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Friday, February 11, 2005

A really, really bad idea: mandatory health insurance in California.

Here they go again. California has had a mandatory liability auto insurance law on the books for years. You cannot register a car without proof of insurance. Also, not wearing a seat belt is a "primary ticketable offense" and you can be stopped by a cop or a CHP officer if s/he has reasonable suspicion that you are not wearing your seat belt. I call laws like this "weeny laws" because, well, the people who write these godawful laws are, to my mind, weenies. Some others call them "nanny laws." Admittedly, wearing a seat belt, especially if your car has an airbag, is a good idea (tm). But I don't know about any decrease in accidents caused by uninsured drivers, and I am pretty sure that hit-and-run accidents have actually increased in California thanks to the mandatory auto insurance law.

Health Insurance is a national problem, and should have a national solution. We are the only industrialized country that still does not have some sort of national health plan. Even South Africa, on the ascendancy of the African National Congress, has a national health that is struggling now under the weight of the AIDS crisis.

Failing that, California needs to deal with this problem on its own or in concert with other states. Oregon did that with its OHP system, although it is now struggling thanks to the sorry state of the Oregonian economy. However, the solution that Assemblyman Keith Richman (What an apropos name for a Repug politician whose constituency is one of the wealthiest in the San Fernando Valley!) is proposing is no solution to the problem.

However, if this system was buttressed by an Oregon-style system which would provide an insurer of last resort for all those whose incomes are at or below a certain level -- the income eligibility regulations for California's Healthy Families program are pretty fair, although Arnold wants to tighten those requirements with the new budget -- it might work. The Healthy Families program could serve as a good model for this insurance of last resort.

However, there is a mortal flaw for piecemeal, state-by-state projects: it does nothing about nationwide problems with the high cost of medical care and prescription drugs. It does nothing about the issues that surround and complicate health care, issues like liability insurance and Worker's Comp abuses and so forth, issues that would actually be directly addressed by the adoption of a national solution to this national problem. It might go a long way to helping to unburden California businesses from the crushing burden of rising health insurance costs, but if costs continue to rise on a national level we're just as screwed as we were without any solution.

Imagine if there was a national health plan that covered EVERYONE in the country. EVERYONE. We'd be less sue-happy...if health care was there for everyone at a reasonable cost, there'd be no need to sue to get treatment of injuries. Worker's Comp would cease to be an get injured, you go to your doctor, you get treated, no problem. The cost of health care would be artificially controlled, but right now health care costs are artificially pumped up because the US is the only market in which Big Pharma can charge as much as the market will bear.

History has shown that private armies of mercenaries who hold no stake in the country they protect aren't so hot at defending great civilizations: the fall of Rome comes to mind. More recent history has shown that private fire departments and rent-a-cops do a crummy job as "first responders." The experiments with toll roads in Orange County are money losing failures. There are simply some things that should not be left to the private, for-profit sector. Perhaps health care is part of the social contract that every US citizen is part of...the one that starts like this:

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.