Glenn Jacobs compares health insurance to auto insurance: he’s wrong

Knox County Mayor Glenn Jacobs, perhaps better known as the wrestler Kane, recently penned a column, joining with Justin Owen of the Beacon Center, the go-to place for right-wingers seeking material to support a predetermined conclusion. The column in the Knoxville News Sentinel could be dismissed as just another radical rightwing piece of blather, but Jacobs is widely known to harbor ambitions to become Tennessee’s governor. Thus, we need to grapple with what that column reveals.

The Jacobs work is a disjointed screed that careens from ambulance service delays in Knox County to hospital wait times and staffing to Medicare reimbursement. It’s as if we were watching a notion bounce around Jacobs’ mind seeking a libertarian landing point with which he could live.

If Jacobs wants to talk about insufficient federal reimbursement, a good place to start would be Medicaid. Our state’s failure to expand Medicaid to date has meant that Tennessee has chosen to leave on the table more than $22.4 billion. Jacobs, however, goes in the opposite direction.  Jacobs and Owen write glowingly of a time before World War II when they were pleased that insurance only covered catastrophic events. The authors blamed workers (perhaps those pesky unions played a role, too) in seeking health insurance as part of their benefits.  With third party insurers, Jacobs and Owen lament that consumers have little incentive to control costs. They even have the temerity to compare health insurance coverage of your family to car insurance.

Most of us, Jacobs excluded, know that your child is not the same as your Buick.  Imagine the kind of conversation that would take place if the Jacobs philosophy were routine.  “Now, stop crying Chrissy. Your father and I don’t think you have a broken ankle, just a sprain.  We are responsible consumers and want to avoid large bills and avoid possibly unneeded services. Just limp for a while.”

The only supporting information offered by Jacobs and Owen is that, horrors, large chunks of our health insurance system consist of popular programs like Medicare, Medicaid, and the Children’s Health Insurance Program. They also seem upset there is an Affordable Care Act which lets consumers easily compare plans, and sets minimum standards for policies. Jacobs and Owen insist these government programs, not corporate greed, are the source of the problems. 

It seems unlikely that Jacobs has encountered tallies by The Commonwealth Fund.  Earlier this year it reported on key health outcomes and concluded the U.S. spends dramatically more on health care than other developed countries but across nearly all metrics has worse health outcomes. Countries with strong government programs, health insurance, or other guarantees routinely did much better.  These included Australia, Canada, Germany, Japan, South Korea, and the United Kingdom.

Jacobs and Owen even drag out the trope that government rules are “preventing competition by making it illegal to sell insurance across state lines, further driving up the costs for patients to pay for health care.” Companies are free to open Tennessee-based subsidiaries and to follow our state’s rules. What Jacobs and Owen really are advancing is the notion that companies can incorporate in states with the weakest consumer and patient protection laws and then not be required to maintain standards we insist upon. Consumers may not realize that until routine claims are denied and other business shenanigans cost consumers thousands of dollars.

We also should note that Jacobs was an early and loud opponent of mask mandates. I pointed out at the time that we had a natural, and deadly, test of that proposition in Kansas where state law allowed an opt out of mask mandates for counties.  Published academic research documented a rough doubling of COVID cases in unmasked counties when compared to ones requiring masks. Extrapolating to Knox County, if Jacobs had his way hundreds more of his county residents would die from COVID, and many more would get sick, possibly developing long-term symptoms.

The Jacobs and Owen column unintentionally tells us of a health danger. We cannot put in charge of public policy people who don’t believe in any benefit from public policy.  The results can range from chronically bad health outcomes to catastrophic results in health emergencies.