Hillman on Mandates

The October 26, 2007 Denver Post has printed the following OpEd by former Colorado State Senator Mark Hillman on the problems with insurance mandates:

Consumers deserve choice in health care
By Mark Hillman

"Everybody talks about the weather, but nobody ever does anything about it." - Mark Twain

You might say the same goes for health care. Politicians are constantly tinkering, making promises they can't deliver, and usually creating a bigger mess than the one they promised to fix.

Ironically, despite the abysmal record of lawmakers and bureaucrats to produce lower prices or create greater choice, the public still clamors for government to "do something." Perhaps the more logical outcry should be: "undo something."

The newest solution du jour is mandated universal coverage — i.e., requiring everyone to buy health insurance and/or requiring all employers to buy it for their employees.

At first, this sounds rather reasonable. State law already mandates insurance for all vehicles licensed in Colorado. Extending the same principle to health insurance would promote personal responsibility, right? After all, we are told that those of us who buy insurance are constantly paying for those who aren't insured and cannot pay.

Reality, human nature ignored

On the other hand, there's reality and human nature — two factors conveniently ignored by so many who always want to legislate the rest of us into their utopian mold.

The first reality is that another law won't produce universal coverage any more than traffic laws eliminate speeding. Even with mandatory automobile insurance coverage, at least 12 percent of vehicles on the road are still uninsured. By contrast, the health uninsured rate is only a slightly higher 16 percent without a similar law.

The next reality is that the auto insurance mandate is fairly simple. State law requires only two types of auto coverage — liability and uninsured motorist — and a minimum of $50,000 coverage for each category. Other than that, we can decide what to buy and how much to pay. We won't be so lucky with health insurance.

Once lawmakers require everyone to purchase insurance, they won't be satisfied to simply mandate $500,000 or even $1 million of coverage. That's because special interests perennially lobby the legislature to require you to buy things you don't need, don't want or can't afford.

Colorado law already requires most health plans to cover at least 16 specific items. Let me put that another way: know-it-all politicians don't think we are smart enough to make our own health care choices, so rather than give us options, they order us to buy what they think we need.

Women who plan to never have children or who are beyond childbearing years must buy maternity coverage. They also, inexplicably, must pay for prostate screening. People who don't drink must purchase coverage for alcoholism. And despite the added cost of mental health coverage, everyone who buys insurance must purchase it.

For many, these mandatory extras make health insurance unaffordable, thereby exacerbating the so-called "crisis of the uninsured."

Strange bedfellows?

If lawmakers didn't spend so much time bashing insurance companies, you might think they were in cahoots. How else do you explain the absurd decree that we must buy insurance for preventive measures, such as mammography or prostate screening?

No one questions the wisdom of these screenings. However, requiring you to finance them through insurance, when you could more easily and less expensively pay for them yourself, doesn't demonstrate lawmakers' compassion so much as their economic illiteracy.

Moreover, any legislator who actually trusts people to decide for themselves and votes against mandatory coverage is usually rewarded with dishonest campaign attacks claiming that he or she opposes coverage for breast cancer, birth defects, diabetes and such.

The end result is that you and I are no longer allowed to choose the insurance coverage that best fits our needs, and insurance companies can't respond to what we want.

Instead, lawmakers and lobbyists control the health care market, as they have increasingly for the past 40 years; then they react in amazement when the product is something you and I either do not want or cannot afford.

Mark Hillman is a wheat farmer in Burlington and a former state senator. Contact him at www.markhillman.com