James Madison warned New Yorkers that in a representative republic, Congress posed a much greater threat to liberty than the presidency. Proving his point, here is a jewel from Diana Kastenbaum’s website. She’s the Democratic Party Nominee to represent New York’s 27th District in the U.S. House of Representatives.
“For Diana, health care reform is about giving American families and small businesses — not insurance companies — control over their health care. For far too long, America’s health insurance system has made health care more costly, less accessible, and less efficient for families and small businesses. No one in America should have to declare bankruptcy because they can’t afford to pay their medical bills. Premiums should not be increasing at a rate of six times the rate of our GDP. That is why Diana is a supporter of the Affordable Care Act.”
Statements like this have a way of washing over most people without making more than a vague, emotional impact. Let’s unpack what she’s said here.
First, she says health care reform is about giving American families and small businesses – not insurance companies – control over their health care. This in support of a law requiring every soul in America to purchase health insurance, whether they want it or not. Not only does the ACA mandate insurance, but it mandates the services insurances will cover, meaning a smaller portion of total healthcare is left outside the purview of insurance companies.
Does this give insurance companies more or less control over health care?
She claims insurance companies have “made health care more costly, less accessible, and less efficient for families and small businesses.” Even if that were true, the ACA would only make things worse. But have insurance companies made health care more expensive? No.
Insurance companies reflect rising healthcare costs; they don’t drive them. Health insurers have all the same self-interested motivations of home insurers, automobile insurers and liability insurers. But we don’t see the premium rates of those other insurers outpacing inflation like health insurance premiums. Why?
Kastenbaum isn’t at all curious about this. But clearly, something besides the profit motives of health insurers is increasing the cost of healthcare disproportionately. Assuming the same laws of supply and demand apply to the price of healthcare as to other products, could it be the artificial limitation of supply caused by medical licensing laws, the FDA and other disproportionate regulatory burdens on healthcare? Could it be the gross artificial stimulation of demand by huge entitlement programs like Medicare and Medicaid?
If the government gave a trillion dollars to clothing shoppers next year, would you expect the price of blue jeans to go down, remain the same or go up?
Kastenbaum says health insurers have made health care less accessible and efficient. But the ACA hasn’t increased the supply of doctors and hospitals; it’s decreasing supply. And major insurers are dropping out of the program en masse, specifically because of the burdens imposed upon them by the ACA. In many states, there will be only one insurance option for consumers next year. All this in exchange for subsidizing coverage for a tiny portion of previously uninsured consumers, some of whom were uninsured by choice.
As for efficiency, the law imposes a one size fits all plan on everyone in the country, prohibiting efficiency-enhancing discrimination on the basis of gender, medical history and local risks. Is it really more efficient to force men without dependents to purchase OB/GYN coverage? Wouldn’t healthcare be less expensive for society as a whole if they weren’t?
Kastenbaum then makes the emotional appeal, “No one in America should have to declare bankruptcy because they can’t afford to pay their medical bills.” Agreed. How is this an argument for the ACA?
Finally, Kastenbaum says, “Premiums should not be increasing at a rate of six times the rate of our GDP. That is why Diana is a supporter of the Affordable Care Act,” which is driving premiums up faster than ever before our very eyes. Media everywhere are reporting premiums increasing as much as 25% for many next year, also specifically because of the ACA.
While Kastenbaum’s ideas on healthcare markets might be particularly obtuse, electing her less delusional Republican opponent is by no means a silver bullet. If Americans truly want to make healthcare affordable again, they’ll have to change their expectations. As long as massive entitlements like Medicare and Medicaid make demand virtually unlimited and massive regulatory burdens severely limit supply, the price of healthcare is going to continue to skyrocket. And as long as we keep sending people like Kastenbaum to Washington, Congress will remain the greatest threat to our liberty.
Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.