Tuesday, January 1, 2008

Bad prescription

Here's a notable legacy of Mitt Romney's mis-rule of Massachusetts: mandatory health insurance, with hefty fines for state residents who demur. Now, those fines are heading through the roof.

When the new year begins Tuesday, most residents who remain uninsured will face monthly fines that could total as much as $912 for individuals and $1,824 for couples by the end of 2008, according to penalty guidelines unveiled by the Department of Revenue on Monday.

Individuals who failed to sign up for health insurance by the end of 2007 faced only a one-time loss of their $219 personal income tax exemption.

The theory is that people who have willfully declined to pay for health care are irresponsible, not that they've rationally assessed their own needs and concluded that paying for coverage doesn't make sense -- at least when the options are limited to what the government of the Bay State considers acceptable.

For the record, I spent some time as a freelancer in Boston in my twenties without health coverage simply because I considered it an unnecessary expense for a man with zero health concerns. It was a gamble, but one I considered quite reasonable. I switched over to the most bare-bones catastrophic policy I could find (not so bare-bones in the people's republic by the sea) when I started riding a motorcycle, with all of the risks that entailed. Frankly, it was my choice to make, and my responsibility to live with the consequences of my choice.

But assuming that people are too stupid or irresponsible to make their own decisions is a popular pastime among politicians. Hillary Clinton has made coerced coverage a centerpiece of her platform, while John Edwards adds mandatory coverage to a far-reaching scheme for government-regulated care.

It's probably no surprise that mandates rarely stand alone. Once government officials get into the business of ordering people to get health coverage, they become ever more enthusiastic about defining what constitutes coverage. Edwards, for one, wants to drag folks to regular doctor's appointments whether they want to go or not.

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat "the first trace of problem." Edwards and his wife, Elizabeth, announced earlier this year that her breast cancer had returned and spread.

Call it eat-your-broccoli social policy. Oh hell; call it finger-wag-or-else, because nothing says "good for you" like the prospect of being held down by a couple of health cops while a state-contracted sawbones checks your prostate.

More regulation will inevitably drive up costs or hammer-down the quality of medical care. When providers and consumers don't respond to legislation the way politicians promise, the result will be rising penalties all around to penalize "uncooperative" doctors and patients.

Just look at Massachusetts.

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1 Comments:

Anonymous Anonymous said...

^^ nice blog!! ^@^

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March 18, 2009 11:49 PM  

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