West Virginia University College of Law professor Valarie Blake's forthcoming scholarship, The Freedom Premium , was recently featured by Jotwell, in its Health Law section. The review, Freedom and Health Care , was written by Amy Monahan.
From the abstract:
Most Americans are forced to pay a “freedom premium” for health care, trading measures of control over their personal lives in return for health benefits. For the publicly insured, many recipients must live at poverty levels, forgoing work, marriage, and security in old age to meet strict income and asset tests. People with disabilities, their medical needs routinely pigeon-holed into public programs, have for generations been denied equal opportunity in this way. Private employer-sponsored insurance presents its own freedom losses, limiting the range of jobs people can work, when they can retire, and whether they may divorce.
The problem of freedom loss in health insurance has been minimally studied and in a fragmented way, exploring only facets of the problem. Neither has it featured prominently in health reform. Where legislation has spurred progress, it has largely been a side-effect of other aims like reducing uninsurance rates. For example, the Affordable Care Act’s expansion of Medicaid and subsidization of private insurance freed up some people to choose options other than employer-based plans. Legislation expressly aimed at the problem has been minimal, and piecemeal, concentrated almost exclusively on reducing job lock in employer plans.
This Article is the first to advance a systematic critique of U.S. health care finance that it structurally oppresses personal freedoms in ways that can be comprehensively addressed through health reform. First, it characterizes the breadth and depth of the freedom premium to signal the corresponding need for and magnitude of reform. Next, it highlights where law has made progress and fallen short at remedying the problem, and why. Lastly, it advances a model of health reform that corrects the problem. Universal health care uncouples benefits eligibility from work, poverty, and dependency, and replaces it with neutral criteria like residency, leaving people free to live their lives as they choose. A novel contribution to arguments in support of the adoption of universal health care, the Article offers a meaningful alternative to long-standing rhetoric that universal health care is anti-freedom and anti-American.
Find more of Professor Blake's scholarship on SSRN and her SelectedWorks scholarship profile.