What Is Insurance?
Wasn’t insurance invented by Dutch businessmen who recognized that capitalizing trading ships was risky? Pirates, shoals, gales, rum-soaked captains (predecessors to the captain of the Exxon Valdez), any could scuttle a huge investment quicker than you can say “Titanic” or “Captain Jack Sparrow.” Charging a premium for each trip would spread the risk and minimize the pain.
Fast forward to 20th century, the USA, and mandatory car insurance. Okay, we skipped some steps; insurance evolved from protecting shipping investors from Cape Horn storms to protecting all sorts of businesses and private property owners from risks.
The basic principle of casualty and liability insurance is sound: make sure that every business venture has a pool of money to cover losses suffered by the insured (casualty insurance) and third party victims (liability insurance). The result: a broad slice of society shares the cost of creating a fund to protect the injured.
Next we get to car insurance. This is currently important because people like me analogize mandated car insurance with mandated health insurance. Yes, there is a difference: car insurance pays only when there is a loss (property damage or personal injury), while health insurance is supposed to pay for regular care as well as catastrophic illnesses.
Every state in the Union requires automobile liability insurance to be purchased for all motor vehicle drivers. These laws require sharing the risk for protection of the public. But only a few states, maybe only Massachusetts, require all residents to purchase health insurance. Arguably such a law protects the public as well, enabling the poor and working classes to have coverage, while relieving hospitals and clinics of absorbing enormous costs caring for people with no money.
If a state adopts a law requiring universal health care, paid for by employers and employees and supplemental risk pools, plus Medicare and Medicaid, does anyone complain that’s unconstitutional?
If some states have better health care laws than others, they may attract people with health care needs and no money. Don’t we need uniformity across the country? Otherwise the deadbeats and the desperate will move to Massachusetts or Wyoming.
In Gillette our public hospital sports big new signs informing people in two languages that they cannot be turned away if they have no insurance or money. Any time services are free, abuse is invited. Regardless of abuse, people admitted for free but expensive care create huge losses which are absorbed partly by the public hospital, partly by taxpayers, and mainly by the rest of us who pay for service.
Is it any more unconstitutional for the health care system to cost me thousands of dollars per year in insurance and co-pays to subsidize care for those who do not have coverage, (which is happening right now), or is it more unconstitutional to require everyone to obtain coverage?
To whom is the burden “unconstitutional”? Small businesses who struggle to offer employees health care benefits or watch the employees go down the street to a better offer or go broke when they need the hospital? Doctors who turn away Medicaid and Medicare patients to skim the cream off the well-insured pool? Hospitals which absorb the costs of treating the uninsured? Taxpayers who pour their hard-earned revenues into black holes subsidizing people who will not or cannot pay their fair share?
Sage Grouse Perspective Time: The draft, long since unlamented, is not unconstitutional. The income tax is not unconstitutional. Passports are not unconstitutional. Social security numbers are not unconstitutional. Federal subsidies to highways, schools, sewers, water systems, irrigation, farming, housing, clean water and the environment are not, however much deplored by certain constituencies, unconstitutional. Why is insurance reform unconstitutional?
The U. S. Constitution created a tripartite government. Congress analyzes policy and makes laws. The courts protect us from oppressive majoritarianism. The courts do not substitute their policy judgment for that realm entrusted to Congress. This is great theory on paper, but messy in implementation. Congress has abandoned rationality and non-partisan policy making in favor of polarized histrionics which make a rabid skunk look sane in comparison. Bloody messes invite the sharks. Congressional messes invite intervention by the courts, right or left, right or wrong, perceived as activists when they, uh, act.
The scepter of majority rule is hot like a potato, juggled from Pelosi to Cantor, oh I am so sorry, I mean Boehner, to who is next, Gingrich again? Well, no, the speaker of the house is not an elected position, even though two heartbeats from the White House. Which reminds me that Dick Cheney’s heart, now in a secure garbage can outside a naval hospital, could have failed at about the same time that George W suffered the near-fatal choking on a chip episode while watching TV in his private quarters. Oh my God, George W choked out and Cheney stroked, the next President would have been Tom Delay!! What is wrong with this constitutional picture? Tom Delay as President? All because of an impulsively ingested potato chip while the TV was tuned to what? And Dick Vader on life support.
When James Earl Jones publishes his memoir, one chapter will be: “Darth Vader: I channeled his voice but Dick Cheney channeled his soul.”
The phone is ringing but I ain’t answerin’. The “Off-Topic” alarm is sounding. Weren’t we talking about health care?
Yes we were. Boys and girls, what did you learn today?
- Dick Cheney’s new heart means he can run for President as a 45-year old in 2016.
- The Sage Grouse doesn’t like Dick Cheney.
- Complex issues like the environment and health care cannot be rationally resolved by a constitutional model invented in the 1700s when the most advanced technologies were muzzle-loaders and mule harnesses.
- Pumping hundreds of millions of dollars into unrestrained political campaigns, money which could have been used to feed and educate people, is an obscenity blessed by the same Supreme Court which formerly said that it would recognize pornography when it saw it. Apparently not.
- Health care should be a fundamental right, but not a selective burden.
Back to Dutch foreign enterprise. Insurance premiums spread the risk and spread the pain. The alternative: some investors suffer total loss, and some innocent victims suffer total loss.
Contrast Obamacare: Insurance premiums spread the risk and spread the pain. The alternative: the rich pay for care for the poor and shrug it off; the middle class pays for care for the poor and can’t afford it; the poor take advantage. And some victims fall through the cracks, which is why bankruptcy courts are so busy.
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