ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Monday, February 26, 1996 TAG: 9602270021
SECTION: EDITORIAL PAGE: A-5 EDITION: METRO
SOURCE: MICHELLE MALKIN
HERE'S A simple question for state legislators across the country: Do you want more people to have health insurance - or not?
Let's examine deeds, not talk.
In half a dozen states, health insurers are required to provide coverage for acupuncturists. Yes, acupuncturists. Beginning this year, Washington state intends to force insurers to cover not only acupuncturists in every plan, but also a wide range of ``alternative'' health-care providers including naturopaths and deep-massage therapists. Ten Pacific Northwest health plans are suing the insurance commissioner over this expansive interpretation of the new alternative-medicine law.
Acupuncture-by-fiat is just a small part of a growing trend by states to mandate specific health benefits. Over a dozen treatments, from chiropractic services to in vitro fertilization to ``scalp hair prosthesis for alopecia areata'' (read: toupees for balding men), are now codified into law.
In all, the 50 states share nearly 1,000 such mandates among them. In 1965, there were only two in the entire nation.
Perhaps the mother of all state health laws is the ``mommy mandate.'' These new edicts require insurers to provide mandatory minimum hospital stays for new moms and babies (48 hours following a vaginal delivery, 96 hours after a Cesarean section). Five states - Maryland, New Jersey, Massachusetts, New Mexico and North Carolina - have enacted the provision.
Legislatures in almost one-third of the country, including those in California, New York, Pennsylvania, Rhode Island, Wisconsin and Washington, are considering similar proposals. So is the U.S. Senate, where Sens. Bill Bradley, D-N.J., and Nancy Kassebaum, R-Kan., are co-sponsoring a federal version of the law.
First lady Hillary Clinton champions this legislative health-care strategy in her statist best-seller, ``It Takes a Village.''
``Although some have suggested that such laws are another example of unwarranted government intrusion,'' she writes, ``it is difficult to dispute that the health of new mothers and infants is important enough to be safeguarded by the government.''
Yes, it is difficult to be against ``safeguarding'' moms and babies or guaranteeing coverage for alternative therapies - until you step back and think hard about the implications of safeguarding every politically correct sub-population and guaranteeing coverage for every politically popular health benefit under the sun.
If insurers are forced to cover 48- to 96-hour hospitalizations for every mother and newborn, why not five days or two weeks? And why just postpartum patients? Why not all postoperative patients?
If acupuncturists and naturopaths deserve government-imposed coverage, why not faith healers and hypnotists? Aromatherapists and yogis?
Why not? Because this unwarranted government intrusion comes at a high price. Mandating the inclusion of benefit after benefit increases the cost of health care. According to a July 1995 report by the federal General Accounting Office, studies in several states have found that benefit mandates generally increase claims costs by 5 percent to 22 percent. Insurers pass most of these costs onto the purchaser in the form of higher premiums.
At the margin, small firms who would otherwise offer health insurance to their workers decide that it's too expensive to offer. Economists have a phrase for this phenomenon: the ``displacement effect.'' Workers who would otherwise get basic health benefits are priced out of the market, while those who can pay the higher premiums demand more and more mandated amenities.
Don't get me wrong. If people want to pay for these services themselves, go for it. Besides, market forces are already persuading many insurance companies to offer them voluntarily to consumers. The problem lies with state legislators forcing everyone to pony up for the Cadillac plan.
Thank goodness they don't do to automobile insurance what they do with health care. Think about it. Most of us would prefer to have the works: liability, collision and comprehensive coverage, plus uninsured motorists insurance, personal injury protection, rental-car reimbursement, and towing services. But frills aren't cheap. Fortunately, bare-bones liability coverage is available and we're only required to buy a standard package.
If states mandated all the trimmings, however, few low-income workers would be able to afford any coverage at all. Not a good thing when there are already too many people without auto insurance.
And without health insurance.
Statehouse health czars see themselves as champions of the poor, rescuing the masses from market failure. Yet, their actions are in all likelihood increasing the ranks of the uninsured - and exacerbating the health-care spending spiral. Consider the alternative-medicine mandate. According to a highly publicized study in the New England Journal of Medicine three years ago, Americans spend $13.7 billion on alternative therapies. Imagine how much more they'll spend with full (``free'') health-care coverage. A mandate proponent, Dr. Fran Brooks of the Washington Association of Naturopathic Physicians, exulted in the Puget Sound Business Journal recently, ``cost will no longer be a deterring factor.'' Exactly.
Health-care resources, like all resources, are limited. We can't afford every enticing new mandate that promises to buy a little health for a lot of money. The next time your state legislators try to persuade you otherwise, ask them: Do you want more people to have health insurance - or not?
Michelle Malkin is the Warren Brookes Fellow at the Competitive Enterprise Institute in Washington, D.C. She wrote this for the Seattle Times.
- Knight-Ridder/Tribune
LENGTH: Medium: 100 lines ILLUSTRATION: GRAPHIC: Bob Newman/Newsdayby CNB