CON: Learn more about Prop C before you vote

By Herb B. Kuhn

It's usually a bad idea to make a decision without all the facts. That's why before you vote on Proposition C on Aug. 3, you may want to learn more about its potential consequences. Your head and your heart may disagree on the measure.

Proposition C's sponsors have been outspoken about the referendum's intent: to force a confrontation on states' rights and the 10th Amendment to the U.S. Constitution. Moreover, they want you to help them send a message to Congress and President Obama about health care reform.

Without any additional information, the request seems fair. After all, there's a lot of anger and uncertainly about where the nation is headed.

Here's what the proponents won't tell you: The message they are asking you to send could have real consequences for your wallet and your community.

Supporters of Proposition C call the measure the "Health Care Freedom Act." There's some irony in the name. In fact, Proposition C would allow those who can afford to purchase insurance the choice of not buying it. At the same time, Proposition C would force health service providers to continue to make up the costs of the uninsured by charging more to those who have insurance. That is to say, the freedom it protects is the freedom not to take responsibility for the costs and risks of being uninsured. Ultimately, those risks -- and the costs -- are shifted to the rest of us.

Hospitals are required by law, and driven by mission, to provide necessary care in their emergency departments. This care is provided without respect to insurance coverage. The cost of providing this care has historically been borne in part by patients who have insurance and support from federal payments.

There is a reason hospitals have historically supported expanded health insurance coverage. When individuals have health insurance, they are more likely to seek needed care earlier and in the most appropriate care venue. And, when care is delivered this way, not only are patients healthier, costs for health care services are reduced throughout the health care system.

Proposition C would only reinforce a broken system. More than 700,000 Missourians don't have health insurance, and the state's hospitals spent more than $830 million in 2008 providing care for these individuals. Under Proposition C, this system of cost shifts would continue.

Ultimately, Proposition C comes down to a choice. If you believe that purchasing health insurance is a decision each citizen has a right to make, then you may want to support Proposition C. However, if you believe it is unfair for Missourians who pay for health insurance to pay higher insurance premiums to cover the cost of care for those who decide not to buy insurance, then you may want to reject the proposal.

There's an old saying that "freedom isn't free." Proposition C could make it a lot cheaper for health insurance-free riders. And that's a freedom they'll be earning with your money.

Herb B. Kuhn is president and CEO of the Missouri Hospital Association in Jefferson City, Mo.