Friday, January 27, 2006

Romney's Dance Around Healthcare Reform

Massachusetts Governor Mitt Romney is trying to solve his state's healthcare mess. I thoroughly get where he is coming from. He wants to apply the car insurance principle, i.e. make health insurance mandatory. Get almost everyone into the health insurance market, thereby lowering premiums given that most of those who don't pay into the system are healthy.

Then he's done a few dances around the Medicaid campfire to get the poorest people out of emergency rooms and into his managed care.

[Thanks, for this picture.]

Admittedly, this isn't the way I'd do things if I were creating a new country with a blank slate to work with; but remember: He's got financial doom right in front of his door, a bunch of liberals in the legislature, and Medicaid is already in place and will be for some time. The least he can do is protect his citizenry's tax dollars by planning ways to avoid its abuse.

As he sees it, his plan doesn't necessarily make for nationalized insurance, or at least it hasn't so far with car insurance. After all, making it against the law not to have insurance is not collecting and managing people's money, as the federal government has done with social security. It's simply forces everyone to participate in the existent free market system.

I know, forced participation in the free market sounds like an oxymoron. I realize that mandatory anything is anti-libertarian, and goodness knows that most of what I believe in comes from some form of libertarianism and free market capitalism; but I'd love to find a reason not to try this transitory step. We cannot go back to a pure free-market insurance picture. There is no point is dreaming libertarian dreams, because we're already way beyond that point. (Libertarians annoy me for that very reason: They're always daydreaming.)

The problem comes about when trying to make exceptions for those who "cannot afford" coverage. Romney has tried to solve this by fusing his own failing state insurance coverage into a managed care compromise. I do think he makes a mistake when calculating deductibles, because he seems to prefer no deductible or low-co-pay managed care whereas I think forcing people to pay for their "oil changes" in cash would be a good thing for the market; but on the whole, I think there is justification for his idea. He has basically proposed that a state could simply put a law on its books requiring every citizen to either sign up for state Medicaid, purchase low premium managed-care health insurance, or have a high deductible with a health savings account worth at least $10,000.

I say, What's a man to do if he doesn't get with the music? Get down, Romney.


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