It’s Not About Health Insurance, Part I

It’s Not About Health Insurance, Part I


It was only appropriate that I found myself sitting in the emergency room in the early morning hours of March 23, 2011. That was the one year anniversary of President Obama’s signing of his boldest and probably most controversial piece of legislation: The Patient Protection and Affordable Care Act of 2010.

As my family member was being attended to, it made me think for a little bit about how we, as individuals and as a nation, are taking care of ourselves. The statistics say that we are not doing a very good job.

For example, according to the National Center for Health Statistics, 34% of individuals age 20 and over are obese. Another 34% of individuals 20 years of age or older are overweight.

Bringing it a little closer to home, 71.8% of African American males are either overweight or obese, while 79.1% of African American women fall into that category.

Yes, we are a fat nation and a fat people.

Some of us may joke and say, well, it just means that there is more of us to love, but in reality, it means that we may not be around too long to be loved. Any doctor or health care professional worth their hourly rate will tell you that this level of obesity and excess weight is a tell tale sign of potentially life threatening problems such as hypertension, diabetes, and heart disease.

Take for instance uncontrolled hypertension or high blood pressure. Almost 71% of African American males have uncontrolled high-blood pressure while 51.5% of African American females suffer from this disease.

And we are a stressed out nation. According to the NCHS, the number one diagnosis given during physician office visits is essential hypertension. In addition, our demand for treating hypertension and other adult maladies has been on the rise.

For African Americans aged 18 to 44 years, the percentage of visits to a doctor for the purpose of internal medicine (treatment of adults) increased from 9% in 1980 to 15.9% in 2008. For African Americans in the 45 to 64 age group, that increase was from 22.6% in 1980 to 25.9% in 2008. African Americans aged 65 and older saw those visits increase from 14.2% to 31.7%.

As the demand for health care services increases, I would expect the cost for health care to rise as well. The data supports this conclusion.

According to the Kaiser Family Foundation, total spending on health care was $2.5 trillion in 2009. That represented 17.6% of the nation’s gross domestic product or $8,086 per person. The U.S. Insurance premiums increased 138% between 1999 and 2009, while wages increased 42% and inflation rose 31%.  Average insurance premiums were $13,770 in 2010 and employees pitched in $3,997 of those costs.

But in this environment of rising demand for health care services and increasing costs, what does it say about our government’s role in the health care market? Is government supposed to require that more people buy health insurance in order to reduce health care insurance premiums? Is government supposed to subsidize someone for being sick in order to reduce the cost for purchasing health care? Is government supposed to help boost the profit margins of health insurers in order to address the availability of health care services?

The answer is no to all of the above. First, just because 40 million people are uninsured does not mean they can’t access the health care market. Some simply choose not to buy health care services while others may pay out of pocket.

Second, mandating that I buy insurance is straight-up unconstitutional. Just because states force you to buy car insurance does not mean that the U.S. Constitution supports a federal mandate that you buy health insurance. The two products are different in purpose and scope with two different social policy goals.

Third, with the exception of catastrophic injury or illness, many of us choose to be sick, primarily by making poor health choices. Why should the government pay you $10,000 in health insurance subsidies just because you chose not to take preventative measures and are now ready to go see a doctor.

Fourth, health care insurance is not the only alternative to financing health care. All a mandate to purchase health care insurance does is increase a health company’s revenues and because of increased demand, justify further increases in premiums.

So what’s the solution? I have one, but you have to promise to eat your vegetables, take a thirty minute walk, and come back here tomorrow for part II.