Hsieh OpEd on Employer Insurance Mandate

The September 19, 2008 edition of the Rocky Mountain News has printed my OpEd supporting free market health care reform and opposing Colorado Amendment 56 (which would require businesses with more than 20 employees to purchase health insurance for all its workers):

Free market reforms healthier than Amendment 56

By Paul Hsieh, MD
Friday, September 19, 2008

This fall, Colorado voters must decide whether to require all businesses with more than 20 employees to provide health insurance for their employees (Amendment 56). Although voters may be tempted to say "yes," this is an immoral and impractical solution to the problem of rising health insurance costs.

It is morally wrong because it violates the rights of employers and employees to negotiate to their mutual self-interest in a free market.

Businessmen create jobs through rational thought and hard work. Consequently, they have the moral right to decide on what terms to offer those jobs to prospective employees, including specific wages and benefits.

Similarly, workers have the right to negotiate for any specific wages and benefits they desire, and the right to reject job offers that don't meet their criteria. But they have no right to demand a specific salary or benefit from employers (such as health insurance) via government force.

Two motivations behind this proposed law are (1) the mistaken notion that health care should be a guaranteed "right," and (2) the desire to force businesses (rather than government) to pay for this supposed obligation. But health care is a need, not a right. A right is a freedom of action in a social context, such as the freedom of speech.

It is not an automatic claim on a good or service that must be produced by someone else. There is no such thing as a "right" to a car or an appendectomy. Any attempt by the government to guarantee a false "right" to health care can only be done by violating the actual rights of someone — in this case, business owners.

Forcing businesses to provide health insurance to employees will also cause serious economic harm to Colorado. Such a law would cause many businesses to fire workers, outsource jobs, or cancel plans to hire new workers. This will disproportionately harm unskilled workers and those at the lower end of the income scale — the very people the measure is intended to help.

According to Howard Roerig, owner of Seale & Associates, Inc. in Centennial, "This measure will have a chilling effect on all small businessmen. Although I don't have 20 employees at present, I would make certain never to hire that 20th person. The costs would be so high that I would be better off starting another firm in a different state, and letting it do business in Colorado as an out-of-state firm.

"I would have to find some means of skirting this measure or else close my doors."

Other states such as California have driven away many businesses and jobs due to high taxes and heavy regulations. Colorado must not repeat these mistakes.

To "solve" the problem of high insurance costs by foisting those costs onto businesses would be just as wrong as "solving" the problem of rising gasoline prices by forcing businesses to pay their workers' gasoline expenses.

Our current high health care costs have been caused by decades of government interference in the free market. Hence, the proper solution is not more government regulations, but instead free market reforms that addressed the problems caused by prior government controls.

Some examples of free market reforms include allowing Coloradans to purchase health insurance across state lines and eliminating mandatory insurance benefits. Patients should be allowed to purchase Health Savings Accounts (HSAs) for small routine expenses and insurers should be allowed to sell low-cost catastrophic-only policies to cover rare but expensive events. These measures could greatly reduce insurance prices and allow patients to purchase from the best offerings of all 50 states, thus making insurance available to thousands of Coloradans who want to purchase it but currently cannot afford it. Furthermore, the state legislature could adopt these reforms without permission from the federal government.

If Coloradans want to address the problem of high health insurance costs, they should reject the Amendment 56 and instead demand free market reforms. This is right for employers, right for employees, and right for Colorado.

Paul Hsieh, MD, of Sedalia is co-founder of Freedom and Individual Rights in Medicine (FIRM)

I'd like to thank Ari Armstrong for suggesting that I write about this issue and Howard Roerig for providing me with a fantastic quote that concretizes the economic issues at stake.