Poor Diagnoses, or Munchausen by Proxy?

Rhode Island Kids Count's Jill Beckwith is correct that Rhode Island is "heading in the wrong direction" when it comes to healthcare. According to Projo Medical Writer Felice Freyer, fewer Rhode Island workers have healthcare coverage, a higher percentage of children are without it, and yet:

Rhode Island spends a higher proportion of its economy and its state budget on health care than the rest of New England and the nation.

Why, then, do three of the four recommendations that Freyer reports from "a first-of-its-kind report" by the state's health insurance commissioner, Christopher Koller, call for increased public aid, with the fourth suggesting that the state "require employers to offer health insurance and individuals to buy it"? Either the problem is being misdiagnosed, or the care-for-you community in the public sphere has a social manifestation of Munchausen by proxy (the disease that led that mother in The Sixth Sense to spoon Pine-Sole into her daughter's soup).

Don't misunderstand: requiring people to buy their own health insurance is a key component of the solution that I've increasingly been favoring, but in typical Rhode Island fashion, it looks as if the powers that be are fixin' to get it all wrong. Expanding the number of people who can claim publicly funded insurance while leaning on companies and slightly wealthier individuals (such as those at three times the poverty level), and while taking no steps to decrease regulations or draw additional insurers to our local market, will only reinforce the trends that are killing the state.

If, for instance, RI Senate Majority Leader Teresa Paiva Weed should decide to act on her observation that (in Freyer's words) "it may be difficult to regulate large employers because many are self-insured," large employers will have one more incentive leave, even as disproportionate handouts continue to spur the needy to come.