Keep Government Out

Commentary by John C Goodman

Only a few years ago, the Clinton Administration was touting the joys of managed care. That sentiment was echoed by big business, big insurance and on Capitol Hill by politicians on both sides of the aisle. Had the Clinton health plan become law, we all would be enrolled in HMOs by now.

How times have changed. Today, Republicans and Democrats alike are riding to the rescue to save us from the greedy clutches of profit-hungry insurers. Last summer Bill Clinton was even leading the charge, asking the federal government to protect every woman in America from the horrors of drive-through baby delivery. Now there are proposals to prevent drive-through mastectomies, to guarantee free mammograms and to let people go to hospital emergency rooms for every ache and pain.

So what's wrong with politicians' meddling in the practice of medicine? Plenty. Government can't be our doctor. What happens between doctors and patients - when it happens and where it happens - and which procedures insurers do and don't pay for should be totally off limits to politicians. The proper role of government is to make sure insurers keep their promises and don't defraud or cheat us. It should help low-income families pay premiums they can't pay on their own. Beyond that, the free market should decide.

Like most people, I would love to have insurance that lets me see any doctor, order any test, go to the emergency room any time I feel like it, get any service they offer there and send the bill to someone else. Trouble is, that type of insurance is so expensive few of us can afford it. As an alternative, some are managing their own health care dollars through Medical Savings Accounts paired with high-deductible health policies. Others are joining HMOs, which hold down costs by restricting choices and imposing sometimes arbitrary rules.

Pick any plan you like. But don't join an HMO, take advantage of its low premiums and no deductibles or copayments - and then complain because you can't have everything you want. And please spare us the spectacle of craven, vote-seeking politicians kowtowing to people who want to have their cake and eat it too.

A lot is at stake here. One silly regulation invariably leads to many more. Bowing to special interest pressures, state legislatures are already forcing insurers to pay for services ranging from acupuncture to in vitro fertilization. Insurers must pay for hair pieces in Minnesota, marriage counseling in California and pastoral counseling in Vermont. These regulations make insurance more expensive and price more and more people out of the market.

Enough. The best policy for government in these matters is also the simplest: hands off!