If You Like Congress’s Health Plan, Ya Wanna Buy a Bridge?
When I was younger, we thought the line “I’m from the government and I’m here to help you,” the height of hilarity, invariably greeted with derisive hoots of laughter. Today it seems that any government official’s exhortation to “Trust me” is greeted as holy gospel, with nary more to be said. A case in point is the newly unveiled health plan from House Democrats, which despite taking up 1,990 pages, does not include the details of what the government’s own insurance plans would include or what they would cost or who would be forced to participate under them. Instead, a “Health Benefits Advisory Committee” of political appointees, headed by a new health czar (a/k/a a “health choices commissioner”)—are to be trusted with a blank check drawn against all of our lives and deaths, and given 18 months to decide the terms and restrictions on our future access to health care. They are empowered to define “all covered benefits and essential, enhanced, and premium plans,” and what the “cost-sharing”—i.e., insurance premium—will be for plan participants. In short, the health czar will have extraordinary powers to define what health care services insurance—public or private—will cover, at what cost, for whom. Those claiming that participation in government insurance plans is and will remain voluntary are also advised to have a little less trust and a little more skepticism: in short, read the bill.
There is little argument that the health insurance industry is not chronically in need for reform—mostly of the current government mandates that have broken it—and many more expert than I have put forth well-researched and presented proposals that effectively resolve the problems of insurance being too expensive and unavailable for some: allowing individuals to purchase insurance from any firm, anywhere (currently prohibited by law); and extending the tax-deductibility of health insurance premiums to individuals. This would arguably incent those risk-takers who currently choose to spend their money on something other than health insurance to purchase coverage for themselves, and make insurance affordable to those many for whom it is not currently. Of the remaining uncovered, as demonstrated throughout our history, ours is a nation of extremely generous individuals who time and again have provided voluntary assistance to those in need. (See, for example, our “Health Insurance Before the Welfare State: The Destruction of Self-Help by State Intervention.“) The anecdotal horror stories offered up as evidence of the dire need for a nationalized solution to health care gaps have been largely discredited upon further investigation, and there is better evidence to believe that the voluntary sector can and will pick up those others than blind faith that a centralized bureaucracy will do so.
Bay Area commuters have been learning first-hand the irrevocable consequences of going along on pure faith and little evidence. Following the damage done to the Bay Bridge by the 1989 earthquake, sound proposals were made for relatively simple reform for the bridge’s shortfalls by seismic retrofitting and repairing the existing bridge. Initial projections were that the bridge could be retrofitted for $150-200 million, in about four years. And then the big thinkers entered the fray: Rather than just the same old bridge, why not a whole new one? The bureaucrats duly studied the question, and decided that for $843 million a replacement bridge could be built that would be safer and last longer.
But soon, rather than simply providing a secure form of transportation between the East Bay and San Francisco, the bridge was completely repurposed. As Berkeley’s mayor put it, the bridge “should make a statement about the beauty of our side of the bay.” Oakland’s public works director likewise chimed in, calling for a “world-class design”—a bridge capable of “creating an inspirational identity for Oakland and the East Bay.”
Eventually, the story was a floated—and bought—that a new bridge could be built for $987 million, and take eight years, versus retrofitting for $909 million. Hardly a dime’s worth of difference! And thus began a saga in which a politically-appointed “Bay Bridge Design Task Force” eventually selected a design for a bridge never before built, protested by knowledgeable engineers as unsafe, especially for the seismically active Bay Area, and for which no bids matching projections could be obtained—none of which interfered with actually proceeding to build to a “signature design” rather than a functional mode of transportation.
The bridge is currently projected to be completed in 2013, at a cost of $6.3 billion, but no one now expects those dates or dollar figures to hold, any more than any of the previous ones did. Two months ago, while work was being done to tie-in one of the newly-built sections to the existing bridge, serious problems began manifesting themselves. A retrofit to get the bridge reopened nearly on schedule was hastily fabricated, which dramatically failed last week in the middle of Tuesday evening’s rush-hour. Meanwhile, the previous bridge has been being dismantled, removing any possibility of a fall-back. Thus, one of the nation’s busiest bridges, carrying an estimated 270,000 vehicles per day, was closed for five and a half days as engineers experimented with fixes for a “signature design” gone wrong.
Low-tech, low-cost reforms to resolve current problems do not make heroes of elected officials and do not provide opportunities to enure vast new budgets and powers to them; vast new “replacement” schemes do. The current, largely extremely well-functioning, health care industry does not need replacing by a federal plan any more than our utilitarian but slightly flawed Bay Bridge needed this new “world class” design, so beautiful in the eyes of its bureaucratic proponents. If Americans buy this health plan, they can expect to see spiraling costs and shrinking benefits, in line with the actual record of every other government program. If politicians can’t fix our schools or our bridges, why do we want to hand over our very lives?