Sunday, April 11, 2010

Insurance and You -- commentary

There have been a lot of poorly thought out ideas floated on talk radio and letters to the editor columns during the ongoing debate over health care, and I can’t help but take my swing at a couple of them.

One idea compares the government forcing people to buy health insurance to forcing people to buy automobile insurance, the idea being that one is no different than the other. But, there is a difference. The government only forces us to buy liability insurance. If you are forced to buy comprehensive and collision insurance, it is the institution financing your car that insists on that.

The law requiring you to buy liability insurance is there to protect others from the damage you might do. In most states, if you can prove you have the assets to self-insure, you don’t have to purchase liability insurance on your car. The fellow who came into my lane of traffic, knocked me off my motorcycle, and put me in the hospital for two months suddenly incurred a $400,000 liability. He carried a minimum liability policy of $25,000 required by the state of Arizona. Who gets stuck with the difference, since he had no assets worth pursuing? Insurance and me. Medicare and Tri-care covered a large part of the medical costs. I ate the rest, plus missed wages, and compensation for pain and suffering and diminished quality of life. Obviously, the law was inadequate to protect me, even though it was intended to do so.

I don’t know what the state of Arkansas requires, but I believe the state of Arizona is amiss by not requiring a much larger liability policy. If you think the government is being intrusive by requiring you to purchase liability insurance, explain how you would meet such a liability in case of an accident?

So, then we hear the argument about the intrusive government requiring people to wear seatbelts and motorcyclists to wear helmets. Though I wouldn’t think of leaving my driveway without a fastened seatbelt when in a car or a helmet when on a bicycle or motorcycle, my libertarian instincts agree with those arguing against such laws. But those instincts get checked by something else.

To begin with, insurance companies should be enforcing the wearing of seatbelts and helmets through their pricing schemes, and maybe they do. But, the government also gets involved, because it is expected to be the payer of last resort. The law states, I assume with the consent of the governed, that a hospital cannot turn away anyone in need of medical attention. Therefore, the cost of treating the uninsured is born by paying patients and government programs. This gives the government a vested interest in passing laws to minimize this expenditure.

If you want to repeal seatbelt and helmet laws, you should first repeal the law requiring medical providers to make their services available to those who can’t pay. I promise you the average motorcyclist suffering a severe head injury cannot afford to pay the ensuing medical bills. Until we are willing as a society to let people die for lack of adequate medical attention, somebody is going to have to pay for those services, either the individual, an insurance company, or the government.

Since the government has the taxing capacity, the ability to make law, and is looked upon by the people as ultimately responsible, these laws will prevail. In fact, with the advent of the new health legislation, the government now has an even bigger, and rightfully so, interest in how you live your life as it relates to your health. I say rightfully so because as long as it is paying for health care, it has a right to expect certain behavior from those it cares for.

Life and health insurers have done this for a long time. If you want to jump out of airplanes, smoke cigarettes, drink alcohol excessively, ride motorcycles, participate in combat, or be overweight, you pay extra. They do this because they have a vested interest in your behavior. Now, the government too has such a vested interest. However, the government’s response won’t be to charge extra so much as it will be to pass laws restricting your behavior. The price we pay for allowing it to pay for our health care is to accept this intrusiveness.

My libertarian bent is often tugged at by my Christian convictions. I have to ask myself if I am willing to live in a society where people are allowed to die in the streets for lack of medical care or where many people do not have adequate health care? I am not, though I wonder if it takes a 2,000 page bill with lots of back room bargaining to solve the problem.

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