Downplaying the Uninsured
By Arnold Kling
My Cato friend Michael Cannon writes,
I may lose my health policy decoder ring for asking this, but should we really be focusing specifically on covering the uninsured?
…there are other approaches that could purchase more health for the money spent. Nor would expanding coverage appear to increase overall longevity. Health economist James Smith of Rand notes that health insurance “is vastly overrated in the policy debate.”
Would it improve the quality of care? Evidently not by much. Steven Asch and colleagues found that “health insurance status was largely unrelated to the quality of care.” If you show up at a hospital or clinic in the U.S., you generally get the same quality care whether or not you have insurance.
Amy Finkelstein, in her paper that used the Medicare law to estimate the impact of insurance on spending and health outcomes found that the latter was close to zero. However, she did argue that insurance increases consumer well-being by reducing the variation in income that otherwise would come from health spending.
My view of universal health insurance is that it is a policy with very little social benefit, but also very little social cost. Giving people vouchers to buy catastrophic health insurance, and setting up “high-risk pools” for individuals who are uninsurable because of pre-existing conditions, would be fairly inexpensive.
What would be costly would be universal government-run health insurance, which is what many on the Left think of as universal insurance. The Massachusetts plan falls in this category, because the new law there puts so many coverage requirements and deductible restrictions on now-mandated health insurance that it is effectively government-run health insurance. In fact, the new law added to the rolls of the uninsured–the existing health insurance policies of over 150,000 Massachusetts residents no longer meet the regulatory requirements.
Somehow, I think that no matter how many facts Michael and I put out there, the Left will never lose its emotional attachment to government-run health insurance. My guess is that the Left is salivating over Michael’s piece, and they will use it as evidence that those of us who oppose single-payer health care are the cold-hearted SOB’s that the they always knew we were.