When it comes to mandates, it boils down to this: If you want to visit a chiropractor, great. Pay for it out of pocket!
But let's laser in on the kind of government intervention that stifles care and drives up cost. Take my own home state of New York. It is one of three states that have both "community rating" and "guaranteed issue." In a nutshell, community rating obliges insurance companies to charge everyone the same rate regardless of their age or health status. Young people get screwed by this formula: We're stuck paying higher prices to help subsidize the premiums of older Americans. Guaranteed issue means that insurers must "cover anyone at any time," usually at the same rate.
It's no surprise, then, that the states that pile on mandate after mandate and impose community ratings, thereby giving everyone nearly uniform premiums, are the states that have the highest annual insurance premiums. In New York, for instance, insurance is "roughly two to three times higher than the national average," and neighboring New Jersey has premiums for individuals bucking $5,000.7 The result is that young New Yorkers pay through the nose.
It is government intrusion into health care that is screwing everything up in the first place. Rather than let people choose what they want covered, some government bureaucrat from on high lays down the law of the land. Such diktats are wholly at odds with a free society.
Now, to be fair, Barack Obama does have a point about "insurance security." If you lose your job, chances are you will lose your medical insurance. For most of the country, and for most young people, insurance is directly tied to employment. It's one of those benefits we're offered for employment, but it's also a government-created system that has turned out to be woefully inadequate for the twenty-first century. Young people are more fluid in the job market. We hop around. We're not like our parents or their parents, who worked at one company building up seniority and benefits over the course of their careers.
Employer-based health care started during World War II when the government imposed strict wage and price controls on American businesses. The result, among other things, was a shortage of people in the workforce. Entrepreneurs did what entrepreneurs do best: they devised a plan to attract skilled workers despite the government's onerous regulations. That plan was to pay for a worker's and his family's medical care. It was a hit. Repressed salaries were made up with "fringe" benefits. Congress eventually passed legislation that allowed those benefits to be tax-exempt, a response to IRS rules requiring that medical coverage be counted as salary and therefore subject to taxation.8
The implications are broad. Most individuals now rely on their employers for their health insurance. The trouble is that a system like ours punishes people who don't have employer-based health care and must therefore instead buy insurance privately. The reason this is problematic is that government-sanctioned mandates have driven up the costs of privately purchased insurance. And unlike large companies that buy insurance packages in bulk quantities (thus resulting in cheaper costs), small business owners can't band together with others to buy lower-premium insurance. Worse, those without employer-based health care must use after-tax income to purchase insurance, whereas employer-based coverage gets a huge tax break. It's inequitable.
THE LIBERAL MACHINE'S ability to churn out Obama Zombies on the health-care issue boils down to this: Unfortunately, young people are more susceptible to liberal bloviating about free health care and massive overhauls because younger Americans are the least likely to use health care. That means some left-winger comes along and talks about "shared sacrifices" and drops the 46-million-uninsured myth on a young person's unwitting head and, presto, you've got yourself a freshly minted Obama Zombie. The problem is that waving a magic wand won't produce free health care for everyone.
It's more complicated than that. The very instrument that created the mess in the first place (government) is the very instrument that liberals advocate can solve the mess (more government). Let's see: The government introduced the inefficient concept of employer-based health care, state governments imposed huge burdens with mandates, yet somehow we should trust the government even more?
In any case, the federal government is the reason for exploding costs and the ban on a free exchange of services from people to providers. Did you know that the federal government set up strictures that prevent people from purchasing insurance across state lines, another inhibitor to competition? Insurance companies must fashion health-care policies to the guidelines of each state. Competition does not exist on a national level. Instead we get a hodgepodge of fragmented markets and the large price differences that accompany them. This drives up the health-care insurance prices considerably, especially, as the Heartland Institute points out,9 if you live in a state that must cover things like acupuncture and marriage counseling (about one-fourth of states), social workers and contraceptives (more than twenty-five states), and hairpieces and hearing aids (seven states).
Competition, as Obama likes to say, will drive down cost. But we need real competition and real deregulation that will rid costly mandates. Some insurance companies, for instance, steer up to 80 percent of the health-care market and pour money into whatever politicians' hands will protect their monopoly and not allow access across state lines. And while competition is hampered by so much regulation, so much bureaucracy, and so many mandates, liberals in Congress such as Barney Frank (and even Senator Obama while running for president) think they can undo the problems caused by a limited monopoly by converting it into an overall monopoly.
Columnist Ann Coulter said it best: "It's the famous liberal two-step: First screw something up, then claim that it's screwed up because there's not enough government oversight (it's the free market run wild!), and then step in and really screw it up in the name of 'reform.' "10
For too many young Americans, the clarion call for "reform" translates into thinking that health care is some magical right that somebody else must pay for and shouldn't be treated as any other commodity, such as food, electricity, or cars, for that matter. During the election, Obama called health care a right, not a privilege, adding that Americans have a "moral commitment" to provide health care to every American. It's a great feel-good sound bite. But such an entitlement mentality is a dramatic departure from the Declaration of Independence's guarantee to protect our life, liberty, and pursuit of happiness. The federal government accomplishes this, as our Constitution outlines, with less than twenty enumerated roles.
