"Qualifying Plan," Liberty and Politics

At the NY Daily News is a nice column detailing likely effects of the health insurance bill presently making its way through a Senate committee. From t he column we note briefly the issue of a proposed federal mandate that all health insurance plans "qualify" at a certain standard.

SWNID has passing familiarity with this issue, one member of the SWNIDish clan having just concluded a sojourn in the People's Republic of Massachusetts. MA has, at the initiative of a certain Republican governor, a mandate that all its citizens have health insurance. The notion, not entirely unsound, is that by such a mandate costs for the otherwise uninsured are not foisted on responsible citizens who bothered to get insurance. There's a subsidy for the less well off to pay insurance costs, so a progressive tax system is at work, not unlike other governmental programs.

We leave it to others for the present to debate the merits of such matters. But we call attention to the fact that a resident of MA must not simply buy health insurance but must buy insurance that covers very specific services. We cite one as an example: MA requires that chiropractic services must be covered by a policy or it doesn't qualify.

We will also leave it to others to debate the merits of chiropractic. We know well people who have received relief associated with such services and suspect we know people who have wasted time and money on them. What we call attention to is that a resident of MA is considered unacceptably insured if her policy does not pay for chiropractors. MA doesn't think a citizen ought to have discretion to assume responsibility to pay a chiropractor directly if such services are needed or wanted. MA knows best.

Now, where did such a thing come from? From stories of people bankrupted by the high cost of chiropractic? Doubtful. From a lobby of chiropractors who believed that if a third party paid the bill, more people would seek their services? We don't know. We do suspect. We think that's how politics works.

And so, from the people who brought you earmarks, who gave the otherwise tasty and satisfying dish "pork" a bad name, who assume on a daily basis that you don't know the difference between various numbers ending in "-illion," comes the concept of a "qualifying plan" that they can pile up with everything from laser hair removal to meditation therapy, all the while claiming that recordkeeping efficiencies, greater bargaining power and lowered administrative costs will save the day financially.

There's an old, mathematically demonstrable rule in buying insurance: use insurance to protect yourself only against the risks that you cannot assume yourself, given your relative wealth or poverty. Insurance costs more than the risk if the risk falls within affordable bounds for the individual. Hence, in buying automobile insurance, for example, the smart buyer asks at what threshold of expense he experiences hardship and sets his deductible at that point. The same ought to apply to health insurance, which over time in this country has become decorated with all kinds of additional geegaws, like payment for ordinary office visits, because it is subsidized by a tax break and paid for by third parties with dollars that consumers don't even remember belonged to them once.

SWNID warmly embraces responsibility for the risk of needing a chiropractor sometime and is ready to throw tea in the harbor of anyone who suggests that he is so much the child as to be required to act otherwise.