Conservatives Still Think You're Over-Insured

Posted by Steve Benen, Washington Monthly at 9:01 AM on November 5, 2009.

This comes up from time to time, but it's good to see former House Majority Leader Dick Armey (R-Texas), a new ringleader for right-wing activists, state it plainly.

"The largest empirical problem we have in health care today is too many people are too overinsured," he said.

There it is, the right's philosophy on American health care in 17 words. Most of us think the problem with the existing system is that we pay too much, get too little, and leave too many behind. Dick Armey sees the existing system and thinks we'd all be better off with less coverage. Lest anyone think this is unique to Armey, the opposite is true. A few years ago, during Bush's pitch in support of health saving accounts, the LA Times' Peter Gosselin explained, "Most conservatives -- including those in the [Bush] administration -- believe that the root cause of most problems with the nation's healthcare system is that most Americans are over-insured."

Just two months ago, Reps. John Shadegg (R-Ariz.) and Pete Hoekstra (R-Mich.) had an op-ed in the Wall Street Journal making the same case. "When was the last time you asked your doctor how much it would cost for a necessary test or procedure?" they asked, making the case that consumers need more "control ... over their care."

For those with insurance, we visit a physician, and follow his/her recommendations, knowing that insurers and our employers will shoulder most of the costs. If we didn't have that pesky insurance -- if we had more "control" -- we could, you know, haggle and stuff. Think of the savings!

It's all premised on the notion that health insurance encourages medical treatments. If we have coverage, we might get tests and procedures that we wouldn't get if weren't so darned insured. Less coverage means fewer costs.

Josh Marshall recently explained:

The problem is that you go to the doctor and agree to take the tests the doctor recommends. Shadegg and Hoekstra want a system where if your doctor suggests a biopsy for a suspicious lump you think about the pros and cons. Is it worth the money? Do you have the money? How suspicious is the lump anyway? Maybe you get the first one. But not necessarily the follow up scan six months later.

This is the essence of the Republican plan: the fact that you're insured and aren't directly feeling the cost of individual tests and procedures is the problem and getting rid of the insurance concept is the solution.... [T]he problem according to most Republicans in Congress isn't that there's not enough insurance or that it's not good enough. It's that there's too much. The problem is that you have insurance. And good policy will take it away from you.

Dick Armey is only saying explicitly what conservative lawmakers have been arguing for quite a while.

Steve Benen is "blogger in chief" of the popular Washington Monthly online blog, Political Animal. His background includes publishing The Carpetbagger Report, and writing for a variety of publications, including Talking Points Memo, The American Prospect, the Huffington Post, and The Guardian. He has also appeared on NPR's "Talk of the Nation," MSNBC's "Rachel Maddow Show," Air America Radio's "Sam Seder Show," and XM Radio's "POTUS '08."