Category Archives: regulation

A Thought on Medicare for All

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University of Massachusetts-Amherst Economics Professor and Co-Director of the Political Economy Research Institute, Robert Pollin, had a thought on this.

Of course, so do I.

Pollin opened his tract with this:

All Americans would be able to get care from their chosen providers without having to pay premiums, deductibles or copayments.

No, we’ve already seen the lie in this. We experienced the broken, falsely presented promise with the sales job on Obamacare and the oft-repeated lie that if we liked our doctor, we could keep him and the associated lie of lower premiums.

Roughly 30 million people, 9% of the US population, are uninsured. Another 26%, 86 million people, are underinsured…

With millions of those Americans thrown off insurance plans they preferred because Obamacare made them illegal. This “economist” carefully elided that small fact.

We propose that all businesses that currently purchase health insurance for their employees be mandated to pay 92% of what they now spend into Medicare for All—saving 8% of their health-care expenditures.

Thereby throwing even more people off the plans they prefer.

This person also ignores another salient fact: the complete failure that is an existing single-payer plan, the VA.

And one more: even now, folks with surgical needs or prompt-but-expensive care needs or any other non-cookie cutter needs in other nations’ “free for all” health programs come here for those needs’ satisfaction rather than bear the interminable delays in getting that care in their nations’ programs.

Disruption

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And the widening gyre may be dissipating, finally.

Recall that a Federal judge in the 5th Appellate district ruled rump Obamacare unconstitutional because the tax imposed on not having health insurance was rescinded and the law had no severability clause—making the law itself an unconstitutional demand that private citizens buy something they did not want.

An outcome of this is feared by the NLMSM and Progressive-Democrats to be

particular disruption within the industry as no replacement system would be put in place.

It’s certainly true that there will be disruption—but no greater than the disruption from the imposition of Obamacare in the first place, which entailed the Federal government seizing control of the health care provision and health care coverage industries—a full sixth of our economy—and throwing millions of Americans off the health insurance plans they had and wanted to keep by making those plans illegal.

The disruption will be considerably less than the current plans of Progressive-Democratic Party Presidential candidates, whose aim is to make illegal all hints of private health insurance and to seize the rest of those two industries through “Medicare for all” plans, forcing Americans to participate in—and to pay for—yet more programs that they don’t want.

Indeed, both Obamacare and the current Progressive-Democrats’ plans have nothing to do with insurance, health or otherwise; they were and are nothing but Government mandated and privately funded—lately proposed taxpayer funded—welfare programs overlain like a new room on a settler’s prairie house on the existing ramshackle house of welfare programs.

The disruption will be short-lived, too.  The “no replacement system put in place” is only technically true: the Federal government isn’t mandating a particular system (whether by design or by Republican fecklessness).  The resulting newly unfettered health free market will very quickly fill that niche.  The freed-up industries will rapidly produce plans that fit the customers’ needs and wants for their personal health care and true health insurance plans.

The new insurance plans will be based off the plans extant prior to the Obamacare debacle, and then they’ll be tailored to current customer wishes rather than Government one-size-fits-all coverages.  No longer will Americans be required to pay for coverages they don’t need or don’t want, no longer will young and healthy Americans who don’t need or want coverage be required to pay for any sort of it, no longer will grown, adult human beings be treated like children barred from making their own risk-related decisions concerning their own health and the specific insurance coverages they want.

When the Bad Man Comes

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Forty-nine people were murdered in their house of worship in Christ Church, New Zealand last Friday. The thug

slaughtered worshipers at Al Noor [mosque] in a roughly two-minute rampage within that building. He then left for about two minutes before re-entering the building and firing on people on the ground for a further minute.

Left and came back.  Then he drove five miles across town to another mosque and started in again.

The butcher was active for thirty-six minutes before police arrived—that’s thirty-six minutes from the first call to the police, not from the start of the shooting.

When the bad man comes and seconds count, the police will be only minutes away.

Our Progressive-Democrats want to disarm us with their idiotic gun “control” laws.  New Zealand’s gun laws already require a citizen to satisfy the local police in order to get permission to bear any arm at all, and they want to tighten gun laws further.

