If I set out to accomplish a task, I have to start with the basics. What is the job? What steps are involved? The list goes on. The same concept applies to ObamaCare. It’s broken. Whether we repeal it or fix it, we have to start with foundations. In other words, as Herman Cain notes, we have to ask the Right Questions.
Paul Ryan didn’t ask any of the right questions. And the very first one is simple: “What is our objective? Do we want to make health insurance affordable, or do we want to make health care affordable?” Put differently, do we want to guarantee a subsidy for the health insurance companies, or will we put patients first?
Health insurance is a subsidy to health insurance companies, because it has preferred status in the tax code. Taxpayers get a tax break for supplying health insurance companies with profits. That means that insurance companies will spend breathtaking amounts of money to support legislators who protect their profits. Legislators will respond by creating bigger tax incentives to buy health insurance, and the cycle will continue. Health insurance is a classic example of the Law of Subsidy in action.
The Law of Subsidy: Every time you subsidize something, you get more of it, and it gets more expensive.
Nobody asked, “Does health insurance improve health?” Had they asked, they would have learned that for the general population, health insurance does not improve health. The Oregon Health Insurance Experiment showed that:
“Medicaid coverage resulted in significantly more outpatient visits, hospitalizations, prescription medications, and emergency department visits. Coverage significantly lowered medical debt, and virtually eliminated the likelihood of having a catastrophic medical expenditure. Medicaid substantially reduced the prevalence of depression, but had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk. Medicaid coverage also had no statistically significant effect on employment status or earnings.”
Notice that there was essentially zero overall effect on health. Insurance did reduce individual financial risk, and that’s what insurance is supposed to do. But because of a 20 percent increase in use of medical resources, it substantially increased overall cost, suggesting that there may be better ways to protect individual finances.
Where did that excess money go? Providers! Insurance is a subsidy to the health care industry. Since this was Medicaid, it took taxpayers’ hard-earned money and gave it to insurance companies, doctors, and hospitals. We didn’t get to decide whether to use (and pay for) their services. The money was taken from us and given to them. And it did no good for poor patients.