Mandates not proper solution for health care

Freedom New Mexico

As election time nears, the presidential candidates move toward the political center. This can make the differences between Barack Obama and John McCain seem smaller. But on one issue — health care — the contrasts are stark and indicate the difference between the two candidates:

Obama is all about mandates while McCain relies more on market forces.

How the two major parties view health care points to a difference in basic philosophy. Democratic plans stress providing increased, preferably universal, access to health care, while GOP proposals address costs, believing more Americans could get health insurance if health care was more affordable.

The stretch run of the campaign promises to highlight those basic differences.

Obama’s plan is basically a series of government-enforced mandates on employers to provide insurance coverage to employees. Forcing employers to provide and pick up the tab for coverage sounds appealing, until one considers who will actually pay the bill.

Employer-provided health insurance began as a result of a labor shortage during World War II and the postwar years. Because of wage and price controls mandated by the federal government, employers were forced to compete for workers using means other than simple salary.

Thus was born the benefits package.

It’s not much different today; benefits, including health insurance, are part of an employee’s total compensation. If employers are forced to buy insurance for employees and their families, it’s unlikely companies are going to pay those costs. The premiums will be reflected in lower wages, deferred raises and fewer employees.

Hardest hit will be entry-level and low-wage workers. According to economists Katherine Baicker of Harvard and Helen Levy of the University of Michigan, forcing employers to provide coverage for workers would cost about 315,000 jobs.

Employer mandates also would do little to address the cost of health care. If anything, it likely would boost the prices charged by insurance companies and health care providers.

Another problem with government mandates to require health coverage is mission creep. That’s when bureaucrats and politicians see their meddling isn’t producing the desired results (usually because it can’t), so they pile on more mandates requiring more comprehensive coverage.

Residents of Massachusetts have seen this up close as a result of health coverage mandates imposed under then-Gov. Mitt Romney in 2005. Since then, laws have been added to limit deductible payments and to phase in prescription-drug benefits not required under the original law. Requiring dental and other coverage is on the horizon. Other mandates likely will come as health care providers see there’s money to be made in mandates and clamor for their specialties to be covered.

Under a President Obama with a willing Democratic Congress, such expansion is practically guaranteed. When he was in the Illinois Senate, Obama voted against new mandates for benefits a grand total of zero times, and in the U.S. Senate Obama co-sponsored an expensive bill requiring mental health parity. At least he’s consistent.

The way health care is provided in this country doesn’t work well for everyone. But improving it for those on the lower end of the economic ladder doesn’t have to come at the cost of making it worse for everyone else.