Is Gielow a RINO?

Jenna outs my state representative for introducing a bill establishing "socialized" medicine in Wisconsin. Peter and Dad29 and, I'm sure, others express their dismay.

I haven't pored over the plan but the idea seems to be to solicit bids from insurers to provide policies that would have to provide certain coverages but which could apparently differ in some ways. The bill appears to fix the deductibles that can be permitted under the policy and eliminates deductibles for certain type of care. The state would credit each resident with an amount sufficient to buy the low cost policy and, if you wanted a higher cost policy, you'd have to pay the difference.

The plan certainly is "socialized medicine" in the sense that it would be publicly funded (although how it would be funded is not specified) and would seem certain to mostly, if not completely, take employers and out of the health insurance business and to force state residents, at least for basic care, into a policy provided under the plan.

It's not "socialized" in the sense that you would have private insurers to choose from but it's not clear how much they would really be expected to differ.

Although some folks might be surprised that a Republican would co-sponsor a bill like this, I'm not. There is a growing consensus among business people that employers ought to get out of the health care business and there are strong arguments based in market efficiency that they are right. Say you are a 51 yr old and you've got a great idea to start your own business. If you were 25, you might decide to go without health insurance. At this age, that would not be wise. But, particularly if you have some adverse history, you may not be able to buy affordable coverage - or any coverage at all. You might have an idea for the best mousetrap ever, but you'll stay put.

An efficient market wouldn't throw up this barrier to entrepreneurship.

There are other examples. A company with a mature work force is going to have higher costs than a company with younger employees. This either puts it at a competitive disadvantage unrelated to its quality and efficiency or creates pressure to lay off the older workers; something that it is illegal and that may well diminish both its quality and efficiency.

I don't know that this bill does it and, in fact, I'm not sure that it makes sense for the problem to be tackled at a state level. While I'd like to think that a more or less unrestricted free market approach would work, there are some huge market imperfections residing in the fact that 1) for a good portion of their lives people may rationally decide that they won't need insurance, 2) people are not well positioned to judge among health care providers and to make the same trade-offs between dollars and consumption as they are with goods and services upon which their survival does not depend and professional expertise is not required, and 3) we are not willing to allow people to suffer and die for the lack of personal resources or foresight.

I think the solution is going to require some type of mandatory purchase of at least high deductible insurance by everyone and perhaps some restrictions on underwriting by risk profile.