An MTV reporter in Delaware did a report on young people and health insurance called "The Young, Hot, and Uninsured." One individual interviewed, Gabriel Humphreys, a twenty-eight-year-old techie, grumbled that he didn't have health insurance, especially so he could go to the hospital after a snowboarding accident. "I actually hurt myself like eight weeks ago," Humphreys said. "I tore my rotator cuff while snowboarding and, you know, I couldn't go to the doctor. I could, but, you know, I didn't want to pay that out of pocket because it would've been horrible."
Zombie Gabriel said that he favors a "nationalized" health system, where everyone is covered, and he bemoaned the fact that we can fight wars but don't have the government insure people. Obama's generalities are an easy target for young people who are told they're in need of insurance, with catastrophe knocking on their doorstep.
Hey, dude, if you don't have health care, and you don't want to pay for it, then don't go snowboarding! If you still believe in personal responsibility, any personal responsibility, raise your hand. Why should you, I, or anyone have to fund this brother's snowboarding accidents?
During the campaign, story after story told us how young voters wanted health-care "reform." One Rutgers University student, Joe Shure, told an NBC reporter that "health care is a huge concern. And the fact that the U.S. is an industrialized country without universal health care is an embarrassment, I think."11
Obama certainly embodies this mentality. His rhetorical tactics are always the same: hook young people with big-government schemes by calling it the "empathy deficit," which is our in
ability "to put ourselves in someone else's shoes," as he told the students at Northwestern:
We live in a culture that discourages empathy. A culture that too often tells us our principal goal in life is to be rich, thin, young, famous, safe, and entertained. A culture where those in power too often encourage these selfish impulses. . . . I hope you choose to broaden, and not contract, your ambit of concern. Not because you have an obligation to those who are less fortunate, although you do have that obligation. Not because you have a debt to all of those who helped you get to where you are, although you do have that debt.
It's because you have an obligation to yourself. Because our individual salvation depends on collective salvation. And because it's only when you hitch your wagon to something larger than yourself that you will realize your true potential--and become full-grown.12
Nice do-gooder rhetoric, but my goodness, collective salvation? Obama's razzle-dazzle logic-free sound bites induced their intended Zombie effect: "I have listened to him and I liked what I've heard so far," said Julie Rattendi, a first-time voter. "I'm just looking for someone to believe in."13
Yet now that Obama is the leader of the free world, what's interesting is that young people have been visibly absent in supporting the government plan for health care. It's caught the eye of the media. Where are the Obama supporters, or the "Obamaniacs"? Where are those troubled, unconfident students who put all their faith in Obama during the campaign? They sang songs about him; prayed to him; rapped to him; made love to him; marched to him; fainted to him; obsessed over him; and now, well . . . they're absent.
The drop-off goes right to the cult of personality, and the fact that young people buy into the utopian bulldoodle that Obama serves on a platter but are generally healthy, so there's no urgency or need to engage in the debate. Plus, the campaign is over. They can wait another four years to grovel, faint, and copulate at the Messiah's feet. Leftists and youth vote poseurs of Rock the Vote such as Heather Smith dismiss the disinterest as a backlash from the partisan rancor seen at health-care town halls. So to step up interest, Heather gets blogger Perez Hilton and other celebrities together to try to get young people motivated to back Obama's policy.
But the reason none of this seems to be working is that it all smacks of further limits on individual freedom and choice. Heck, liberals are already calling on Obama to regulate the food Americans eat, just as New York City banned trans fats. One liberal, Michael Pollan, wrote in a New York Times op-ed that the Obama administration must declare a war on the "American way of eating"; Dear Leader must work with the food industry to "take a good hard look at the elephant in the room [fat people] and galvanize a movement to slim it [us] down."14
Jim Geraghty of National Review Online summed up the Obama pie-in-the-sky health-care philosophy quite nicely:
We're expected to believe a Democrat-controlled Congress, with deep divisions in its ranks, will put together a bill that will keep everything the same for those who have health insurance through their jobs, Medicare, Medicaid, or the VA; mandate coverage of pre-existing conditions; ban caps on coverage; mandate coverage of routine checkups and preventive care, like mammograms and colonoscopies; offer health insurance to 30 million uninsured; provide tax credits for small businesses; painlessly mandate coverage for the young healthy uninsured; provide hardship waivers; provide choice and competition; keep insurance companies honest; avoid taxpayer subsidies for public option plans; keep out illegal immigrants; not pay for abortions; and not deny care to the elderly because of cost-benefit analyses, all while not adding one dime to our deficits--either now or in the future.15
Let's punt all our personal responsibility and just lay it at the feet of Dear Leader. The government can't even make a profit delivering mail, yet they want to dictate a health-care policy for 300 million Americans?! Say what? That makes as much sense as letting Michael Vick take care of your dog while you're out of town.
