Let Them Eat Insurance

Over at The Corner (Conservatism is dead; long live conservatism), this illuminating piece from Mark Steyn on the subject of these so-called "death panels":

What matters is the concept of a government "panel." Right now, if I want a hip replacement, it's between me and my doctor; the government does not have a seat at the table. The minute it does, my hip's needs are subordinate to national hip policy, which in turn is subordinate to macro budgetary considerations.

Mark Steyn, have you always been a moron, or did you have to work at it?

Right now, if you want a hip replacement, it's between you, your doctor, and your insurance company. 1) The insurance company must first approve of your need to get a hip replacement (presumably to stop you from wistfully eyeing that new designer, rocket-propelled Nike hip even when you don't need a new one). If they don't approve it after examining your medical records and talking to your doctor, you're out of luck buddy. Pony up the $40,000 you'll need to pay for it yourself. 2) If they did approve it (because, you know, they're compassionate and all), you and your family must think about your insurance deductible and whether you can afford the $3,000 copay at this time--i.e., your insurance company indirectly has a seat at your kitchen table because they wrote the rules for your policy. 3)Perhaps you could only afford a catastrophic health coverage policy...you would be exploring the possibility of "falling down the stairs" so that you could be rushed to the ER and get some treatment there. Again, the insurance company is a factor.

Nothing is "just" between you and your doctor. Health care is rationed to those that can afford the insurance premiums. Even when you have a policy, someone else reviews your major health treatment decisions with you and your doctor and your family. Whether that's my insurance company or the government, I'm not sure which is worse, but I certainly don't think of one as better than another. Besides, I already trust my government to secure my liberty, so if they want to secure my toothless gums, I don't give a crap.

All that is assuming you have insurance to begin with! If you're too poor to afford it, and/or you work for a company that can no longer afford to pay for your coverage because of crazily escalating premium costs, you're out of luck. Now, maybe Mark Steyn can afford to simply write a check for his brand new Nike hip. Maybe he doesn't even need insurance. In that case, I'm thrilled for him. Most everyone else depends on having health insurance, thank you very much.

None of this means that I'm anti-insurance companies. They aren't the devil incarnate, they're just looking to make sure they stay profitable. They're just businesses, which is why it's weird to me that folks like Steyn would waste time talking about how the current system is more compassionate! What's compassionate about a system where you can't be covered for a pre-existing condition? What's compassionate about a system where if you lost your coverage for a few months because your company went bankrupt and you couldn't afford the astronomical COBRA payments to keep your policy active, any new policy would automatically exclude any disease you had been getting treatment on until then?

I think Mark Steyn, by opposing any change to our currently perfect system, is essentially saying that those who can't afford health insurance need to...wait for it...buy insurance!!! If that isn't the pinnacle of elitism, I don't know what is.

Bureaucratific

In what passes for conservatism these days, criticism of Obama's health-care plan has seemed to mainly be, "We don't want someone else, least of all, one of them Washington bureaucrats, making our life-or-death decisions for us." As if private insurance bureaucrats were somehow more compassionate than their lowly government counterparts. The "death panels" hysteria is comical given that insurance companies lay out in advance exactly what procedures they will or, more likely, won't, cover and at what price limits. Nevertheless, this ought to be entirely beside the point.

Today, since you can get as much care as you can afford, we don't think of it as rationing, but from a societal standpoint, it absolutely is. Health-care is rationed according to one's ability to pay. Basic economics. So long as resources are limited, no one can get everything. Things get costs assigned to them based on how much people need/want them. The left is being entirely consistent, and noble, in arguing that it is immoral to deny anyone care just because they can't afford it. I fully stand behind that sentiment. However, we still won't be able to afford unlimited care for everybody. We never will as long as resources are finite. The real question is which system best rations health-care while covering as many people as possible, not whether we need to ration. We already do. The fact that the right is babbling about the greater compassion of private insurance companies is mind-boggling.