October
24, 2017
Editor Sunday News-Register:
Many
critics of the Affordable Care Act argue that nobody should have to pay for
insurance to cover services they do not need, including maternity care. Most recently
in a column published in the October 22 issue of the Sunday News-Register,
Betsy McCaughey complained: “You have to pay for maternity care even if you’re
too old to give birth.” She could have added that even a lot of young people
will never need maternity care. McCaughey praises the current administration
for rejecting the maternity provisions of the Obama era.
The
problem is that few people could afford health care without insurance and all insurance
is premised on the fact that there must be more payers than users. Specifically,
if only those who hope to have babies paid for maternity care, the cost of
childbirth would be prohibitive for most families.
If
the financial base of maternity care is removed, we can expect that the rate of
abortions, which has been steadily declining, will take a sharp upward turn.
Why are pro-life groups, including the Conference of Catholic Bishops, not protesting
against the attack on maternity care? If politicians and citizens who call
themselves “pro-life” really care about the value of all human life, they will
want to assure that all women of child-bearing age have maternity coverage.
Richard P. Mullin
160 Poplar Avenue, Unit 4
Wheeling, WV 26003
e-mail: Mullin160@comcast.net
Shorter question for Betsy: did she have a mother that could have used maternity care giving birth to her, or was she one of those babies made in a vat?
ReplyDeleteRichard, I imagine you are aware that prior to the government's attempt to dictate the value of labor during WW2 by instituting wage controls, health insurance was relatively rare. Since companies could not compete for quality employees through higher wages they did so through offering benefits. Health insurance was one such benefit. As with anything that is perceived to be "free" demand increased. You make the supposition that women get abortions because they can't afford maternity care. I would take issue with that. My view is that being subsidized and cheap it has become an alternative to birth control. I tend to agree with people who view it as murder and find late term abortions particularly abhorrent, but whatever. The strongest argument in my mind for legalizing them is that they have always happened and always will, but I would be in favor of not having to subsidize them and them being much less convenient. I think that the drop in the number of abortions can as easily be attributed to having children being seen as a career path for single mothers as well as women becoming more aware that they are killing more than a random few cells.
ReplyDeleteAs to your argument that non child bearers should subsidize those who have children, as someone who owns a home and bears the high costs of home insurance would it make sense for me to demand that renters be forced to carry a homeowner's policy to bring the costs down for those who do? This would bring the cost of home ownership within reach of many people who just can't quite swing buying.
I would also point out that my understanding is that one area of medicine that has experienced dramatic cost reductions is elective cosmetic surgery. Since said surgeries are not covered by insurance one could suspect that this is the result of competition and consumer choices. Perhaps when insurance companies are no longer forced to offer maternity coverage costs will likewise come down?
ReplyDeleteAnd in regard to your question to Betty, it may shock you to know that women commonly had babies without the aid of a physician in the not very distant past.
ReplyDeleteBen,
ReplyDeleteThanks for your reply. I am aware of the origins of employer paid insurance. I believe that we would be better off if health insurance could become disentangled with employment. In the seventy some years since WW2 there have been many life-saving breakthroughs in medicine that every one this side of Dr. Kervorkian should be thankful for. But they are expensive.
I did not say that women seek abortions only because they cannot afford maternity care. I said that if women cannot afford maternity care, many of them, not all, are more likely to seek abortions.
About the analogy with home insurance. I stated that insurance depends on their being more payers than receivers. For my whole adult life, my wife and I have paid for fire insurance and never needed a dime of it back. I don't feel cheated. I don't envy anyone whose house burned down, and I'glad that my payments could help them. (I don't know what will happen in California with so many fires).
I feel a much stronger solidarity with young families who wish to have children. Anyone, religious or secular, who is pro-life will share this sense.
Rick,
DeleteSorry for typing in the wrong name. I had a very bright student at Wheeling Jesuit who reminds me a lot of you and I tend to confuse names.
Richard, no problems about "Ben". I think I'm flattered to be confused with him. With all the students that have passed through your classes over more or less 50 years I certainly did not expect that you would have any memory of me when I contacted you to say "thanks".
ReplyDeleteYou are surely right about medicine becoming more sophisticated and high tech since the forties. That has certainly contributed to it's rising cost. At the same time my understanding is that processing insurance claims accounts for around 30% of the overhead of the average practice. I agree that separating insurance from employment would be a good thing, as would separation insurance from health care. They are not the same thing but often referred to as if they were.
I am very unhappy that our rulers have done nothing in the way of tackling ANY of the issues driving up the cost of medicine but it is simply because I haven't totally let go of the idea that they work for the American people, but I am getting there. Some things that I think would help a lot are...
Putting a cap on tort awards. Not only do the sometimes ridiculous
malpractice judgements drive up the cost of Dr's insurance (typically 100K a year for a practice from what I understand) but these large judgements result in doctors practicing "cover your ass" medicine as a defense against possible law suits, also driving up costs.
Letting people know up front what they are paying for services. I don't think anyone would go into McDonalds not knowing what the burger was going to cost or a car dealership to buy a car of unknown price (until they got their payment book in the mail). As a good example of this, I have a prescription not covered by my insurance plan. I was shocked to learn that said prescription for thirty tablets was almost $600 through the pharmacy my plan contracts with. Same prescription at America's most popular retailer, a little under $100. A little further looking turned up 50 tablets from a NC based online drugstore for the same $100. I had hernia surgery a month or so ago. No idea what it cost and didn't give a care because Medicare and supplemental insurance paid for it but a little research turned up a hernia clinic in Jacksonville FL where it cost $2000. If not for insurance I would have gone there. So I think introducing consumer choice and competition into medicine would go a long way toward reducing costs of health care. My own senator Lindsey Graham had the balls to have caused a piece of campaign lit appear in my mailbox bragging on how he had helped defeat a bill that would have allowed people to import drugs from Canada. Protecting the health of SC residents and all. How stupid do you think we are, Lindsey? You are protecting the drug manufacturers. So nothing meaningful is going to happen where healthcare and it's costs are concerned.
A better example than homeowner's insurance would have been requiring people to buy auto insurance whether or not they owned a car or rode the bus. It would spread out costs and assure people that they would never more fail to be made whole by having an accident with an uninsured driver.
Rick,
ReplyDeleteI think your analysis is accurate. The insurance companies, the drug companies, and the courts have driven up the prices. If we had had a working congress over the last seven years, they might have at least mitigated some of these problems.
They might have if they worked for us, but they do not. They work for the insurance and drug companies among other powerful interests. The only thing that will bring costs down is more competition in the healthcare market. The more government meddles in things the worse things get. (I understand this at least in part because of the Econ 101 class I took with a woman named Marion Mullins long ago. :) )
ReplyDeleteSorry, Marion Mullin.
ReplyDelete