Tuesday, May 20, 2008

Can't Someone Else Do It?

Today's Hartford Courant had an article on a nonprofit encouraging towns to petition the state to solve the "health care insurance crisis." It got me thinking about a long overdue discussion I've been meaning to have about the nature of health insurance and the nature of this supposed crisis.

I've blogged before about individuals with "preexisting conditions" and how this problem is not an insurance problem at all. What it is, is a problem of people with very high medical bills. Insurance is meant to insure against risks, not provide a mechanism from shielding you from your routine medical expenses. Sure, maybe people with preexisting conditions need help, but that doesn't mean there's some inherent flaw in the insurance system.

But beyond questions of preexisting conditions, I see a real problem with the general approach to health care and health care policy. Now it's not just individuals, but municipalities who are looking to foist th costs of health care on someone else. And deep down, this is the real issue. Health care is expensive regardless of how it's provided and people can run into multitudes of problems when they run into unexpected costs that they haven't insured for, be it an unexpected injury or medical condition, a stolen car, or a home that burns down.

The argument being made is that these costs are unmanageable for ordinary Americans, but that's really not the case. Yes, the system we have is skewed in favor of employer provided health insurance, basically disadvantaging those working lower end jobs. But we also have a system skewed by complex mandates and restrictions on limited coverage that drive up the costs for those specifically looking to avoid a future medical bankruptcy. There are plenty of problems with our system, many of which do drive up the cost of health care. But in the end, we do have system that, while distorted, is still a market system. Costs are what they are. Drugs are expensive and treatments that didn't exist 30 years ago are expensive. Health care costs more today because there's so much more to it.

As the health care debate has gone on, what's become clear to me is what many advocates of universal health care actually want is really just a middle class subsidy, no different than what I've written about before with complaints over the cost of college. We can deal with the problems of the poor and those who have fallen on hard times. But why make this crisis out to be something it isn't?


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