A Wall Street Journal editorialist chimed in today (subscriber link) on his opinion of the effect of “RomneyCare”. While, as is usual when I peruse the WSJ OpEds, I don’t agree with everything written, that doesn’t prevent a few good points being made:
The truth is that Americans have far better health coverage than the media and liberal politicians contend. A vast and expensive ($330 billion a year) Medicaid system covers people who are genuinely poor, and emergency rooms must treat anyone regardless of ability to pay. In Massachusetts as in every other state, about 20% of the “uninsured” are Medicaid-eligible but haven’t bothered to sign up. Yet they can sign up whenever they need care. Another hefty chunk of the uninsured (40%) can easily afford insurance but choose not to buy it. There’s no inherent free-rider problem here, since they can be pursued for bad medical debts like any other debts.
The real people to worry about are those who are too well off to qualify for Medicaid but are priced out of the insurance market thanks to mandates and other regulations. The Romney plan will subsidize them for buying the compulsory insurance, but it does little on the regulatory side to make that insurance more affordable. Some of our friends praise the bill for setting up a government-sponsored insurance exchange to help people find coverage. But we don’t see why a state exchange is preferable to a private marketplace such as eHealthinsurance.com (which doesn’t even market individual policies in Massachusetts because of over-regulation).
The two points, in a nutshell:
First — the free-rider problem is allegedly a non-issue because free coverage is already an issue for many uninsured individuals, who choose not to participate. You’ve got to wonder if that isn’t indicative of the system needing to be made a bit more consumer friendly…and for education in this country to cover such basic things as filling out applications and researching available government services.
In the same statement, the Journal asserts that hospitals can pursue uninsured patients with debt collectors. While on the surface, that point can be challenged (e.g., it’s hard to squeeze blood from a rock)…well, has anyone else noticed just how inefficient medical billing is in this country? For example, I just received in the mail yesterday a hospital bill for services rendered over six months ago. I can’t help but wonder how much of the medical system’s account receivable woes could be solved with better financial management.
The second point — the Massachusetts bill does nothing to stem the cost of medical care. That point I do agree with. The Journal points out that part of the cost could be the results of state-legislated mandates (mandatory chiropractor coverage was specifically named)…and there does need to be an awareness that if you’re going to vote in a requirement that cake be served, someone’s going to have to pay for it.
However, I think that point is acknowledged by most folks familiar with the issue. The consensus on Beacon Hill seems to be “if we tried to tackle that part of the problem, we never would get anywhere.”
