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Page Three
Will the Universal Mandate Actually Increase Life Expectancy?
Yes, it will. Older people are, on average, sicker than younger people. For this reason no for-profit health insurance company would insure those over 65, who are 1/7th of the population, but generate 1/3rd of all health care costs. Before 1965 the market solution for those over the age 65, therefore, was to simply let them go untreated – unless they were wealthy and could afford to pay for their treatments themselves. Before 1965 these market imperatives dictated that many seniors would simply be allowed to suffer and die with minimal medical attention.
Medicare passed in 1965 to preserve and prolong the lives of those over 65. It has been an amazing success. Since its passage in 1965, lifespan in the United States has been extended from an average of 70.2 in 1965 to 78 in 2006, a gain of almost eight years per person on average. This is a remarkable increase. While many factors contributed to this success, the advent of universal medical coverage for those over 65 – socialism, to be sure – played the largest role.
While we have seen remarkable improvement in our average lifespan over the last 45 years, the United States still ranks relatively low on this statistic – 50th – when compared to other advanced nations. The 2nd-ranked Japanese live more than 81 years, on average, while Americans live an average of 78.11 years – just slightly longer than the citizens of Libya, Cuba, and Panama.
In our country people without health insurance often postpone doctor visits, and some of them pay for it with their lives.
Almost everyone who thinks about these statistics believes that the 12-16% of all Americans who are uninsured on any given day has a dramatic impact on our average life expectancy. In almost all other countries in the top 50, socialized medicine is the norm. In these countries mortality rates below the age of 65 tend to be lower for many treatable diseases. This is because people with treatable diseases have access to affordable medical care and are therefore less likely to postpone doctor visits until it is too late. In our country people without health insurance often postpone doctor visits, and some of them pay for it with their lives.
Will the House or Senate Bill Actually Solve This Problem?
The short answer is yes – for middle class people, certainly. For disadvantaged people, not so much.
Both House and Senate Bills contain the universal mandate. In the Senate Bill, insurers would be prohibited from taking medical condition into consideration even in the establishment of their policy rates – a provision which is absolutely essential if the bill is to produce the intended consequences. The Senate bill would make it very difficult for private companies to discriminate against relatively sick people, or those with chronic conditions like diabetes or bipolar disorder. As long as these people can pay their premiums, the companies would have to insure them at the same rates as anyone else, or face Federal law enforcement action. Most will comply.
The new universal coverage mandate will force the private insurance companies to cover everyone who can pay. In addition, it will provide a system of subsidies for low income individuals to defray a portion of their health insurance expense. It is these subsidies that will cost the Federal government billions of dollars each year. The universal mandate itself does not cost a nickel.
Americans will bend the law to suit themselves, as they have always done.
The insurance industry will also gain revenue from millions of young and healthy customers, mostly in their 20s, who do not buy insurance today because they don’t feel they need to. These young and healthy participants will balance out the older and less healthy, so that the overall cost of insurance per enrollee may actually decline. But this depends critically on how many of these young and health twenty-somethings actually obey the law and buy insurance for themselves, as required. A recent AP poll indicated that more than 60% of all Americans are opposed to any legal penalty for individuals who fail to comply with the universal mandate. Partly for this reason I expect law enforcement efforts on the individual side of the universal mandate to be virtually nil.
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