McArdle quotes economist Robin Hanson's theory that we finance health care through insurance because we're attracted to "reciprocal altruism." If so, wouldn't we be more likely to have a public health insurance system, like every other developed nation on earth? I doubt anyone thinks health insurance corporations are "altruistic."
The real reason our system is structured this way is more prosaic. Wages were fixed during World War II, but the agency that administered them exempted fringe benefits. So employers began offering health insurance to attract workers, and our hodgepodge system grew up around this historical anomaly.
That system is a financial and moral failure. The employee portion of employer-based health premiums is skyrocketing, rising 83 percent between 2005 and 2015. The average American family with "good" employer coverage now pays $10,473 per year for health care. One-third of all Americans, including 40 percent of women, have an unmet health care need because of cost -- even if they have insurance.
The U.S. paid more than twice as much per capita on health care as the average for developed countries, paying nearly twice as much as a share of the economy (despite its many uninsured and under-insured) -- with poorer outcomes than comparable countries on standard measurements like life expectancy.
By any objective measure, the U.S. insurance industry has failed to manage either the cost or the quality of health care. Health care is a human right, and private insurers have failed to safeguard it. They had their shot, and they blew it.
McArdle gradually morphs from a defense of "greedy insurers" to the argument that health care cannot be a right because "it has to stop before we run out of wallet." (That distastefully buzzwordy phrase presumably means, "before we run out of money.")
That's another straw man, since virtually no one argues otherwise. Every right is limited by outside constraints. That's why the right to free speech doesn't allow you to shout "Fire!" in a crowded theater.
We all agree that hard choices must be made when resources are limited. Let's see, where do we begin? Profit-taking is driving up health care costs at all levels. UnitedHealth's operating earnings were $11 billion last year. Aetna's were $2.7 billion. Big Pharma? Don't even ask.
I'm sure most Americans would agree: If we're going to talk about pulling the plug on Grandma, which is where McArdle is headed, then we sure can't afford these guys. Maybe when they show up for their next big payday, we'll have to explain that we've "run out of wallet" to pay them.
Government's first obligation is to protect rights, not profits. When the Declaration of Independence proclaimed our "unalienable rights" to "life, liberty, and the pursuit of happiness," it even put "life" first.
Health care is a right, not a business.
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