Health Insurance? Forget It - self-employed have few choices in Washington State

National Review, Oct 11, 1999 by David Klinghoffer

By 1995, companies had begun reaching a decision that they could no longer do individual-insurance business here. Estimates vary, but between 30 and 40 carriers have ceased writing individual policies in Washington State. In 31 of 39 counties, you couldn't buy such a health-insurance policy if your life depended on it.

Paul Guppy, of the Washington Institute Foundation, a free-market-oriented think tank, takes the commonsensical view that "the more government restricts freedom in the marketplace, the harder it becomes to stay in business and offer your product at competitive prices. . . . Deborah Senn's opinion is that a little bit of socialism doesn't work, but if you put the whole socialist straitjacket on like they've done in Canada, then it will work."

That's pretty much what she does say. Queried as to what lessons insurance chaos in her state may have for would-be reformers like Hillary Clinton, an irritable Commissioner Senn replies, "You'd have to ask her." The commissioner's own appetite for insurance reform remains undiminished. "We didn't have reform, we had half reform. The lesson that everyone should have learned is that you can't take a piecemeal approach." The party to blame is not the reformers, Senn insists: "This is very much a stand-off created by the carriers." She blames, for instance, Blue Cross for spending too much money on administrative costs and other carriers for selling insurance to larger employers for too little.

Cleverly, Senn avoids falling into the liberal trap of calling health care a "right." Instead she says that reform of the kind envisioned in 1993, and presumably still glittering in the mind of Mrs. Clinton, is ultimately about "finding a way to be really smart with our health-care dollars. It's very pragmatic. We're all going to pay for it as a society, one way or another." In the absence of guaranteed access to health care, individuals will wait till they're good and sick before seeking out a doctor, then end up in expensive emergency-room care.

Anyway, she thinks, the real crisis isn't with the individual insurance market at all, but with the group market. Her office recently published a "white paper" asserting that carriers lost $43.8 million on group policies in 1997, but only $11.9 million on individuals. If so, it remains deeply mysterious that insurers continue to sell group policies as they always did, while evacuating the individual market almost en masse.

Clearly, even a little bit of socialism is a very bad thing. What will Al Gore and Hillary Clinton, the latter currently expressing interest in gradual rather than dramatic insurance reform, make of all this should either attain higher office? To paraphrase Deborah Senn, you'd have to ask them.

Meanwhile, about the pain in my stomach area . . .