Tag Archives: health care

Four Pillars of a Health Care System?

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The Wall Street Journal posited this in a Wednesday op-ed.

1. Provide a path to catastrophic health insurance for all Americans.

The WSJ then supports this with old saws: being covered generally leads to better medical results, health insurance is good for the wallet, and so on.  Then they want a government solution—while they carefully avoid saying how they would pay for it:

The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.

Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit….

They don’t even say why catastrophic health insurance should be particularly targeted by Government.  They ignore an actual market solution for this: free market competition, accompanied with lower tax rates (which leave more money in people’s pockets), and no annual or income caps or requirements for high deductible insurance plans (and no requirement for any insurance plan at all) on Health Savings Accounts.  Folks are fully capable of making their own decisions about the structure of their health insurance plans without the Know Betters of Government holding them by the hand.  And insurance companies, in a fully competitive environment, are fully capable of developing and delivering the products actual customers want without Government mandates.  If that includes catastrophic insurance plans, those will appear.

2. Accommodate people with pre-existing health conditions.

See above regarding free markets.  Of course such coverage would come at a higher cost than other sorts of health coverages; the risk being transferred to the insurer is higher.  But even this risk is not certain.  Folks who’ve had a heart attack (or more than one), for instance, have a preexisting condition (unless a single heart attack has occurred sufficiently far in the past that a medical doctor (the patient’s, not the insurer’s or a Government hireling) says it’s a one-off and not preexisting), but not everyone who’s had heart attacks will have their next one simultaneously.  Even a preexisting condition can be amortized across time given a free market that allows pooling of [those who’ve had heart attacks] so that premiums can be adjusted to match the actual payout requirements, the actual risk—just like “ordinary” insurance plans.

So as long as someone remains insured, he should be allowed to move from employer coverage to the individual market without facing exclusions or higher premiums based on his health status.

This conflates two separate questions.  The preexisting question is addressed just above.  The mobility of an insuree (or someone who’d like to buy a health insurance plan) is separate: and yes, in a free market environment, an insuree would be able to take the plan he’s purchased, whether originally obtained through his employer (unless it was the employer who actually did the purchase and the premium payments) or bought on the individual market, with him wherever he went or to whatever job he moved.  The latter case, too, would reduce or eliminate the need for the new employer to offer health insurance coverage through his benefits program.

3. Allow broad access to health-savings accounts.

There should be a one-time federal tax credit to encourage all Americans to open an HSA and begin using it to pay for routine medical bills. And HSAs combined with high-deductible insurance should be incorporated directly into the Medicare and Medicaid programs.

Another Government solution—again carefully unpaid for—and it’s much too timid.  I addressed HSAs and their market availability above.

4. Deregulate the market for medical services.

This is the only move necessary.  It’s the move to enable the free market solution.

Full stop.

Obamacare’s Cost Increases

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As even President Barack Obama (D) has finally confessed, Obamacare plan premiums and deductibles are skyrocketing.  But the Democrats and their Progressive fellows are cynically obfuscating the matter.  Here’s a typical remark, by HHS’ Assistant Secretary for Public Affairs Kevin Griffis:

Headline rates are generally rising faster than in previous years…headline rates are not what they [recipients of Obamacare subsidies] pay.

Indeed not.  Those rates are what you and I and our fellow taxpayers who don’t get subsidies pay, and they’re rates for which we pay a second time in the form of the subsidies Obamacare passes on to potsful of Obamacare plan purchasers.  We pay for those subsidies with our tax payments.

This is carefully elided by those pushers of Obamacare.

Federal Funding for Medicaid

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Medicaid is a State-run program for providing a measure of medical service for that State’s relatively indigent citizens.  The program is State-run, but it’s jointly funded by the State’s taxpayers and by the nation’s taxpayers via Federal funds transferred to each State for the purpose.  I’ve often written that Federal funds for Medicaid should be ended and that the States should  be allowed to fund and manage their Medicaid programs alone—without Federal funding and associated Federal interference.

Here’s another reason to end Federal funding for a State’s Medicaid program.

US District Judge Kristine Baker issued a preliminary injunction preventing Arkansas from suspending payments to Planned Parenthood for any services to Medicaid patients in the state. Republican Governor Asa Hutchinson last year terminated the organization’s Medicaid contract because of secretly recorded videos made by an anti-abortion group.

Baker also expects that Planned Parenthood would win at trial, hence her injunction.

Unfortunately, the Federal judge is right on the law, if only on 14th Amendment grounds, and on the courts’ Taney-esque position that unborn babies aren’t fully human.

Other than changing that law, though, the way around this sort of thing is that elimination of Federal funds for any State’s Medicaid program.  With that elimination, States that disapprove of Planned Parenthood’s funding of abortions could stop funding Planned Parenthood, and States that approve of easy abortions could continue to do so.

Obamacare Fail

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The headline of this Wall Street Journal piece pretty much says it all: Average Cost of Employer Health Coverage Tops $18,000 for Family in 2016.

The sub-head, with careful reading, adds clarity: Pace of cost increase slowed by accelerating shift into high-deductible plans, new survey shows.

That cost of employer coverage, buy the way, refers to the premiums employees must pay: $18,142 for a 2016 typical employer-offered family plan, and employees have to pay 30% of that, typically, up from 29%.  Like a sergeant I once worked with liked to say, sort of, “Holy cats.”

Is that cost increase rate actually slowing, though, where it matters to the individual—the employee?  Not in the deductibles.  Shifting into high-deductible plans means the policy holder—the employee—has to pay lots more out of his own pocket just to get to the point where the coverage plan begins to pay its 50%, or 60%, or maybe as high as 80% of the medical costs.  For that year.  Then the deductible has to be paid anew.

Notice another part of that sub-head: accelerating shift into high-deductible plans.  That means that in that next year, the erstwhile high-deductible plan may not be available: the employee may be stuck with purchasing a different plan, perhaps with an even higher deductible, perhaps with higher yet premiums, perhaps with coverage not as useful to the employee.

This is what Obamacare, not the employers, has wrought.  This is what needs to be tossed in its entirety into the medical waste disposal and replaced with a more honest environment within which actual insurance can be had, and competitively so.

The Progressive Socialist Goal Made Manifest

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In the context of Aetna’s decision to sharply curtail its participation in ObamaMart—because such participation was costing Aetna millions of dollars—Socialist Senator Bernie Sanders (I, VT) has said openly

The provision of health care cannot continue to be dependent upon the whims and market projections of large private insurance companies whose only goal is to make as much profit as possible.

Because making money—the engine of economic growth and the economic welfare of all Americans—is inappropriate when it’s done outside Government control.  American businesses and Americans can’t be allowed to earn more than Government deems fit.  President Barack Obama (D) has held this before Sanders became a public fixture:

I mean, I do think at a certain point you’ve made enough money. But, you know, part of the American way is, you know, you can just keep on making it if you’re providing a good product or providing good service.

Of course, the Progressive-Democrat Obama considered it to be Government’s role to determine the goodness of that product or service, not the private citizens choosing to buy, not to buy, that product or service.

Sanders’ disdain for private insurers’ market projections and their goal to make as much profit as possible are easily extensible to the economy as a whole.  That Progressives in the Democratic Party are demanding a government option to “compete” with private enterprise in ObamaMart is a clear demonstration of where that Party will take our economy the moment they gain control of our government.

You can bet Progressive-Democrat and Democratic Party Presidential candidate Hillary Clinton soon will be echoing Sanders’ call for government control of our economy in her effort to retain Sanders’ supporters and to extend Obama’s policies.

This will be the Progressive Socialist economy.