Mandates: Bad for Your Healthcare

May 7, 2009

In the public-policy world, it’s the best scam going.

Left-wing advocates successfully lobby for more regulation of and subsidies for healthcare. As a result, costs soar, quality falls, innovation stagnates, and the number of uninsured grows. “Reformers” then label the system badly broken and in need of a complete overhaul -- one that greatly expands the role of government.

The strategy’s working quite well in Connecticut, where a vital weapon in liberals’ war on market-oriented healthcare is being wielded once again this legislative session.

Connecticut already places dozens of mandates on insurance providers -- requirements that health plans include everything from infertility treatments to mental illness, hypodermic needles to occupational therapy. (Unions and large employers that self-insure are exempt from state mandates.) This session’s proposals would force insurers to cover the costs of:

• bone-marrow testing

• participation in clinical trials

• additional colonoscopies in a policy year

• ostomoy-related supplies

• wound-care supplies for epidermolysis bullosa (a rare skin condition) sufferers

• prosthetic devices

• stepchildren (on the same basis as biological children)

• hearing aids for children

• wigs for hair loss due to any medical reason, not just chemotherapy

Each of the bills made it out of committee (most by wide margins), and before the session ends next month, many are likely to pass both chambers and be sent to a governor who has shown little willingness to veto mandates.

All but the most committed single-payer extremists acknowledge that micromanagement by mandates is expensive. States with the costliest premiums tend to place the most requirements on providers. Connecticut’s a stellar example. Its 51 mandates make it one of the worst offenders. Only Minnesota (64), Maryland (63), New York (55), Virginia (55), Texas (54), Maine (53), Washington (53), and Nevada (52) have more.

In 2006 and 2007, the trade association America’s Health Insurance Plans surveyed its membership to determine the price of premiums by state. AHIP found that a year of family coverage in Connecticut was $7,749, or more than 33 percent above the national average.

By hiking the price of health insurance, more citizens choose to go without it. Devon Herrick, a healthcare scholar with the National Center for Policy Analysis, notes that “several studies have estimated that about one-quarter of the uninsured have been priced out of the market by costly mandates.”

That’s of little concern to the healthcare-is-a-right movement -- in fact, a rising number of uninsured is a blessing to it. An ever-growing roster of “victims” of the “brutal” healthcare “marketplace” provides one more talking point.

Which brings us to “SustiNet,” the boondoggle-in-the-making crafted by the Universal Health Care Foundation of Connecticut. At 41 pages and 17,000 words, the bill to implement the foundation’s proposal creates the “SustiNet Authority,” an entity with the mission to “(1) improve the health of state residents; (2) improve the quality of health care and access to health care; (3) provide health insurance coverage to Connecticut residents who would otherwise be uninsured; (4) increase the range of health care insurance coverage options available to residents and employers; and (5) slow the growth of per capita health care spending both in the short-term and in the long-term.”

The usual suspects -- including the Connecticut Health Policy Project, Permanent Commission on the Status of Women, Commission on Children, Connecticut State Medical Society, Connecticut Public Health Association, Connecticut Catholic Conference, Bridgeport Child Advocacy Coalition, Connecticut Association for Human Services, Connecticut Citizen Action Group, and Connecticut Voices for Children -- have lined up in support of SustiNet.

Standing in opposition to this lobbying behemoth is … well, not much.

That’s too bad. Because the answer to healthcare woes in Connecticut and the nation isn’t more bureaucracy. The only way out is to put consumers back in charge.

Mandates must be repealed, empowering insurers to sell no-frills policies that will doubtless cost far less. But that’s just the first step. Federal permission for interstate competition offers another promising reform. (Big shock: Connecticut’s congressional delegation is AWOL on that proposal.) The nonsensical link between employment and health insurance should be severed, and eligibility for taxpayer-subsidized programs needs to be tightened, not expanded. (Currently, 45¢ out of every healthcare dollar is spent by government.) Health charities need to return to their traditional role of providing care, not lobbying for socialized medicine.

With the exception of electricity, no good or service is more heavily regulated and subsidized than healthcare. Before embracing the “solution” offered by universal-coverage advocates, consider the role they’ve played in creating the problem.  

D. Dowd Muska is a writer, commentator and lecturer. His website is www.dowdmuska.com.

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