Mandatory health care has promise

Published 12:00 am Wednesday, August 1, 2007

Mandatory insurance laws that dictate every driver hold automotive insurance have always seemed to me an intrusion into the pocketbooks of the individual in an attempt to pad the pockets of an industry that doesn&8217;t like the end-sum of their business risk.

Granted, if I were in an accident tomorrow with a driver who had no insurance, I would cuss them under my breath. But then, I would file my claim and expect my insurance company to pay for my car. Likewise, I&8217;m sure they would in turn stick me with higher premiums the next quarter or the next year, and I&8217;d then cuss them about that as well.

I understand the system is broken, that it is not perfect. But far more broken and far less perfect is the health care system and the insurance industry that serves it.

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Given my admittedly tepid disdain for mandatory automotive insurance, it surprised me to conclude that proponents of mandatory health insurance might actually be on to something.

Socialized medicine works, mind you. Look to the health care systems in European nations. They have it, and it works. But with it comes some serious side-effects that we don&8217;t have in America.

Our privatized system has fostered more innovations, access to faster testing and results, better drugs and accessible trial programs for more serious diseases for which there are no known cures. Such arguments against socialized health care I can sink my teeth into.

But when people start talking about high taxes for health care, well, I start to yawn. The United States spends more on health care per capita than any nation in the world, and &8220;any nation in the world&8221; includes those nations with socialized health care. To show for it, we have more uninsured citizens than either of these nations. High taxes? Increased spending? Give me a break.

What is broken in America is not privatized health insurance but the way in which we administer it. Proponents of mandatory, individual health care that remains a privatized industry understand this. They realize that both liberal and conservative views on how to fix our health care insurance crisis hold worthy ideas that must be enacted.

That, as we consider a solution to rising health care, is the first necessity &8212; the solution must be bi-partisan. Those who fight for the poor and those who fight for the industry must find common ground, or both will suffer from what could be irreparable damage to our health care system by the mid-part of this century.

On July 1, 2007, a mandatory health insurance law became active in the state of Massachusetts. It is easily the boldest initiative to date in the United States, one that seeks to curb the cost of health care and provide affordable access to all people.

The Massachusetts model is not perfect, and many question its long-term viability because of foreseeable problems with its funding mechanism. Still, the alternative was funding problems with the status quo, and Massachusetts has said it will not stand for the status quo.

The law was passed in 2006, when Republican presidential candidate Mitt Romney was governor and a group of liberal Democrats were entrenched in the leadership of the legislature. In other words, they didn&8217;t see eye-to-eye on a lot ideas. But on this &8212; one of the third-rails of politics &8212; they found a way to compromise.

So what does a mandatory health care program involve? In short, it moves us away from an employer-based system to an individual system. The best proposals involve employers providing employees tax-free portions of their salary that currently go to insurance plans. It also creates low-premium, high-deductible plans geared toward catastrophic health care needs (think $6,000 deductibles that cover fully chemotherapy or heart transplants) for people who either do not wish to have much health coverage or people who cannot afford it. In addition, a subsidy pool would be created into which individuals, employers or the health insurance industry itself pays to help cover the cost of those who cannot afford health care.

The plan works on basic economic principles: If individuals are now faced with the management of the health care options (as they are their grocery bills), they will seek more cost-effective means. Likewise, they will demand &8212; as will physicians and hospital operators &8212; more cost-effective drugs and equipment, along with higher payments from insurance companies.

Granted, we would see growing pains when implementing a system like this. People would be forced to change the way they thought about insurance. For the older generations, it would be more difficult. But for the younger generations, those who change jobs often or work for themselves, it would make more sense.

As to the mandatory part, I&8217;m still not convinced, though I find it more palpable with health care than with automobiles, if for no other reason that the rising cost of health care is affecting essentially everyone. The same cannot be said for the impact of uninsured motorists on our society as a whole.

Granted, this is an elementary explanation of a rather complex idea, an idea that has merit. Too, it has drawbacks. The funding mechanism must be well thought-out. In building such a system, we must be careful to ensure that no one goes without adequate health care.

It is a good start, far better than the nationalized health care programs offered by some, Sen. John Edwards&8217; plan to mandate health care plans from all businesses or the lack of serious alternatives from the Republican side of the presidential aisle.

Sam R. Hall is editor and publisher of The Times. He can be reached by e-mail to