Third, denying people health care – especially children and the elderly – is immoral. Our society believes everybody should have the right to basic healthcare – and they do. That’s not a bad thing, even if the market disagrees. (The market, oddly, is often at odds with human beings.) The uninsured’s visits to the emergency room are not cost-efficient. They’re also not covered by insurers, but by tax dollars.

Pooling together our resources to ensure everyone has access to health care is the way to go. It’s cheaper, both for policy holders and taxpayers. It’s more efficient, meaning less paperwork for care providers. And it’s better care. The evidence for all of these claims is ample.

The only reason I can see for opposing national health care is ideological, a desire to see, say, market principles prevail, even if means ignoring or even destroying programs that work (the privatization of Walter Reed, anybody?), and thereby putting people’s lives at risk.