In response to Hurd's ACA observations

November 13, 2013

Michael Hurd (Nov. 5) contrasted the purchase of health insurance under the Affordable Care Act with purchasing a car. This analogy quickly careens into the ditch.

In order to register a vehicle, state governments require minimum levels of insurance. Liability coverage protects others. With health care, uncovered personal expenses become a liability for all other health care users, therefore it is consistent to protect against that transfer of costs. That also seems to be a very conservative principal of personal responsibility.

Government defines vehicle specifications, especially regarding safety. That does not make all cars look alike or result in one manufacturer. Health insurance companies that must provide required coverage will still compete based on service and price. Also, there are options to market policies with greater levels of coverage.

Consumers at most income levels can often find a vehicle to purchase. Not so with health insurance. Even those with reasonable wealth cannot purchase policies if they have pre-existing conditions; the free market will not sell to them. This is a far cry from “sign and drive” auto sales.

The free market is a great engine of economic activity, but it does not magically address all issues. In fact, considering all the buyers and sellers in the healthcare market over the past few decades, it is striking how the free market has failed to control costs and ensure a broad quality of care. The current system was on the way to collapse long before the Affordable Care Act was even conceived. Ironically, the ACA is actually the conservative proposal for what health insurance reform should look like, in the days when conservatives were interested in workable solutions.

There is also the troubling aspect of defining health care coverage as a privilege, like buying a car. It may not be a constitutional right, such as freedom of speech or assembly, but providing health coverage and care is in the enlightened self-interest of our country. Government and the free market are both at work here, and neither has a magical solution. It is critical that we find a workable plan that provides for the needs of all Americans.

Edward and Irene Fick

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