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I have to hand it to the governor and the less libertarian-leaning of the Idaho Republicans. They have proposed an answer to Idaho’s population who want less expensive health insurance. Not only that, it seems that Idaho insurance companies may access out-of-state markets since there have been rumors that the new tax bill will allow buying insurance across state lines.

While I want to give credit where credit is due, I do not believe that the less expensive, less comprehensive, policies enhance public health. They also leave insureds exposed to significant costs not covered by insurance. Economics aside, I am especially concerned about people’s access to best practices in health care. When I consider public policy, I look for sufficiency first, but I am mindful that tax money should not buy more than is needed.

Sufficient health care means medical, dental and vision care from birth to death. It includes regular checkups, inoculations, testing, and disease intervention at the earliest possible moment. I include dental because disease in the teeth and surrounding gums can attack other parts of the body, notably the heart, and can significantly weaken overall wellness. Vision affects the ability to be mobile and to access information. Mobility is crucial to exercise which, in turn, is crucial to the prevention of a plethora of diseases. One could argue that hearing is also part of the mix.

The Affordable Care Act began to bend the cost curve of medical care in the United States in a more sustainable direction because of the comprehensive medical care that was available to many who did not have it before. Eventually, it will make the cost of Medicare less expensive because individuals aren’t arriving at age 65 having postponed needed care until Medicare coverage. If the ACA had been implemented as designed or, better yet, tweaked as appropriate, insurance rates for everyone would have stopped their relentless rise and even fallen somewhat.

In my perspective the one great problem with the ACA was that it never became universal. There were people in the population who refused to participate on ideological grounds. There were people who could not afford to buy insurance and were not covered by a public program. Additionally, there were people who did not or would not take advantage of the benefit of having annual physicals or going to have something checked out before it became more serious.

The economic and social impact of a more effective health care system would be enormous in terms of quality of life as well as the costs of social welfare. From successful childbirth to robust school children to fewer disabled adults to fewer frail elderly, the benefit of comprehensive health care is probably best seen in the Scandinavian countries. Enhanced by good public health policies advanced by the surgeon general and the CDC, we can have it all.

I suspect that my arguments will fall on deaf ears to those individuals whose outlook favors no market or social regulation at all. A belief that it’s every man for himself. That position goes against my personal moral beliefs. I have lived a fortunate life, and I want similar fortune for everyone possible. I want to live in a society where access to extraordinary medical care doesn’t depend on fundraisers initiated by caring friends. I want to live where disability is not caused by diabetes or heart disease or pain that is untreated until the individual is covered by Medicaid.

Less expensive policies are better than nothing. They are very profitable because they depend on three things: Few people will meet the coverage thresholds, people are healthy when they sign up, and people will drop them when times are tough if they are healthy and it’s a safe bet they won’t need them. When I was selling insurance, I didn’t want to bother with that market, and still wouldn’t. Still, in these uncertain times, I have to agree that some health insurance is better than nothing. We can, however, do better.

Linda Brugger retired from the Air Force and is a former chairwoman of the Twin Falls County Democrats.


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