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Health Care / Free-Market Reform

Health Care Solutions Need to Be Feasible

By Caitlin Hartsell on Nov 2, 2009

The Missouri Budget Project recently wrote a special piece for the St. Louis Beacon about affordable health care, “What to do about health care? Make it affordable.” In it, the author conflates increased coverage with affordability, ignoring the systemic and regulatory factors that have led to the ever-increasing costs of health care we’ve seen in the United States. The piece makes a particularly problematic assumption that passing new government mandates for more coverage will guarantee better outcomes.

One way in which the author proposed to increase coverage is an expansion of Medicaid, because “Medicaid has a good benefit package, low administrative costs, and requires minimal out of pocket expense.” This may be true, but not because Medicaid is more efficient than private markets, but because the program pays a very low rate to doctors, which may become even smaller as a result of recent state budget cuts. Many doctors who face these lower mandated prices conclude that they cannot afford to take Medicaid patients, and are refusing to accept new ones. How will this improve coverage? It may actually decrease coverage by limiting the number of doctors available for an ever-growing Medicaid population.

Increasing coverage by creating deficits or a large burden on the state budget is not a long-term solution. It would be better to lower costs, as described in a recent study released by the Show-Me Institute, through increasing personal accountability. While the Missouri Budget Project’s proposed solution is well-intentioned, it is ultimately not fiscally feasible.

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Caitlin Hartsell

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