Ignoring the Economics of Health Insurance

Rejoice, fair citizens of this great land! Rejoice, young and old! Your fearless leader and friend, Barack Obama, President of the United States and Perpetual Beacon of the Free World, the Hope and Change of the Nations, the Mighty One, has accomplished another mighty deed, worthy of our praises. Four years after halting the rise of the oceans, He has achieved even greater heights by completing his repeal of the powerful laws of supply and demand:

Today is a big day for birth control. Under President Obama’s health care reforms private insurance companies have to start providing contraception for free on August 1. That means no more co-pays for birth control.

The article does mention a caveat. These costs will still appear somewhere? No, silly! The caveat is that the free goodness doesn’t happen for all women just yet, but it will surely come to all in the next twelve months. The excitement is all over the media. The San Francisco Chronicle saysinsurers will now have to cover eight kinds of women’s services – everything from contraception to domestic violence counseling – without charging co-payments, deductibles or any other cost to the patient.” Local news stories say “private health insurers have to offer eight preventive services to women for free.”

Wow! President Obama just completely erased the costs of all of these services! The previous restraints of resources and skills and labor required to create these things have all been removed with a stroke of His hand, and they can all now be infinitely provided for free!

OK, maybe not. A Scientific American blogger, while she revels that the health care bill “will begin removing insurance co-pays,” does provide a bit of a killjoy:

It’s hard to say exactly where the extra money for getting rid of these co-pays will come from. “Any time benefits are added to a policy, the additional costs are reflected in the cost of health care coverage,” Robert Zirkelbach, a spokes person for America’s Health Insurance Plans, a trade group that represents insurance companies, wrote to me in an email.

But fear not, the author concludes, for the benefits of the new provisions “should reduce reimbursements for insurance companies for many decades to come,” so she’s just going to “appreciate the extra money in my pocket for the coming year.” Yay! Free money!

The economic illiteracy is astounding. Hardly anyone seems to realize that the costs of these extra benefits have to come from somewhere. A few do, but they seem to think the benefits will pay for themselves, never asking themselves why, if this was so obvious, insurance companies weren’t already providing these benefits for free.

Maybe there’s some public good magic the Obama administration will extract from this that individual insurance companies couldn’t, but I haven’t seen a good argument for it, and I’m pretty sure all these journalists haven’t. More likely, they probably assume that, well, we all know insurance companies are greedy and stuff, so of course they can afford to just give this stuff away! Maybe the majority of women who were previously paying for birth control will end up subsidizing the “free” stuff for the poorer minority through higher premiums. But considering that “in 2014, insurers will not be able to charge women higher premiums than they charge men,” I think I know who’s going to be paying for these benefits: me.

I wouldn’t be so upset if everyone would just admit that men are being asked to subsidize these benefits for women. We could then have a lovely philosophical discussion about whether or not that’s something we want to do as a society (after all – and please don’t miss my tongue in cheek – maybe we also want to have women subsidize car insurance for men?). Of course, it’s much easier to just pretend we can wish away the economic realities that lead to these cost differences in the first place.