Tuesday, April 22, 2008

Do We Need Individual Mandates?

Linda Gorman and R. Allan Jensen ask this important question in their recent article, "State Health Care Reform: Key Questions and Answers," (National Center for Policy Analysis, Policy Report No. 311, April 2008).

They make the following noteworthy economic points:
* The imposition of an individual mandate with minimum coverage requirements will likely mean that thousands of people who currently have health insurance will find that their policies do not meet the minimum standards because their deductibles are "too high" for the officials defining the minimum standards, or because their policies lack certain benefits.

* These decisions will be made by a regulatory body that has no direct knowledge of the incomes, assets, health status or values of the individual policyholders.

* This is what is happening under the failing Massachusetts health reform plan.

From an individual's point of view, a mandate is a tax:

* By forcing people to buy a product they may not want at a price they cannot control, the individual mandate functions as a potentially unlimited tax for health insurance.

* People who currently get health care but have no insurance will be required to purchase insurance, thus increasing their costs.

* People who are allegedly unable to purchase insurance because it is unaffordable will have to be subsidized to a larger extent than they are at present.

* Funding those subsidies will require direct tax increases that will raise costs for all citizens, whether those increases are in the form of taxes on insurance premiums, provider taxes, sales taxes or increases in the income tax.
These are all economic consequences of the broad fact that a mandate forbids people from spending their own money according to their best judgment for their own benefit; instead they are forced to spend it according to a bureaucrat's judgment as to what's best for some "collective good".