Should You and I Pay for Austin’s Daughter’s Asthma Pills?

This is Austin Frakt at The Incidental Economist:

Asthma medication is exactly the type of health product that should be free, or nearly so, especially for low-income families. I cannot imagine many would take the meds for “fun”. I don’t think “skin in the game” causes patients to avoid overuse. All I think it does is risk more asthma attacks and more ER visits, even more deaths…

I’d call breathing a merit good, something we all have a right to enjoy. Let’s not charge people for medication that permits it, particularly if doing so means we’re likely to pay vastly more if they don’t take their meds.

Here is the response I posted:

Austin, on first reading, I thought you were saying that I (as a taxpayer) should help pay for your daughter’s asthma medication — even though you agree that you can afford to pay for it yourself. Disbelief overcame me, so I read your post a second time. Then I read it a third. Each time, the message was as incomprehensible as on the previous reading.

Is there a persuasive reason why I owe the Frakt household something? If so, it’s not in this post.

Comments (7)

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  1. Devon Herrick says:

    This argument could be taken much farther. Why does any taxpayer owe any other citizen a medical benefit? Some proponents argue there is an implicit natural right as a human being. But that argument ignores the difference between negative and positive rights (i.e. the right not to be bothered versus the right to bother other people to satisfy your rights). These are issues we as a society have a hard time dealing with. It’s easier to grant a right (knowing someone else has to pay) than it is to make hard decisions. I wonder how these natural beliefs might change if voting required a personal commitment to helping fund the particular right granted. These hard decisions are difficult for compassionate people to make. However, each generation should be allowed to make its own decision rather than have to pay for the decisions of past generations.

  2. Hoads says:

    Didn’t the FDA or EPA just outlaw over the counter asthma inhalers (eroding ozone layer)? Now asthmatics have to rely on a $65 Rx inhaler. And now the EPA is pushing for some major regulation to contain “pollutants” that they say cause asthma and other breathing problems. And what about the huge rise of asthma in children? Is this real or some kind of statistical shenanigans?

    Me thinks it is a tactic to create demand for Obamacare in the midst of the high disapproval ratings.

  3. steve says:

    You left out this line between the two you copied.

    “Value-based insurance design is a good concept. We have a long way to go in getting it implemented more thoroughly.”

    Any thoughts on VBI?


  4. Austin Frakt says:

    As already noted above, this post is one big misquote on top of an incorrect understanding of value-based insurance design.

    Details on those two points here:

  5. Juan says:

    If we can’t force the evil pharmaceutical companies to provide free medicine, maybe we can force millionaires and billionaires to pay for it.

  6. Buster says:

    As Austin points out, his original post was actually about value-based insurance design — not whether taxpayers should be saddled with the cost of his daughter’s asthma pills. But the question still seems valid: should insurers be saddled with the cost of his daughter’s asthma medication; or should cost-sharing rules apply?

    Austin made a good economic argument for insurers to pay for asthma pills without cost-sharing. But who should decide? Should insurers decide which benefits to offer when they design health plans, based on consumer demand (i.e. which benefits hold value for them)? Or should public policy mandate asthma benefits without cost-sharing? I vote to allow insurers to decide. Otherwise, lobbyists will attempt to interview and tell insurers what benefits hold value (i.e. the benefits that benefit special interests).

  7. Carolyn Needham says:

    And why is asthma different than another chronic condition?