Former Republican Senator Bill Frist starts out the U.S. News And World Report article in which he comes out in support of a government requirement that each American have health insurance with what can only be described as a fair degree of irony:
I believe in limited government and individual responsibility, cherish the freedom to choose, and generally oppose individual mandates—except where markets fail, individuals suffer, and society pays a hefty price.
Or, to put it another way, I believe in individual government and individual responsibility, cherish the freedom to choose, and generally oppose individual mandates — except when I don’t.
While Frist spends much time in his article talking about the alleged benefits that an individual mandate would bring, he spends no time whatsoever addressing the fundamental issues that need to be talked about if we’re seriously going to pass what amounts to the Health Insurance Industry Subsidization Act of 2009.
First, there’s the issue of why a mandate is necessary. Frist does not address at all the “market failure” that he claims exists which would be remedied by forcing everyone to purchase health insurance. What he does do, though, is reveal what the individual mandate is really all about — forcing young, healthy people who otherwise might choose to forgo the several-hundred-dollars-a-month worth of premiums they’d have to pay:
When healthier people opt not to carry insurance, only those with poorer health, and thus higher costs, remain in. This leads insurance prices to spiral up. And it further impedes markets’ ability to mitigate risks and prevent personal economic catastrophe. The “free-riders” who do not purchase insurance and the “voluntarily uninsured” who depend on emergency room care paid by others would then pay their fair share for services received.
What Frist doesn’t address, of course, is the fact that an individual mandate is likely to create upward pressure on premiums for one very simple reason — once insurance companies know that you have to buy their product whether you want to or not, they have zero incentive to keep premiums down. That’s the reason why, for example, auto insurance rates (which in most states are mandatory if you want to own a car) are higher than most other forms of insurance that individuals typically purchase.
What the individual mandate really does is to force the young and healthy to subsidize the older and sicker. It’s worth noting that hat’s the same logic that Social Security and Medicare are built on, and they’re in the process of going into an demographically inevitable bankruptcy. One can foresee much the same thing happening under an individual-mandate health scenario.
First goes on to cite Massachusetts as an example of an individual mandate plan that “works,” but that isn’t necessarily true:
The Massachusetts experiment with the same scheme has left the state with the nation’s most expensive insurance, with program spending up 70 percent in just three years and with a third of the uninsured remaining so. The cheapest insurance we can find in Massachusetts for an average family of four is $906 per month. In Iowa, it’s $145. Different coverage, certainly, but at least in Iowa cheaper coverage choices exist.
That’s what could come to America if we adopt the individual mandate.
Frist also fails to address a more important issue — what right does the Federal Government have to force me or you to buy health insurance ? I don’t just mean to ask what Constitutional provision authorizes it, although that is certainly important, but also why should the government be allowed to do this at all, even if it technically had the power to do so ? As a Republican who claims to “believe in limited government and individual responsibility, cherish the freedom to choose, and generally oppose individual mandates,” that’s a question that should be relatively easy for Frist to answer.
His silence, and the silence of other Republicans, is deafening.
Updated to reflect my failure to note that Frist is in fact a former Republican Senator