No Appeal

There’s no question that our household will be better off under the health-care legislation passed by the House of Representatives last night. Without this legislation* and if we lose our current coverage, we would probably find it hard to obtain insurance because of pre-existing conditions. It’s also comforting to know that our under-26-year olds can remain on our policy. When surtaxes on investment incomes kick in, we should be able to arrange our financial affairs to minimize those.

[*At this point it’s unclear which provisions will finally make it into law. The House approved the December Senate bill, which becomes the law of the land when the President signs it. A separate bill containing amendments still must go to the Senate; the Democratic majority claims that the latter can avoid filibuster by the Republican minority through “budget reconciliation.” Whether or not reconciliation is successful , the odds are great that the House amendments won’t make it through unchanged. The health-care legislation we refer to is the Senate bill.]

Nevertheless, I wanted the no’s to win. The Senate bill mandates the purchase of insurance (or penalizes us if we don’t), one of the few times--another is registering for the draft--that the government requires its citizens to do something just for being alive. Other acts of good citizenship are not mandates: we don’t have to vote and we don’t have to give to charities. We are required to file tax returns and get a Social Security number only if we engage in economic activity. Volitional activities such as driving a car or buying a gun come with strings attached, and those are known upfront. But forcing people to purchase health insurance? I can already see the “Just Make Me” bumper stickers and T-shirts.

Another concern is execution. The delays and confusion in something as simple as last summer’s cash-for-clunkers program don’t bode well for an exponentially more complex project like the revamping of the health-care system. There will be even more confusion next month when an uninsured person shows up at an emergency room believing that he can now get treatment for his non-life-threatening condition. And, of course, where there’s more confusion there’s even greater opportunity for waste, fraud, and abuse.

Like most Americans, I’ve interacted with government agencies all my life. While I’ve met hard-working, knowledgeable civil servants, there are also enough job-protected losers and laggards to make government worse than most businesses that I’ve had to deal with. When I encounter problems in the private sector I write a letter of complaint and switch my business if necessary and my company’s business if I can. With the government, as with most monopoly providers, I’m stuck with wheedling and begging, often to the same person that turned us down in the first place. Frustrating as insurance companies are to deal with—and I have many frustrations—I’d much rather deal with them than an all-powerful government that controls both decision and appeal.

More later....

© 2010 Stephen Yuen