Cato’s healthcare expert: Still clueless about health insurance


Michael F. Cannon, whom the libertarian Cato Institute courageously describes as its “director of health policy studies,” is unhappy that I called him out the other day for writing “the lamest anti-Obamacare column of all.”

We know he’s unhappy because he charged me with “falsely” attributing to his column, which appeared in the Los Angeles Register and on Cato’s website, a position he says he doesn’t have. Well, let’s see.

I wrote that he was one of a cadre of “conservatives who advise Americans not to sign up for Obamacare because there’s no downside to going without coverage.” In a reprint of his column in Wednesday’s Orange County Register he adds some verbiage contending that he advises no such thing.


Really? Here’s what Cannon originally wrote:

“You see, for most healthy people, going uninsured before Obamacare, at least for a time, was already a safe bet.... The odds that they would have to deal with unmet medical needs, or unpaid medical bills, were low.... Obamacare makes going uninsured an even safer bet. It increases premiums for healthy people, and the penalty for not buying health insurance is largely toothless. So if you earn too much to qualify for subsidies and/or you take steps to avoid paying the penalty, going uninsured will save you even more money than before.”

Maybe I misunderstood Cannon. But it strikes me that by making the argument that while it always was a “safe bet” to go without health insurance (which is a bizarre assertion in itself), it’s now “an even safer bet,” and adding that you can save “even more money than before” by doing so, his words were indistinguishable from actually advising people to do so. Otherwise why make those claims?

Cannon’s defense is that he wants people “to have stable, secure health insurance,” but that the Affordable Care Act “creates so many incentives for people to free-ride that insurance markets could collapse.”

There he merely circles back to the argument that made his original column so asinine. His basic claim then was that there are so many ways to sign up for ACA coverage as soon as you get sick, you might as well avoid enrolling until you do get sick.

As I wrote, most people in the individual market can’t sign up for ACA coverage except during annual open-enrollment periods, and then only for coverage that starts the following Jan. 1. Cannon’s list of subterfuges that allow instant enrollment outside the open-enrollment window simply don’t apply to the vast majority of customers. As I wrote, his suggestions boiled down to: “get married, have a kid, impoverish yourself so you qualify for Medicaid, or commit fraud [by misrepresenting your real income].”

Cannon asserts that I conceded his point that “the worst-case scenario under Obamacare is that you would need to cover a few months of medical bills.” That is, between the day you drop coverage and the next Jan. 1, when it can be started up again.

Actually, I didn’t concede his point. I ridiculed it. I pointed out that what he calls “a few months” could be as long as a full year, and that some people with serious injuries or diagnoses of dire diseases could well die within that time frame. Even for patients who survive, “a few months of medical bills,” uncovered by insurance, could render many families bankrupt. That’s if they take Cannon’s -- yes -- advice.


Cannon’s utter cluelessness about the whole point of having health insurance -- shocking for a health policy “expert” -- is underscored by a question he put to me today via Twitter: “True or false: ObamaCare makes it safer to drop one’s health insurance than it was pre-ACA.”

Cannon seems to be unaware that the goal of Obamacare is to make it easier to obtain health insurance, not easier or “safer” to drop it. The assumption underlying the ACA is that it’s unsafe to not have health insurance; that must be plainly evident to everyone in the country, except Michael Cannon. (You don’t even have to be a health policy “expert” to know it.)

To be absolutely fair, I qualified my assessment of Cannon’s original column by calling it only the lamest such column “so far.” There will be plenty of opportunities in the coming months and years for enterprising conservative pundits to better Cannon’s mark for obtuseness and irresponsibility. But he has set a pretty high bar.