Monday, November 22, 2010

We all need insurance, even Congressmen

Responding to a challenge issued by Rep. Joe Crowley (D-NY), two new members of Congress have declared that they will turn down the health insurance normally offered to all members of Congress. The challenge was proposed in response to a complaint by newly-elected Rep. Andy Harris (R-MD) that his health care benefits would take a month to kick in.

House Rep. Bobby Schilling (R-IL) of Illinois told ABC news that he and his family are “bringing our own health care to Washington, D.C.” and Mike Kelly (R-PA) has been quoted by C-Span as saying “I got my own plan, I don’t need a congressional plan. I’ve taken care of myself for a long time.”

It’s unclear exactly what kind of health insurance plans these two new members of Congress have, but it’s probably better than what one of their average constituents could afford to go out and purchase.

It would be interesting to see what will happen if any of our Congressmen and women decide to forgo health insurance altogether, in protest of the Patient Protection and Affordable Care Act's (ACA's) individual mandate. An amicus brief, recently filed in one of the many state challenges to the ACA (State of Florida v. HHS, No. 3:10-cv-91-RV/EMT, U.S.District Court, Northern District of Florida, brief filed 11/19/2010) explains why such a decision, which would seem self-sacrificial on the surface, could actually cost the American people more than it would save them.

According to the brief, written by, among others, three scholars who have received the Nobel prize for economics and two who have received the John Bates Clark Medal for outstanding American economists under age 40, and which include professors from Harvard, Brandeis, and MIT, the need for and possible cost of medical care is unpredictable, and, if someone decides not to purchase health insurance, the ramifications of that are far-reaching, affecting the medical care system, prices for other patients, and possibly increasing the spread of communicable disease.

In addition, the brief continues, perfect competition does not exist between medical care providers, due to the constraints already imposed by the government, including licensing requirements, the regulation of the patient-provider relationship, as well as the more general restraints of the limited number of hospitals and primary care physicians. When someone needs healthcare, whether or not he or she has insurance, by law, (such as the Emergency Medical Treatment and Labor Act, (EMTALA)), someone ends up paying for it, the brief points out. The ACA merely assures that everyone will pay his or her fair share of medical costs that they are bound to receive during their lifetime. The brief also states that, according to a Medical Expenditure Panel Survey by the Agency for Health Care Quality and Research, 57% of people without insurance in 2007 used medical services that year.

Add to that the fact that many medical services cost more than the average family makes in a year, and it would seem that many of us have to have access to outside funds to pay for our health care. It looks like few Americans have the wherewithal to follow Rep. Kelly and Schilling’s lead.

Considering the sky-high costs of certain advanced medical treatments, it's even possible that anyone in Congress who decides to forgo insurance altogether in solidarity with their constituents would end up getting treated on the taxpayer's dime, anyway.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, including the full text of the law and additional information on health reform and other developments in employee benefits, just click here.

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