The free market won't cure health care's ills

WASHINGTON — The most popular religion in America isn't Christianity, as most of us have been taught to believe. The most cherished belief system celebrates the principles of unfettered capitalism.

That misplaced faith in free markets was on display in this past Thursday's health care summit, when — between sound bites and talking points — Republicans argued that "choice and competition" would largely resolve the country's health care problems. That belief — that the arbitrary, confusing and consumer-unfriendly policies and practices that we euphemistically call a health care "system" can be transformed by relying on free market principles — is confounding.

Except for beneficiaries of Medicare, Medicaid and the Veterans Affairs system — all government-run insurance programs — those of us who have insurance are utterly reliant on the private market. That's what got us into the mess we're in.

The health care market simply doesn't operate like the market for cars or computers or flat-screen TVs. Sony and Samsung make their profits by selling as many of their products as they can. Health insurance companies make their profits by selling as many of their products as they can and then trying very hard not to actually deliver them.

Try to imagine that you're awaiting delivery of your brand-new 50-inch TV, for which you've already made a hefty down payment. But the company calls to tell you that you violated some obscure clause in your contract, so they're not going to bring it! In the health insurance world, it's called "rescission." Insurers decide they won't honor the contract because of some alleged violation by the policy-holder.

They do that to keep their fat profit margins. Health care giant Wellpoint has proposed substantial rate increases in the individual market (policies for individuals who don't have employer-based insurance), not just in California but in several other states. In congressional testimony last week, WellPoint president Angela Braly said the company had to raise premiums because of soaring health care costs. But Wellpoint hardly seems to be hurting; it reported a profit last year of $4.7 billion.

California's Wellpoint subsidiary, Anthem Blue Cross, is not only proposing stunning rate hikes. The state's insurance commissioner has announced that the company has also repeatedly violated state law by failing to pay medical claims on time and by misrepresenting policy provisions to consumers, according to the Los Angeles Times.

So, it seems, the company tells you that a policy offers broad coverage when they're trying to get you to buy insurance. But when you need the coverage, you find out that the policy doesn't offer broad coverage, after all. That helps explain why so many people, even with health insurance, go bankrupt after a costly illness.

Without stricter government oversight and regulation — which is the essence of the health care reform proposed by President Obama — health care costs will continue to soar while consumers get less and less. Obama's proposals don't represent a "government takeover," as critics contend. The vast majority of Americans would still get their insurance in the private marketplace. But insurers would have to live by a different set of rules.

Vice President Joe Biden said it best at the summit: If Republicans agree that insurance reform is necessary, that health insurance companies should be prohibited from turning away consumers because of pre-existing conditions, that they should be prevented from enforcing lifetime caps on benefits, then the GOP must see the need for strict government regulation. You don't get those changes in the "free market."

And, unlike the choice of buying a computer or a car, you'd don't really get to walk away from health insurance. If you do, you take your life into your hands. Having health insurance increases your chances of longevity.

Once upon a time, political leaders realized that all Americans needed access to electricity, and they stepped in to ensure that all households got that small miracle at reasonable rates — something that the "free market" could not provide. Americans need a similar intervention in health care now.

Cynthia Tucker of the Atlanta Journal Constitution can be reached at; her blog is

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