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Tuesday, November 22nd 2005

Mandatory Health Insurance

The AMA recently looked at backing proposals for all to carry at least catastrophic health insurance. The idea is to broaden quality of care and perhaps more importantly relieve some of the burden of public health funding. The finances of most community hospitals, I imagine, are not in the happiest of shape and government spending on healthcare is certainly rising.

First, let me make it clear, to anyone who it isn’t obvious to that this is based in a far different philosophical model than required auto collision insurance. It is more in line with say, personal seat belt laws, which are completely out of line with the idea of individual responsibility and liberty.

There are two points to be made.

First, the move is unenforceable.

One need look no further than the example of auto insurance to see some of the pitfalls that can accompany individual mandates, said Donald Franklin, MD, a nephrologist and Tennessee delegate.

“We believe the intent [of the resolution] is satisfactory, but requiring a form of health insurance coverage probably sets a bad precedent,” he said. “Even though automobile insurance and driver coverage may be mandated in many states, we all know friends, family, acquaintances who have had the instance of an automobile accident where the opposing driver is not covered by insurance.”

Check out statistics on uninsured motorists. In the past 10 years some states have suffered uninsured rates, despite the requirement for auto insurance, in the one-third range.

Second is a slippery slope argument in which this sort of law is another step in government interference in healthcare.

[S]aid psychiatrist Richard Warner, MD, a delegate from Kansas. “A federal government that is going to mandate health insurance is also going to regulate that health insurance,” he said.

Attempts at upping health insurance coverage are all based in noble sentiments but that sentimentality is their fault as well.