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Health Care Reform with a Heart:

How to Answer the Bleeding Hearts

By Craig J. Cantoni
[email protected]

Previously published in the Arizona Republic, December, 1999

Carol Moore never thought her life could get worse. Carol Moore was wrong.

A single mother with five kids, she has been victimized all her life by abusive men, by hardhearted employers and by a system that is stacked against working women. Now on top of a lifetime of struggle, she finds herself unemployed without medical insurance.

"I just don't know what to do," she pleaded to this writer in desperation. "One of my kids has severe asthma and needs his medicine."

Wait. Before shedding a tear, you should know that Carol Moore is not a real person. She could be a real person, though, since the chances are good that stories like hers could be found among the millions of Americans without medical insurance.

The ideological battle over health care reform is being won by those on the left, because they know how to find and exploit such human interest stories. Anecdote by anecdote, step by step, law by law, they are moving the nation inexorably toward national health insurance. Their brilliant leader, Ted Kennedy, understands that appeals to people's emotions will always win out over intellectual arguments.

Free-market advocates on the right are clueless about how to blunt the human interest approach to public policy. What they should do is simple: Fight fire with fire.

They should preface every health care debate with a human interest story, similar to the first three paragraphs of this article. Then, they should segue to their reform ideas. To see how they might do that, let's pick up the Carol Moore story where we left off above.

[To quote the political opportunists:] "Something is dreadfully wrong in the richest country in the world when a mother does not know how she is going to pay for her child's asthma medicine."

This is what is wrong: Misguided government tax and regulatory policies that stopped a consumer-led free market in medical insurance from developing a half-century ago.

As a result, the majority of working Americans are dependent on the whims of their employers for their medical insurance. Unfortunate people like Carol Moore, who lose their jobs or who do not work for rich companies, face the Hobson's choice of paying exorbitant premiums for substandard coverage or doing without coverage.

Thank goodness this is not the case for other necessities of life as food, shelter and clothing. In fact, the average American family now pays more in taxes than it spends on those necessities, thanks to a free market that empowers the consumer and creates a plethora of options.

[People like Carol Moore are discriminated against in at least three ways when it comes to medical insurance: (1) They must use after-tax dollars rather than pre-tax dollars, and thus have to earn up to twice as much money as a person with employer-provided insurance to cover the same premium cost; (2) They are subject to expensive state mandates; and (3) They can't buy a group policy (which is less expensive than an individual one).]

One of the worst aspects of employer-provided medical insurance is that it benefits the higher-paid over the lower-paid. Employer contributions for medical insurance are excluded from income, thus benefiting highly paid, fat-cat executives more than working stiffs, because the highly paid are in a higher tax bracket. To add insult to injury, corporate employees, unlike the unemployed or self-employed, are protected by the Employee Retirement Income Security Act (ERISA).

The solution is simple, if Congress can stop its partisan bickering. Legislation should be passed to give people parity with corporate fat-cats, nothing more, nothing less. It is only fair that individuals be given a tax credit for their medical insurance premiums and the same ERISA protections provided corporate employees, particularly the ability to buy insurance free of expensive state mandates. Further, the legislation should make it easy for people to buy insurance from nonprofit associations, including religious, social, fraternal and charitable associations.

Association-based insurance would have clear advantages over employer-provided insurance: It would be portable, it would stay in effect for a lifetime, and it would solve the inherent dilemma of for-profit insurance; that is, the conflict between Wall Street's interest in the bottom line and the people's interest in their health and well being.

Carol Moore and her children deserve nothing less.

Pamphlet No. 1070, February, 2000