You, as an individual, and you, as the head of a household, have the single biggest incentive to provide medical coverage. Keep in mind that "rights" never impose financial obligations on other people. But to claim that somebody has the right to health care means that somebody else must pay for it. My right to free speech doesn't guarantee me that you will pay for a microphone; my right to religion doesn't guarantee that you'll provide me with a collection plate, Bible, and hymnals. In reality, Zombies have as much of a "right" to health care as they do to taxpayer-funded trips to KFC to feast on a bucket of wings and biscuits. Food is a much more basic necessity than health care, yet we do not have food-based insurance, or even food-based savings accounts. The late, great economist Milton Friedman had this axiom: Nobody spends somebody else's money as wisely or as frugally as he spends his own. Only in Disney movies does redistribution of wealth work.
We should be allowed to choose our level of insurance, like we do car premiums: to provide risk pools for consumers that cover them against catastrophic and unanticipated costs! I definitely don't expect or want to get into a car accident, but I'm covered for that level of possibility. My insurance, however, doesn't pay for my oil change, my gas, my car washes, etc. I pay for that out of my pocket, and as a result, I search for the best deals. It is truly a free market in action. The closest thing we have to a free market in health care is in the world of cosmetic surgery. There are no heavy government regulations or subsidies. People pay out of pocket, competition flourishes, and consumers are satisfied. As Ed Morrissey of Hot Air explains,
If anyone wants to see how a medical-care market could work rationally, all they need to do is see how plastic surgery and Lasik markets work. Because the consumer has to deal with the actual cost of service, these providers are not overwhelmed. Because the providers get actual market compensation for their goods and services, there is no shortage of providers. And because of both of these facts, competition between providers keeps costs reasonable and rational. Health-care reform should learn from that example and move closer to that kind of market, rather than towards more scarcity, less choice, and less freedom.16
But the liberal lives in his own world, where your wallet is his piggy bank. And the power of their emotion is, well, powerful, but also infantilizing. Take Erica Williams of the George Soros-bankrolled group Campus Progress. She appointed herself to represent "youth" issues. In a column for the Huffington Post in support of Obama's health-care scheme, she impressively manages to showcase her ignorance. After admitting that she doesn't like to "haggle over the nuances" of health care, Erica writes:
I could tell them that health care reform is my fight because my partner, 25 years old, is an entrepreneur, consultant, and all around brilliant guy who cares more about professional fulfillment than financial gain and has thus been without insurance for 3 years. I've cried myself to sleep many a night over his lack of coverage, terrified that at any moment, an illness or accident could push us into financial ruin in the beginning stages of our life together.
I could tell them that health care reform is my fight because 60% of my friends (yes, I did the math . . .) have lost their jobs in the past 6 months and don't go to the doctor. . . .
I could say that a young friend of mine is afraid to get a test that would tell whether or not he has a congenital heart disease because he is worried that he will forevermore have a pre-existing condition.
I could also tell you that in addition to being young, I'm a woman of color and that for my demographic in particular, health care is a life or death issue.
And all of those reasons would be true. But for my generation, health care reform is more than a personal story or experience: it is a moral and humanitarian mandate.17
Well, well. Her "partner" doesn't purchase health care, because he would rather invest his money elsewhere. Fine. That's freedom. Not a problem. If a person would rather spend his money on a BlackBerry and expensive dinners than insurance, cool. Go for it. But he made his choice. Furthermore, Erica claims that her generation has made health care a "moral and humanit
arian mandate." Just one problem: she can't point to any such mandate in any of our founding charters. If she would truly represent the interest of young people, she would discuss the massive redistribution of wealth that flows from young to old.
Our system today, pushed by liberals in government, supports a scheme where grandparents steal from the pockets of their grandchildren. Current entitlements are so out of control that it is inconceivable that people like Erica Williams would try to foist yet another costly entitlement--socialized health care--on an entire generation. In 2008, the U.S. comptroller general estimated that the total burden in present value of our entitlement programs--the three largest being Social Security, Medicare, and Medicaid--is about $53 trillion! With a t! The comptroller, David Walker, said, "I know it is hard to make sense of what 'trillions' means. One way to think about it is this: Imagine we decided to put aside and invest today enough to cover these promises tomorrow. It would take approximately $455,000 per American household--or $175,000 for every man, woman, and child in the United States."18
As Walker notes, the federal government has been so inefficient with Medicare and Medicaid, completely government-run to begin with, that the two programs "threaten to consume an untenable share of the budget and economy in the coming decades. The federal government has essentially written a 'blank check' for these programs."19
Hey, Erica, how about we find a moral and humanitarian mandate to get the government's grubby hands off our wallets! If poseurs like Erica really cared about young people they would demand inaction from a government that has already proven itself to be unworthy with our money. A better option would be to let individuals take control of their medical future. Remember the Friedman axiom: Nobody spends somebody else's money as wisely or as frugally as he spends his own.