Jul 26, 2011

Biting the Hand That Feeds

Last year in Massachusetts*, Gov. Deval Patrick used a special power to reject 235 of 274 proposed rate increases by state health insurance companies. This, of course, did not sit well with said companies and they went to court over it and, in the mean time, stopped creating new policies. Unfortunately for them, a judge quickly ordered them to return to business as usual.

I can't say for certain what his rationale for it was, but I am confident it involved some form of "protecting the people" kick to it. Health insurance is "too important to deny" folks, since it is for so many a matter of health and sometimes life or death, theoretically. So to allow these companies to start denying customers would be, in some way, tantamount to murder, however tangentially or indirectly.

Much of this incident I'm paraphrasing from a recent Peter Suderman article on Reason, and I can't say that I've fact-checked too hard (mostly because all of the Boston area newspaper links he provides are pay-walled). But the validity of this story, which I have no reason to doubt, isn't really important here, because this is just an example of a common occurrence in the world of health care and legal/political matters.

I understand the sentiment of wanting to protect folks, and I understand that yes, in some way this is all much more serious than, say, auto or home insurance, as it deals with the human body's health directly. It's not life-threatening really to go without auto insurance, but it might be to go without health insurance (I say might because, as many correctly argue, hospitals still treat you anyway even if you can't pay. Hell, often in the case of emergency rooms they won't know. If you were severely injured in a wreck or something, they aren't going to wait until you come to so they can ask you where your insurance info/card is before trying to save your life. True, you might be bankrupt afterwards or something, but that's far better than being dead. Well, usually.)

What really burns me, though, is that we wouldn't have such wonderful life-saving services in the first place without the very companies they're trying to punish. If all of the insurance companies went out of business because you regulated them into the grave, then what? You won't have any. I understand you want to ensure that people can still get insurance and so judges are quick in these cases to slap their wrists as soon as they start to appear greedy/uncaring, but for Christ's sake you wouldn't even have the option of purchasing the damn insurance policy in the first place if it weren't for them wanting to make a buck!

I suppose this where the allure of Ayn Rand's Atlas Shrugged comes from. Her basic premise (as evidenced by the original title of The Strike) was what if all of the movers of the world went on strike? What if all of the insurance companies and doctors collectively said "Fine, you want to punish me and make my job so difficult to do? Bye. I'll go do something else, then." And all of the whiners who bemoaned the sorry state of health care and called for more strict, authoritarian control over it will enjoy not having it at all. Just think, no more long waits at the doctor's office, because there's no more office to go wait at!

I realize this is both fantasy (as Ayn Rand's story clearly portrays itself) and a bit silly/vindictive. It has a delicious serves-you-right taste, but it's not actually helpful to us all in the long run. We all want a better system, as it benefits us all as a collective and as individuals. But perhaps most folks are going about "correcting" it the wrong way.

If you're trying to teach your kid how to cook and every time he makes a mistake you snatch the knife/spatula/whatever away and snap "You're doing it wrong. Let me do it." you'll likely just discourage him from wanting to do it at all. We've learned from behavioral science (hell even dog training methods) that positive reinforcement and basically anything but punishment-based correction works far better, as it exploits natural incentives like immediate and long-term rewards.

We've tried for years to be hands-on with things and it never really works as intended. Perhaps now we should try something different. Let go, take your hands off the wheel, Washington, and let the cards fall where they may. Allow people to make mistakes, and instead of punishing those that perform badly, reward those that do it well. If you don't think anyone is doing it sufficiently well, then start your own! You seem to know better than them, right? Prove it.

* Spell-check: ensuring I don't misspell stupidly named states!

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