By Jennifer Vogt-Erickson

Jennifer Vogt-Erickson is a member of the Freeborn County DFL Party.

Is health care coverage best left to the free market, where profit is the bottom line? Does this motivation align with health care’s goal to treat the sick and injured and maintain a healthy population?

Our country has determined it’s in our national interest to provide a number of major resources with taxpayer funds. This includes public education, public roads and bridges, and some public utilities, all things we benefit from in Freeborn County. These could be left to the free market and more companies could profit, but they would create and exacerbate inequalities. They would not only be too costly for many individuals but would also likely be a drag on overall prosperity.

Health care coverage is spread between the free market and public funding. We already determined that those 65 and over and those in poverty should have taxpayer-sponsored coverage. President Lyndon Johnson signed the Social Security Amendment Act of 1965, creating Medicare and Medicaid. The Affordable Care Act (ACA) of 2010 expanded Medicaid coverage to millions more.

Many people, though, still depend on employer-sponsored coverage or must navigate the formidable individual private insurance market.

Ebenezer Howe made a slight error in his Republican column last week — wages were frozen during World War II to control prices, but fringe benefits weren’t ever capped. To overcome workforce shortages, companies could offer choice health insurance benefits to attract workers. This inadvertently established our employer-based system of health coverage.

If health insurance were based on the individual market, perhaps we would take a different approach to reform. Regardless, the bigger and more diverse the pool, the more affordable health coverage tends to be. If only older or sicker people sought insurance, costs would be much higher for them. Thus, free riders (like young, healthy people who don’t get insurance) drive the costs up for other people.

As Howe suggested, if women could get policies based on whether they intend to procreate, women who avoid motherhood could pay lower premiums. Conversely, women who do aspire to motherhood would pay higher premiums and bear even greater costs for producing our next generation. Would this be advantageous with a birth rate already below replacement?

It comes down to the central question of whether we’re a society that looks out for each other or if we mainly look out for ourselves. Some things we can go without, and it makes sense to let the free market determine costs of those nonessential items. But some essential things aren’t necessarily best left to the free market. It can make things prohibitively expensive, especially in rural areas like ours.

Besides public-supported education and infrastructure we socialize many other costs, including fire and police services, military defense, libraries and prisons (mostly). Who grumbles when a socialized orange plow truck thunders down a Freeborn County road during a snowstorm? Who frets about the “Leviathan” when a socialized fire truck pulls around the corner to douse flames shooting from a neighbor’s house?

Would it make sense to socialize more health care coverage too? Would it make us safer, healthier and more prosperous? Would the freedom some people must forego (especially if they’re young and healthy) be worth it?

The ACA is hanging in the balance over these questions. President Trump’s promise to cover everybody at less cost isn’t going to happen. (It sounded a lot like a single payer system.) The Republican proposal would cut costs, but 24 million people would lose or drop their coverage over 10 years, according to Congressional Budget Office projections.

The main winners would be young people who wouldn’t get penalized for skipping health coverage and wealthy individuals.

Here’s how the resource redistribution scheme would work: In exchange for 24 million people losing their health coverage, the richest 1 percent would get an average annual tax break of $37,000. It also would cut $145 billion in taxes on health insurers, $25 billion on drug companies and $20 billion on medical device companies, according to the Tax Policy Center.

Health insurers could also deduct the full cost of their exorbitant executive pay packages. For example, Stephen Hemsley of Minnesota-based UnitedHealth makes $1.35 million in annual salary. In 2015, he also received $4 million in incentive pay and $15 million in stock options. UnitedHealth would be able to deduct those expenses.

Would their boon comfort us when people we know lose coverage and go back to being at risk of losing their homes to medical bills?

Freeborn County stands to forfeit more than it gains if Republicans replace the ACA. Instead of giveaways to very wealthy people mostly in other places like Minneapolis and New York City, we should defend our gains and close the “donut hole,” perhaps by offering a public option so that self-employed people on the individual market here could obtain affordable coverage.