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Health Insurance Mandate Creep Show: Coverage for Prayer, Amen!

November 4, 2009

In yesterday’s LA Times:

Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses…While not mentioning the church by name, it would prohibit discrimination against “religious and spiritual healthcare.” It would have a minor effect on the overall cost of the bill — Christian Science is a small church, and the prayer treatments can cost as little as $20 a day. But it has nevertheless stirred an intense controversy over the constitutional separation of church and state, and the possibility that other churches might seek reimbursements for so-called spiritual healing.

A couple weeks ago Tyler Cowen warned us not to forget the mandate creep. You may spread risk by coercing the young and healthy into the same insurance pool as the old and poor, but, he asked, what constitutes adequate coverage? Once a mandate is on the table, highly motivated coalitions will clamor for a piece of that pie:

A further problem is “mandate creep,” which we’ve seen at the state level, as groups lobby for various types of coverage — whether for acupuncturealcoholism and fertility treatments, for example, or for chiropractor services or marriage counseling…Because mandates don’t stay modest for long, health insurance would become all the more expensive. The Obama administration’s cost estimates haven’t considered these longer-run “political economy” issues.

“But ahhh,” so the democratic prayer treatment goes, “surely legislators will know real medicine when they see it. Surely they will know what constitutes reasonable coverage. After all, everyone knows chiropractors are quacks! The so-called mandate creep is a red herring.”

When the highly motivated few impose highly distributed costs on the many–this is a feature, not a bug, in democratic governance. (Cue Mancur Olson.) The LA Times article worries about the separation of church and state. I worry about the separation of democratic fundamentalism and state. I weep over the slow, steady erosion of freedom by millions and millions of $20-a-day prayer treatments. Spiritual healing today, subsidized sexual healing tomorrow!

  1. March 23, 2010 4:18 pm

    Brilliant article. Lets hope it pays off in the end!

  2. Mike Gibson permalink*
    November 6, 2009 2:52 pm

    Teageegeepea–as I read Hanson, he’s saying that most people should spend their marginal health care dollar on faith healing. What he’s not saying is that including faith healing in mandatory coverage would be a great way to reduce costs.

    Private expenditures are one thing, socialized costs another.

    Tho I will add that he very might well agree to what you’re saying. It’s just not implied in that post.

  3. November 6, 2009 5:03 am

    Robin Hanson endorsed funding faith healers.

  4. Mike Yeomans permalink
    November 5, 2009 8:58 pm

    To be fair, if these christian scientists are claiming prayer treatment, they’re probably not consuming a lot of other health care, so can’t we just throw them a bone? I mean really, it’s the least we could do since they so lower the burden on our HC system.

    I mean, maybe we could grant them a religious exemption from the insurance mandate altogether? Like, we’ll pay for your prayer treatment but you have to sign off on not showing up in our emergency rooms if the lord doesn’t work.

    Conversely, we should probably be encouraging Christian scientist missionaries, you know, to bend the curve.

  5. Nicolas permalink
    November 5, 2009 11:04 am

    Democracy can only lead to French style socialism. It’s not an IF but a WHEN. Depending on the population it takes more or less time but it ALWAYS happens. America WILL experience the mediocrity of France.
    Stable democracies lead to mediocre societies always on the brink of collapse but not quite getting there.

    When all modern democracies have come to a similar point there will be no one left to drive the prosperity train. I fear things will be even closer to the edge.. but not quite getting into the hole still.
    Democracies have a way of backing away from total destruction when it becomes too apparent, only to push back towards it a few decades later. Mediocrity is the rule not the exception. It is the point of equilibrium in all modern democracies. America will be no exception and is now quite far along down that path already.

    Advancing technology is the only reason we still have increasing standards of living. Technology still advances fast enough to compensate for and overtake democracy’s inherent stupidity. Democracy is nothing but a massive boulder attached to the rocket that is technological progress.

    On some level, advancing technology actually allows for democracy to be even more inefficient than it normally could get away with. Democracy is only as bad as it can afford to be.

    I am not worried about social chaos or anything like that. I’m worried about stagnation and mediocrity.

    Because there is no talk about democracy as such (the framework) but only about specific policies or implementers, there is no hope in the foreseeable future within existing political systems. We need an escape mechanism for those not content with it.


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