From Steven Pearlstein's otherwise excellent challenge to Blue Dog Democrats to step up to the challenge of health care reform:
And, to help pay for universal coverage, they would back some sort of tax on gold-plated benefit packages that encourage patients to consume too much health care or become indifferent to what things cost.
This assertion has been making the rounds lately among progressives looking to put a cap on the tax credit for employer-based health insurance policies.
Look, it's one thing to say we need to find ways to pay for reform, and that the consumers of upper-end insurance policies should help out a little, but it's another to bang on the insurance industry's meme that bad insurance leads to smarter consumption of services.
Please, can anyone show me any evidence that better policies lead to patients opting for more costly treatments? Or even make more unnecessary doctor's visits? Because, frankly, humans aren't calculating machines, and don't blithely respond to rational economic incentives. Most humans don't like to visit their doctor. And giving consumers an extra incentive to not visit their caregiver means they'll wait even longer to see someone about a condition -- which costs more money in the long run.
So discouraging people from getting "gold-plated" policies might actually drive health care costs up.
Now if we're talking about doctors opting for more expensive, more unnecessary treatments or tests because of the patient's insurance policy, that's another ballgame. In those cases, we need to examine the financial incentives for doctors at particular institutions... |
