Mirror of Justice

A blog dedicated to the development of Catholic legal theory.
Affiliated with the Program on Church, State & Society at Notre Dame Law School.

Saturday, September 12, 2009

A Market-Based Alternative for Health Care Reform

Michael Scaperlanda directs us to a recent WSJ op-ed and asks what problems there might be to the author's suggestion of a market-based approach and whether such an approach is inherently at odds with Catholic Social Teaching. 

I think the short answer is that if we could obtain a fully competitive private market and provide some back-up for those persons still unable to afford to purchase insurance in the now-more-competitive (and therefore presumably less expensive) insurance market, there would be no reason to complain from the standpoint of Catholic Social Teaching.  Let me say a few words about both pieces of that suggestion.

First, I think any hope of achieving a fully competitive market requires doing away with the tax-favored status of employer plans.  I suspect the author of the op-ed knows this and waffles on the issue because he knows how politically unacceptable such an idea would be.  As we all know from the debates on health care reform, significant numbers of those who are now covered under employer plans don't want to see health care reform that requires them to change their coverage.  Changing the tax provisions to put individual purchasers and employer puchasers on the same footing would mean changes in existing plans.  I think that is a good thing...in fact I'd like to see employers out of the business of providing medical coverage alltogether, but I don't think that is feasible politically.

Second, I'm far less confident that innovations such as guaranteed renewable contracts "would catch on quickly in a vibrant, deregulated individual insurance market," making it likely that even in a competitive market, some of what the author wants would likely require changes in state insurance laws. That means relying on 50 states having to change their insurance laws.  So the change would not be quick in coming.

Third, even in a fully competitive market, there will be some people who can't afford insurance.  I'm guessing that many of the same people opposed to government involvement in health care reform would balk at a substantial increase in Medicaid eligibility to cover the working poor who will not be able to afford coverage.  Relying on a private market and leaving substantial numbers of people unable to obtain medical care because they can't afford it is not acceptable.

The bottom line is that I don't think one can say that a market-based approach supplemented by some means of providing coverage for those who still can't afford insurance on the private market, is at odds with Catholic Social Teaching.  I'm just not convinced we can get there. 


Stabile, Susan | Permalink

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