Republicans haven't been getting much credit on the
health policy front. That could change soon. Last week the
House Energy and Commerce Committee approved a bill that
could dramatically reduce the number of uninsured in this
country and spur general economic growth--all without
costing a dime to the Treasury.
The idea behind the legislation, sponsored by GOP
Representative John Shadegg of Arizona, is simple:
Allow Americans to buy
individual
health insurance from vendors in any one of the 50
states.
Right now Americans who aren't lucky enough to get
medical insurance from large employers or who are poor
enough to qualify for Medicaid find themselves at the
mercy of the legislators and insurance commissioners of
the state in which they happen to live. This can be OK in
states that exercise this regulatory function judiciously.
But in others, the young and working poor find themselves
effectively priced out of the market by special-interest
regulations dressed up as consumer protections.
New York requires every health insurance policy sold
there to cover podiatry. Acupuncture coverage is mandated
in 11 states, massage therapy in four, osteopathy in 24,
and chiropractors in 47. There are an estimated 1,800 or
so such insurance "mandates" across the country, and the
costs add up. "It is always the providers asking for the
mandate; it is never the consumer," says health policy
guru John Goodman, who has testified before legislatures
considering such rules.
What's more, states like
New
Jersey and New York add two more ultra-expensive
requirements: "Guaranteed issue" allows people to wait
till they are sick and then buy health coverage;
"community rating" prevents insurers from charging
different prices to people of different ages and health
status. These may sound like compassionate ideas, until
you realize they make health insurance plans so expensive
that millions of people are exposed to financial ruin
because they aren't allowed to buy basic policies focused
on catastrophic costs.
How expensive? A 2004 study by
eHealthInsurance.com found that a typical insurance
policy ($2,000 deductible, 20% co-insurance) for a family
of four could be had for as little in as $172 per month in
a reasonably regulated locality like Kansas City,
Missouri. But in New York that family's only
option--managed care--would run $840 per month, and in New
Jersey family policies run a whopping $1,200-plus. We bet
Democratic Representative Frank Pallone's constituents in
New Jersey would be interested in his view that insurance
in his state is only "slightly" more expensive than
elsewhere.