Written on January 11th, 2017
Edited on January 25th, 2017
Health insurance companies should be free to deny subscribers coverage, and raise the prices of premiums, on the basis of pre-existing medical conditions.
It may sound inhumane to advance this position, but it only seems cruel when we forget that insurance is supposed to insure against things that haven't happened yet; it is irrational to insure against getting a disease that you already have. If you have a pre-existing condition; what you need isn't health insurance; it's health care.
Taking this position seems even more inhumane when we forget that the
provision of Obamacare that opposes that pre-existing conditions policy, by
design, rests (in terms of implementation) on the completely illogical
Individual Insurance Purchase Mandate, which was somehow found by the majority
of the Supreme Court to be the most appropriate
part of Obamacare. This means that once the Mandate falls, most of the rest of
Obamacare falls. Moreover, the health insurance industry might not even need to exist.
It's not necessary to compel
anyone to purchase health insurance, especially with people they may not want
to be in the same pool with; whether that's because they have expensive
conditions, or because they're older (and therefore more prone to disease), or
simply because their political values - and their ideas about what health
policy should look like - are different from other subscribers'. It is not only
unnecessary to compel anyone to be in the same health insurance pool as any
other particular person, for whatever reason; it is a violation of our
constitutionally recognized freedom of, to, and from association.
Single-payer systems and public
options can be made obsolete through the focused pooling of assets into
voluntary health insurance cooperative plans. This idea replaces
competition-destroying monopsonies (one-buyer systems; i.e., single-payer systems) with consumer-cooperative purchasing
societies; market actors that can grow as large as necessary (in terms of
purchasing power) in order to affect prices in a way that obtains low premium
prices for all members of the pool.
The only way to justify
continuing the Pre-Existing Conditions provision of Obamacare on grounds of
freeing and opening people's access to trade in health insurance, is to
absurdly argue that ordering someone
to purchase something, is the same thing as allowing
them to purchase it.
The blatantly unconstitutional
Individual Insurance Purchase Mandate flies in the face of the Fifth Amendment
Takings Clause, and the Supreme Court opinion that upheld it undermines
everything that a logical and fiscally responsible society ought to understand
about what the difference should be between fees and fines, and between
taxation and theft.
The government regulates people
for refraining to engage in commerce by buying health insurance. Next it tries
to address the problem of people being uninsured because they can't afford it,
by requiring people to spend money they can't afford to buy the insurance. It
passes this off as helping the poor.
Finally, it regulates the
commerce (buying the policy) because it's commerce now, even though you
wouldn't have engaged in commerce unless they ordered you to buy it. Still,
you're theirs to regulate, even if they only have federal jurisdiction but you
can't even buy policies from other states.
None of this is necessary.
Doctors' Hippocratic Oaths include pledges to help patients regardless of their
ability to pay. If Hippocratic Oaths were enforceable (whether by government,
or by non-state-actor contract enforcement agencies), then doctors who agree to
abide by that oath would not legally be free to decide whether to turn patients
away.
If that happened, and if the
parts of Obamacare that violate the Constitution were repealed, then patients
wouldn't need health insurance companies. Not only that, but our supposedly
caring government wouldn't even force
patients to trade with health insurance companies. Without the Individual
Mandate, government couldn't force us to buy from these companies; and without
the Individual Mandate, there would be no need for government to force
companies to accept us.
Remember, this is the same
government that is limiting people's choices about what kind of medications
they can try to save their own lives, taxing profits and sales of medical
devices (raising prices and increasing malpractice lawsuits in the process),
and enforcing medical patents for overly lengthy time periods in order to
benefit Big Pharma (which makes the problem of availability of medical devices
worse).
Meanwhile, the Third World
suffers from disease, and Americans aren't allowed to buy cheaper drugs that
imitate the patented ones, from Canada or Mexico. Figures in liberal media that
"open borders is a Koch brothers proposal" so that we won't become
aware of the hazardous effects that state and national borders have on the
affordability and variety of consumer goods (medications and medical devices
included). There are plenty of changes to health policy that would be more appropriate than six of the seven major provisions of P.P.A.C.A..
I oppose the Pre-Existing Conditions provision because it takes away a valuable freedom - the right of the insurance company to deny coverage - without compensating them for this takings, and without allowing individual insurance companies to refuse or opt-out. If the Supreme Court had ruled the other way, this takings would be seen as the extrajudicial theft that it constitutionally is.
Barack
Obama's signature piece of legislation was a failure and a waste of public
attention and money. In my opinion, about eighty-five percent of the Patient
Protection and Affordable Care Act has absolutely no constitutional or economic
merit to it. I believe that it has only served to make the health care and insurance
industries more complicated (both for its employees and for patients); more
plagued with financial and procedural problems; and less compatible with civil
liberties, due process of law, the right of private property, and a federal
government that enforces strictly limited intellectual property rights laws,
and obeys suggestions by the framers about what kind of taxes are permissible
and why.
We should be allowing more people to buy insurance, not forcing people to do so. If young people
are allowed to stay on their parents'
insurance until they're 26, that's fine, because that's freedom. It would not be freedom if they were ordered to stay on their parents' plans.
For the same reason, government allowing
denial of coverage is a freedom, while government forcing you to be covered by compelling you to buy, is the opposite of freedom; it is
command-and-control economics.
