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Health Insurance Mandate For Comprehensive Coverage Not Good Idea

Armen Hareyan's picture

"Requiring catastrophic coverage (our parents called it majormedical) probably is smart," but a requirement that "everyone havecomprehensive health insurance, covering preventive and routine care,"is not "really a good idea," Betsy McCaughey, a former lieutenantgovernor of New York and an adjunct senior fellow at the Hudson Institute, writes in a Wall Street Journal opinion piece.

Shewrites, "The rationale for this mandate is not personal responsibilitybut 'shared responsibility,' a polite way of saying shared costs,"adding, "Requiring comprehensive coverage, the argument goes, will makeit affordable for the sick, by pulling the young and the healthy --neither of whom use these health services very much -- into theinsurance pool" and "will cure overcrowded emergency rooms and helptame skyrocketing health costs." However, such "arguments are based onmyths, not facts," according to McCaughey.

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Three 'Myths'

She writes, "The first myth is that it's fair to make everyone pay thesame price for health insurance" because, for "young people who rarelyuse health services, this is a rip-off." According to McCaughey, the"second myth behind federal mandate proposals is this: Lack ofinsurance forces people into the emergency room for routine healthcare." She writes, "Federal data ... show that the elderly are mostinclined to go to the emergency room, though they are universallycovered by Medicare." The "third myth" is that the recent increase inthe number of uninsured U.S. residents has resulted from a "suddenmoral failure of the country of a broken health care system," McCaugheywrites, adding, "Instead a major cause is immigration and culturaldifferences that make recent arrivals likely to be uninsured."

McCaugheywrites, "These facts should point the presidential candidates andCongress toward a sounder policy on health insurance." According to theU.S. Census Bureau,of the 47 million uninsured U.S. residents, almost 10 million havehousehold incomes of at least $75,000 and "probably can afford coveragebut have chosen not to buy it," McCaughey writes. In addition, "14million of the uninsured are already eligible for government programs,"such as Medicaid and SCHIP, and "simply need to sign up," she adds.

McCaugheyconcludes, "That leaves about 23.7 million people -- some citizens,others newcomers -- who cannot afford coverage. It's up to the nationto decide what to do about that. One thing is clear: Mandating thateveryone, including young adults, buy insurance, and then hiding ahefty, cost-sharing tax inside their premium, is an unfair solution"(McCaughey, Wall Street Journal, 1/4).

Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report ispublished for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.