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Say What?

Posted by: Ella Hushagen on Apr 13, 2009

Last week, the New York Times published an editorial arguing against universal coverage. Penned by conservative National Review editor Ramesh Ponnuru, it is out of touch at best, and deceptive at worst.

The author's main tenet is,

America's dysfunctional health care financing system needs to be reformed. But the goal should not be universal coverage. Reform should simply aim to make health insurance more affordable and portable.

By decoupling health care costs and health care coverage, he suggests that it would be okay to tackle health care costs while leaving millions uninsured. However, health economists like Ken Thorpe have long argued that we all pay the costs of uncompensated care for the uninsured through higher premiums.

Ponnuru goes on to say,

The moral case for universal coverage is that we have an obligation to see to it that the poor and the near-poor have access to good health care. But universal coverage is only one way of realizing that goal, and not necessarily the best one.

Come again? Health coverage is an unrelenting indicator of health-better health status and outcomes for those with insurance, worse for those without. Uninsured adults are less likely to receive preventive care, more likely to be diagnosed with serious disease at an advanced stage, more likely to delay seeking necessary care, and more likely to die prematurely. Being uninsured has similarly devastating effects on families' financial health.

The author proposes a McCain-like solution to the health care affordability problem: Eliminate the tax preference for employer-sponsored insurance and wipe out all existing insurance regulation. Health Affairs published an article in September 2008 modeling this type of plan; this study found:

The elimination of the income tax preference for employer-sponsored insurance would cause twenty million Americans to lose such coverage. We note, however, that the effect could be much larger.... The McCain plan will not enable many more Americans to obtain health insurance.

This kind of plan leaves consumers all alone and on their own in a wild-west insurance market with no legal protections. According to the Kaiser Family Foundation's January 2009 survey data, the public rejects this vision of reform:

A resounding 78 percent favor requiring insurance companies to take all comers, regardless of their pre-existing conditions. More than 6 in 10 Americans want to rein in the insurance industry's administrative spending and profit.

Controlling health care costs and achieving universal health coverage go hand in hand. And who says we have to choose anyway? Americans deserve a health care system that provides affordable, quality health care to everyone, and we have the capacity and the motivation to build it this year.