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Wrong incentives on health care
by pryoslice

(Too) many ideas are up for discussion as solutions to unavailability of health care. One of the worst is the model advocated for in the article: requiring insurance companies to cover high-risk or high-cost consumers at a price less than the cost of service.

One problem is that it's simply un-American to require companies to give money away that didn't do anything wrong. Why particularly insurance companies? Just because they happen to be in that business? Why not force the cost on the junk food industry or the cigarette industry or the employer or the parents? The health insurance companies are no angels, but they certainly aren't responsible for the person's health problems, so why should they bear the cost?

Problem two: by raising prices, you make it harder for people to buy the product. Full disclosure: I'm a single non-smoking adult who has to buy his own health insurance. I did not have it while I was self-employed, bought it recently because it is partially reimbursed by my employer, would probably drop it if it wasn't. I have used health services, but far from enough to cover the deductible and get the worth of the money being paid to the insurance company. Therefore, I'm still discouraged from using preventative care. Some portion of my premiums is likely going to subsidize other people's health care. I'm not specifically opposed to doing that, but in this form, I'm simply being discouraged from buying health insurance. The price simply makes it not worth it.

An argument could be made for subsidizing health care of the sick, high-risk, or low-income individuals. But why should the burden be borne by healthy (many of the low- or middle-income) individuals and health insurance company shareholders? This is setting up horrible incentives. If you do want to subsidize it, you can spread the burden among all taxpayers according to ability to pay. You can put some of the burden on companies that can effect reduction in health costs, such as those producing health-damaging products. You can even argue that those that benefit from these individuals' better health can chip in: employers, local communities. An argument can also be made for not subsidizing health care at all and approaching it laissez-faire. However, the approach of forcing companies to provide under-priced coverage to all, paying for it with higher premiums to low-risk individuals is ridiculous. Its only defense is that it creates an enemy out of the health insurance company and thus makes for a better slogan in a political ad campaign.

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