The nature of this pseudo-logic is succinctly laid out by Rogério Mendonça of Brazil’s Chamber of Deputies, the lower house of the Brazilian Congress:

The logic of the left is always the same: if a crazy guy uses guns to kill people, the solution is to take guns away from people who have nothing to do with what happened[.]

This would be criminal were it not so self-evidently insane.

Mendonça then supplied the right answer:

Now imagine if a decent person had been armed at that school [referring to a Brazilian school attack in which eight children were murdered]. They could have stopped the attack from ending in the bloody way it did.

Just as is often done in the US; after all, the first responders are those already at the scene.  However, these successful defenses don’t get the publicity that mass killings in gun free zones get.

Medical Services Price Transparency

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Hospital and insurers want to keep their pricing agreements hidden from those who must pay those prices, especially those who must pay under the duress of huge costs and the immediacy of the need for medical services.

Hospitals and insurers are gearing up to battle a Trump administration plan that could require the public disclosure of negotiated prices for medical services, part of an effort to lower US health-care costs.

Because price transparency facilitates competition, which in a capitalist, free-market economy helps drive costs down.  But hospitals and insurers insist

such a move would force them to disclose prices that would be of little use to consumers, who just want to know what they need to pay out of their pockets, not the full price of the service.

It’s true enough we want that bottom line—so we can shop around—but we also want those intermediate prices so we can get an idea of the markups we’re being expected meekly to accept.

A transition to actual transparency also would be disruptive:

While hospitals fear new demands from insurers to lower prices, insurers could also face price pressures if hospitals that get lower reimbursements demand the higher rates their competitors have won. Also, insurers that have wrangled the steepest discounts may not want those rates exposed to competitors that would then be able to push for similar pricing.

That’s uncomfortable, but it’s also temporary.  After a remarkably short time (depending on how piece meal the transition would be vs ripping the band-aid off and being done with it vs something in between), prices would stabilize, consumers would be better off, and hospitals and insurers would be adapted to open competition.  Just like the rest of the economy—say home improvement or grocers—is.

Moreover, insurer contracts are complex and hospital systems typically have multiple contracts with each insurer, each with different terms.
“It’s going to be a big lift to actually make this happen,” said Niall Brennan, chief executive of the nonprofit Health Care Cost Institute, who said he applauds efforts to make health-care pricing more transparent. If it does move forward, “It’s going to put a lot of hospital CEOs and CFOs in the hot seat.”

That last is the crux of the matter.  Transparency will embarrass some folks.  Never mind that the embarrassment often would be unjustified, except in our current professional victim environment.  Those CEOs and CFOs, for the most part, were simply doing their jobs in getting the best prices for their companies—and doing their fiduciary duties to their shareholders.

Complexity, on the other hand, might be a valid beef. However, that’s a consideration related to how to implement price transparency; it has nothing at all to do with whether price transparency ought to be implemented.

Expanding Government for Freedom

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That’s the Progressive-Democrats’ Orwellian claim about their HR1 bill, just passed on party lines.  It’s for the children, too.  If it saves just one life….  Here is some of what’s in the bill:

Mandates a nationalized system to publicly finance federal elections. It would allocate federal money to match certain small-dollar donations 6-to-1 and deposit those funds in campaign accounts.

We already can designate, on our tax returns, a donation to a Federal fund for Presidential campaigns; the monies to be divided equally between the political parties.  That’s been a complete failure over the years, with the amounts designated falling, and private money going directly to the parties, candidates, PACs, etc, expanding. The Progressive-Democrats’ answer is to “correct” that by forcing us to donate to political campaigns in even larger amounts, whether we want to or not.

Requires several classes of politically active organizations, including tax-exempt 501(c)(4) groups, to disclose donors who have given $10,000 or more during an election cycle.

Because anonymity is as anathema to Progressive-Democrats as it is critical to free speech and to liberty generally.

Changes the membership of the Federal Election Commission to five members, with the president’s party in the majority, from its current six members, evenly split between Democratic and Republican appointees.

Because balancing the membership also is anathema to Progressive-Democrats: they desperately need a purely partisan facility for overseeing our elections.

Fortunately, Republicans still have a majority in the Senate.