In vitro fertilization as a healthcare mandate
Why does Obama think mandates are going to solve a problem caused in part by mandates?
This is the first weekly column by Mitchell Blatt, who publishes his columns to email subscribers at MitchBlatt.com.
The centerpiece of Barack Obama and the Democrats’ healthcare bill is increasing regulation to have the federal government decide what insurance must be available and how much it must cost then redistributing income to cover costs.
Obama presented his argument at the healthcare summit last week that if everyone is covered, costs will decline for everyone, thus the individual mandate.
What is true is that if everyone is covered, risk, on average, will decline for the pool, but healthy people will necessarily be subsidizing less healthy people. Total healthcare cost per procedure will remain the same. Indeed, Obama’s new healthcare plan doesn’t even try to do anything to lower cost.
Moreover, the mandate may actually contribute to increasing costs. One of the reasons the mandate is even necessary in the first place is because state mandates have already increased costs.
And it’s not just that healthy people are going to be subsidizing the sick; healthy people are going to be subsidizing in vitro fertilization, hair transplant, obese people and alcoholics.
The mandates in this bill do two things; They force people to buy insurance, and they force insurance to cover specific things, like in vitro fertilization and the above.
Obama’s plan to increase the quality of healthcare is simply to have health insurance cover more procedures then pass the cost onto the consumer. It’s the equivalent of forcing a first-time car buyer to purchase a BMW instead of a used Honda. Is he better off?
Obama is going to try to counter the price changes by gaining power to set health insurance prices and by increasing taxes, but prices don’t equal costs, and even with his taxes, the bill will create ever-increasing deficits for each ten year period it is enacted.
Moreover, the procedures mandated for coverage are not even necessary for most people. Who is going to use in vitro fertilization? If people thought they needed it, they would buy it, because that’s what you do when you need something. Yet it is already mandated by 15 states.
According to a 2009 report by the Council for Affordable Healthcare, in vitro fertilization accounts for 3% to 5% of the healthcare premiums for consumers in states where it is mandated. The study cites over 90 procedures mandated by states, and most account for less than 1%.
Moreover, in vitro fertilization isn’t even healthcare. For the purposes of a national debate about healthcare, healthcare is that which extends and improves lives by helping people recover from injury and sickness. Having children doesn’t help people recover from sickness. According to the proponents of this bill, healthcare is a “right,” yet so much healthcare money is spent on procedures that don’t help extend and improve lives as per this “right.”
There is nothing in the Democrats’ healthcare bill that defines what level of healthcare must be required, but the specifics are left to panels that will make unaccountable decisions and be pressured by interest groups just like at the state level. Left with nothing to do, bureaucrats (and politicians) will continue adding more regulations as time goes by and not deal with scrapping or reforming old ones, because the constituents behind them already view them as entitlements.
If we want to actually fix the American healthcare system, we need to define where it is already ailing, and fix it there, instead of adding more layers and thus more areas where it will break down in the future.
Oriental medicine is even required for healthcare coverage in Nevada, where the population is 8% Asian! Such an obscure item doesn’t contribute to healthcare costs, but it does illustrate the absurdity of mandates.
Many of the items that don’t actually improve people’s health are actually some of the biggest cost contributors. Contraceptive coverage, for example, is mandated in 29 states and accounts for 1%-3% of cost.
Alcoholism and substance abuse treatment, which does affect health but is mostly an issue of personal responsibility, is mandated by 45 states and accounts for 1%-3% of cost.
The most expensive mandates are for prescription drugs (3 states) and mental health parity (47), each of which is estimated to account for 5%-10% of premiums alone.
Mental health parity is a provision that requires that lifetime caps for mental healthcare are no lower than those for physical healthcare. With Obama trying to get rid of lifetime caps altogether, mental health costs will only rise further.
In fact, mental health parity was made into a federal mandate in 1996, but insurance companies were able to skirt some of the provisions of the law by imposing maximum number of provider visits instead of maximum dollar amounts. That loophole was supposed to be closed by rider legislation added to the TARP bailout bill. That was the bill that was rushed through Congress in 2008, because there apparently would be a collapse of the entire worldwide financial system and martial law in the United States, according to what one Congressman says Hank Paulson said during a closed-door meeting, if it didn’t pass. Yet somehow there was enough time to attach a completely unrelated rider that will increase healthcare costs.
Regardless of the relative merits of a mental health parity act, the act is based on the premise that the government can create rights out of thin air that do not exist in the natural world. (Or in natural law, as Socrates, Aristotle and Plato postulated.)
If the Democrats want to decrease healthcare costs, they have to make decisions on what is most cost-effective and what isn’t. Much of the talk about cutting healthcare costs is that there is way too much spent on end of life care.
“We need to take account of the cost-benefit of some of the things we do,” Brandeis professor Stuart Altman said at one of Max Baucus’ early healthcare hearings.
Obama’s 2009 budget included funding for “comparative effectiveness research” and we saw some aspects of this in earlier bills that tried to decrease end of life costs.
If the government is funding healthcare, they need to define what is cost-effective and what isn’t, and things that account for 5%-10% of healthcare premiums must be the first to go.
If you liked this column, please consider subscribing to my columns at MitchBlatt.com and downloading my free ebook Democrats Acting Stupidly.
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Posted by mhblatt on March 1, 2010 10:25 am
» Filed Under Anti-Capitalism, Barack Obama, Congress, Democrats, Government malfeasance/misfeasance, Healthcare, House, Nanny State, News, President, Senate, Socialism, Taxes
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2 Responses to “In vitro fertilization as a healthcare mandate”
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As a woman who has struggled with infertility for 5 years and has been blessed with a beautiful baby boy through invitro fertilization, I take offense to your comments. It is obvious that you have not had difficulty conceiving or you would know that it is an illness. The human body was created to reproduce and when it is unable to do this, it is considered an illness of the reproductive system. What is exceptionally unique to this illness is the deep emotion pain involved in knowing you may never be able to bring new life into the world and celebrate the love you have with your spouse in this way. The fact that there is a cure through modern medicine for this illness is a blessing. So, unless you have been told you can not reproduce on your own and have opted to leave your illness untreated and never bring children into this world….please think about your words as they are both hurtful and ignorant.
I agree that your post was very offensive to those struggling with infertility. I pay for insurance every month and never even use it because other than being infertile I have no other health issues. You should definitely rethink about your comments because obviously you have no clue.