Sandwiches en la Torre de la Vela

Asociacionismo, libertad y comida rápida, por Jahd

6 de Abril 2004

La (in)sanidad pública que todo lo invade

Ays, que no aprendemos de las lecciones de otros. En el Heartland Institute publican el tercer artículo de su serie dedicada a cómo las zarpas de los políticos estropean lo que era un mercado libre que satisfacía a clientes y proveedores de servicios (sanitarios, en este caso):

In the early 1990s, Empire Blue Cross Blue Shield (BCBS) in New York was the largest private not-for-profit insurer in the nation. But its financial statements showed a company in serious trouble.
[...]
Elizabeth McCaughey, Republican candidate for lieutenant governor at the time, described the situation in a September 1994 essay for the Wall Street Journal. “The financial statements [for Empire Blue Cross and Blue Shield] complete a distressing picture drawn by the U.S. Senate Permanent Subcommittee on Investigations last year. Federal investigators concluded that Empire BCBS lacked the ability to ‘properly execute the most basic functions of an insurance company.’”

As insurer of last resort for New York residents, BCBS sold community rated, guaranteed issue policies at state-regulated prices in exchange for an exemption from state and local income taxes. It was allowed to pay hospitals lower prices for services than other commercial health insurers in the market were allowed to pay.

La maquinaria de presión se puso en marcha para salvar la situación de BCBS:

Telling the state legislature it was about to lose more than $438 million from combined underwriting losses in 1991 and 1992, BCBS lobbied for a whopping rate increase. The insurance commission approved an increase of 25.5 percent.

Aunque la realidad es que los políticos no necesitan mucha presión para intervenir en la economía y los mercados:

The situation made legislators think further reforms were needed to control the entire health insurance market and protect BCBS from further losses. In 1993, they imposed community rating and guaranteed issue mandates on the state’s individual and small group insurance markets.

Las consecuencias:

Los pequeños descuentos para los clientes de mayor riesgo se convirtieron en grandes penalizaciones para aquellos con menor riesgo.

La reducción de los beneficios, o incluso llegar a las pérdidas, provocó la salida de numerosas compañías del mercado, afectando a profesionales sanitarios, gestores y accionistas (no olvidemos que en EEUU la mitad de las familias invierte parte de sus ahorros en bolsa; cuando hablamos de accionistas no todos son grandes millonarios).

El incremento de las primas hizo que muchos que antes podían pagarse el seguro ahora no pudiesen permitírselo, debiendo depender del MediCare, sostenido con el dinero de los impuestos.

Y como en Europa somos incapaces de aprender de los errores de otros (bueno, tampoco de los nuestros), vamos a repetir las mismas chapuzas:

In order to ensure that consumers were protected, the Irish government has enforced certain regulations that were written into EU law. The health insurance marketplace has to observe three rules: community rating, open enrollment and lifetime cover.

Cuentan la historia en samizdata.net.