Tag Archives: universal coverage

Health Insurance

What Universal Coverage Means in Massachusetts

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Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses.

In 2009 alone, 936 people signed up for coverage with Blue Cross and Blue Shield of Massachusetts for three months or less and ran up claims of more than $1,000 per month while in the plan. Their medical spending while insured was more than four times the average for consumers who buy coverage on their own and retain it in a normal fashion, according to data the state’s largest private insurer provided the Globe.

Full article on the gaming of Massachusetts’ health care system.

Health Alerts

The Great Disconnect

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All across the country, Members of Congress are facing very angry constituents over the issue of health care. So ferocious has been the response that an estimated two-thirds of the Members are not even going to hold town hall meetings. Reportedly, our elected representatives are shocked.

I don’t know why. At least a month earlier, my colleagues and I at the National Center for Policy Analysis became aware of their anger as we collected more than 1.1 million signatures on the petition http://www.freeourhealthcarenow.com/ and read all their e-mail responses. Where, you wonder, were the politicians as this anger was boiling over? Don’t they have staffers who answer their telephones and open their mail?

Anyway, a great disconnect has emerged. It may be serious enough to cause the Democrats to lose control of the Congress in the next election. How did this happen? I think there are three causes.

httpv://www.youtube.com/watch?v=VL9xOLpwI0I

You know you make me want to
Shout…..(come on now)…..
Shout…..(come on now)…..
Shout…..(come on now)…..
SHOUT!

Continue reading The Great Disconnect →

Health Alerts

The 2% Solution

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What exactly is health reform all about? Readers will be forgiven if they can't come up with a quick answer to that question. No one else can either. But during the Presidential election campaign, Barack Obama mentioned universal coverage a lot. With that in mind, consider that:

  • Uninsurance is a lot like unemployment; it happens to many people for short periods of time, but it afflicts very few people for long periods of time.
  • In fact, of all the people who are uninsured today, less than half will be uninsured a year from now.
  • Less than one in ten will be uninsured two years from now — an amount equal to less than 2% of the nonelderly population.

Let's concede for the sake of argument that these chronically uninsured people have a problem that warrants federal attention. If Congress doesn't keep its eye on the ball (and it is inconceivable that it will keep its eye on the ball) we can end up spending $1.5 trillion over the next 10 years and — at the end of the day — have no assurance that the 2% will actually have been helped!

That works out to about $325,000 for each person who may not be helped!

httpv://www.youtube.com/watch?v=WANNqr-vcx0

When logic and proportion
Have fallen sloppy dead …

Remember what the dormouse
Said: "Keep your head."

Continue reading The 2% Solution →

Health Insurance

Mass. Health Plan: Lessons for Obama Care

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With a 2.6% uninsurance rate, Massachusetts comes closer to universal coverage than any other state. Yet a study published in Health Affairs [gated, but with abstract] suggests that reform may be mainly shuffling the deck chairs:

  • Since health reform in 2006, there has been very little change in the use of hospital emergency rooms for nonemergency treatments.
  • Almost one-fourth of low-income residents said their last trip to the emergency room had been for a non-emergency – the same as in 2006.
  • One-in-five adults said they have been told in the past 12 months that a doctor or clinic was not accepting new patients or would not see patients with their type of insurance.

The rejection rate for low-income patients and those with public insurance was twice that of high-income patients and those with private insurance.

Health Care Costs

Hooray! All Our Problems Are Solved

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The Commonwealth Fund has assembled a group of experts who have created a plan that will create universal coverage so efficiently that "the savings will basically pay for itself." Plus, it has these additional features:

  • No patient, no employer, nor any insurer will have to choose between health care and other uses of money.
  • No doctor, no hospital, nor any other provider will have to compete for patients on the basis of price.
  • No doctor, no hospital, nor any other provider will have to compete for patients on the basis of quality.
  • No health plan will have to worry about how to price and manage risk because everyone will pay the same premium and get the same benefits.

What do you call it when a plan is devised by people at the top and when everybody at the bottom has a self interest in defeating it? Let's call it a Five Year plan.

New Health Care Law

Daschle’s Gone; But His Health Board is in the Stimulus Package

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This is Betsy McCaughey writing at Bloomberg.com:

The National Coordinator of Health Information Technology will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and "guide" your doctor's decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, Critical: What We Can Do About the Health-Care Crisis.

Health Care Costs

Gruber, Cherry-picking His Own Research

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Universal coverage is all gain, no pain, according to Jon Gruber, writing in the New England Journal of Medicine:

Increasing consumer spending: In the late 1980s and early 1990s… families that gained insurance coverage… increased their spending on other consumer goods – by an average of about $800 per year in today's dollars.

Eliminating Job Lock: Fear of leaving jobs that come with health insurance for those that do not… reduces job-to-job mobility among the employer-insured by as much as 25%.

Creating a huge jobs program: Shifting the focus of the health care system from specialists to preventive care practitioners… such as… nurse practitioners and registered nurses… could provide a landing spot for workers displaced from other sectors of our economy.

Being better prepared for the "herculean efforts" needed for entitlement reform: The future obligations of the U.S. government for the Medicare program alone, minus any Medicare payroll taxes collected, will be more than $70 trillion – an amount that is seven times that of our national debt.

New Health Care Law

Health Strategy: Bait and Switch

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The goal of single-payer advocates has never been a secret. Let government get control of the dollars, and then control costs by ratcheting down payments to providers, limiting access to technology, and rationing care. Trouble is, this eat-your-spinach approach doesn't sound palatable to voters. So UC Berkeley political science professor, Jacob Hacker, writing in a New Republic article, has an idea: spend vast sums of money on health reform as a way to buy off the opposition to liberal ideas. 

Hacker, an Obama campaign health policy advisor, argues the Clinton health reform plan was derailed 16 years ago because the convoluted plan was pitched as a way to reduce medical expenditures – causing the population to fear that access to medical care would be reduced and care rationed.  But Americans don't really believe society is spending too much for health care. They only believe that they personally are paying too much. 

Once universal coverage is fully implemented, Hacker says reimbursements to specialists could then be ratcheted down and additional savings squeezed out of the system through rigid practice guidelines and disease management.