Conservatives often change tactics, but never stripes. Their formula is simple, if not simplistic – Ronald Reagan said “The nine most terrifying words in the English language are: ‘I’m from the government and I’m here to help.'” Conservatives want to make government small and insignificant – so they say. They don’t see much in the way of practical use for it, and believe markets self-regulate and self-correct and that we are all best served by deregulated markets.
When evidence flies in their face, as with the current crisis, they usually find a way to blame government. And when it painfully apparent to most all of us that deregulation of the financial markets has created a massive financial squeeze – a near panic putting us on the brink of depression – conservatives go right along insisting that deregulation is a panacea in other areas too. Like, for instance, heath care.
Merrill Mathews, of the right wing think tank Institute for Policy Innovation as a marvelously innovative solution for our health care crisis: deregulation. But he’s not calling it that. He says it’s merely a different kind of regulation. In his op-ed in yesterday’s Wall Street Journal (McCain is Right on Interstate Health Insurance), Mathews offers up a long-standing right wing cure to health care woes: eliminate the barriers that prevent us from buying health insurance in states where we do not live.
Mr. McCain backs legislation sponsored by Arizona Rep. John Shadegg. Known as the Health Care Choice Act, it would allow individuals living in one state to purchase health insurance being sold to people living in other states. The policy would still have to meet the regulations of the state in which it is being sold, and would be subject to additional federal oversight.
In other words, the McCain-Shadegg reform would allow a person living in New Jersey or New York to buy health insurance that is being sold in and regulated by Pennsylvania or Connecticut. That’s hardly the Wild West of health insurance.
Various states around the union have looked at products offered by health insurers, and found them inadequate, often deceptive. So they have mandated coverages for things like maternity leave, mental illness, addictions, and many other items. The reasons are simple – for one, people gravitate towards the cheapest coverage when they are healthy, and usually under-insure themselves. In addition, many public health problems simply go untreated for lack of coverage. Health insurers want to minimize their financial risk, and so offer a range of coverages that tends to minimize their exposure.
Yes, it is more expensive to cover things than not to cover them, but there are valid public policy reasons for doing so. The insurance model is an inadequate vehicle for public health, so we have attempted to fix its deficiencies though law. Insurers don’t like it – they want to tailor coverages to maximize profits, and would rather not cover things that are highly likely to occur. That’s a guarantee of higher costs.
So addiction and mental illness go untreated, and maternity coverage is restricted to men over age 50. That’s the health insurance model.
Under Mathews plan, state regulations would go out the window, and we would automatically default to the policies of the state with the fewest regulations and cheapest insurance. All of Montana’s thoughtful legislation regarding health care policy would be set aside as our people go to Pennsylvania for their coverage. And insurers would flock to the state with the fewest regulations. Pennsylvania would become the new Delaware. We’d be right back where we started – too little coverage. That’s bad public policy.
Mathews surely knows this, but listen to him:
Mr. Obama opposes interstate sales … he doesn’t believe a market can work in health insurance. He believes it is necessary for the government to look over everybody’s shoulder to make sure patients are getting the care and coverage the government thinks is appropriate at a price the government considers affordable.
…Creating an interstate option for individuals to purchase health insurance doesn’t solve every problem faced by the 45 million Americans who are uninsured. But the choice isn’t between a regulated or unregulated health-insurance market. The choice is between an overregulated market favored by Mr. Obama and a regulated market favored by Mr. McCain that provides more options to help individuals afford health coverage.
So Mr. McCain actually favors a regulated market, and would give it to us by doing de facto deregulation.
I love conservatives – they never change – they don’t adapt. Perhaps they are doomed to extinction.
Piece of Mindful 