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Employment Policies Institute:
Who are the Uninsured? An Analysis of America’s Uninsured Population, Their Characteristics and Their Health
This study attempts to increase knowledge in the field of health policy by examining some of the characteristics of those without health insurance. The authors calculate the percentage of uninsured Americans that could likely afford health coverage. Drs. June and David O’Neill of the Baruch College, City University of New York use data from a number of surveys to determine what percentage of the nearly 47 million uninsured Americans lack health insurance because they are likely unable to afford it—classifying them as “involuntarily” uninsured. They find that at least 43 percent of Americans in the 18–64 year-old age group have incomes at or above 2.5 times the poverty line, indicating they likely have the means to obtain healthcare coverage and thus may be classified as “voluntarily” uninsured.
Using data from the Health and Retirement Survey, the authors estimate differences in mortality rates for individuals based on whether they are privately insured, voluntarily uninsured, or involuntarily uninsured. Overall, they find that a lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured—particularly the involuntarily uninsured— have multiple disadvantages that are associated with poor health.
Who are the Uninsured? An Analysis of America’s Uninsured Population, Their Characteristics and Their Health
This study attempts to increase knowledge in the field of health policy by examining some of the characteristics of those without health insurance. The authors calculate the percentage of uninsured Americans that could likely afford health coverage. Drs. June and David O’Neill of the Baruch College, City University of New York use data from a number of surveys to determine what percentage of the nearly 47 million uninsured Americans lack health insurance because they are likely unable to afford it—classifying them as “involuntarily” uninsured. They find that at least 43 percent of Americans in the 18–64 year-old age group have incomes at or above 2.5 times the poverty line, indicating they likely have the means to obtain healthcare coverage and thus may be classified as “voluntarily” uninsured.
Using data from the Health and Retirement Survey, the authors estimate differences in mortality rates for individuals based on whether they are privately insured, voluntarily uninsured, or involuntarily uninsured. Overall, they find that a lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured—particularly the involuntarily uninsured— have multiple disadvantages that are associated with poor health.
The Heartland Institute:
Obama Health Plan: Rationing, Higher Taxes, and Lower Quality Care
by Peter Ferrara
This study will explain how the health policy changes President Obama and Congressional Democrats support would cause millions of Americans to lose their choice of doctors and insurance coverage, require that access to care be strictly rationed, and cause the quality of care to deteriorate. Despite all this sacrifice, nationalizing health insurance in America would require major tax increases, slow economic growth, and increase the national debt.
Obama Health Plan: Rationing, Higher Taxes, and Lower Quality Care
by Peter Ferrara
This study will explain how the health policy changes President Obama and Congressional Democrats support would cause millions of Americans to lose their choice of doctors and insurance coverage, require that access to care be strictly rationed, and cause the quality of care to deteriorate. Despite all this sacrifice, nationalizing health insurance in America would require major tax increases, slow economic growth, and increase the national debt.
Fannie Med? Why a "Public Option" Is Hazardous to Your Health
by Michael F. Cannon
President Obama and other leading Democrats have proposed creating a new government health insurance program as an option for Americans under the age of 65, within the context of a new, federally regulated market — typically described as a "National Health Insurance Exchange." Supporters claim that a new government program could deliver higher-quality health care at a lower cost than private insurance, and that competition from a government program would force private insurers to improve.
A full accounting shows that government programs cost more and deliver lower-quality care than private insurance. The central problem with proposals to create a new government program, however, is not that government is less efficient than private insurers, but that government can hide its inefficiencies and draw consumers away from private insurance, despite offering an inferior product.
by Michael F. Cannon
President Obama and other leading Democrats have proposed creating a new government health insurance program as an option for Americans under the age of 65, within the context of a new, federally regulated market — typically described as a "National Health Insurance Exchange." Supporters claim that a new government program could deliver higher-quality health care at a lower cost than private insurance, and that competition from a government program would force private insurers to improve.
A full accounting shows that government programs cost more and deliver lower-quality care than private insurance. The central problem with proposals to create a new government program, however, is not that government is less efficient than private insurers, but that government can hide its inefficiencies and draw consumers away from private insurance, despite offering an inferior product.
Fannie Med? Why a "Public Option" Is Hazardous to Your Health
by Michael F. Cannon
As it turns out, "universal coverage" may not be so inevitable after all. Much to the chagrin (and apparent surprise) of President Obama and congressional Democrats, squabbling has erupted in earnest over who will spring for the exorbitant cost.
Fortunately, Obama has an exit strategy: "If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way."
Well, there is a way: Let individuals control their health care dollars, and free them to choose from a wide variety of health plans and providers. If Congress takes those steps, innovation and market competition will make health care better, more affordable and more secure.
by Michael F. Cannon
As it turns out, "universal coverage" may not be so inevitable after all. Much to the chagrin (and apparent surprise) of President Obama and congressional Democrats, squabbling has erupted in earnest over who will spring for the exorbitant cost.
Fortunately, Obama has an exit strategy: "If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way."
Well, there is a way: Let individuals control their health care dollars, and free them to choose from a wide variety of health plans and providers. If Congress takes those steps, innovation and market competition will make health care better, more affordable and more secure.
Avoiding Health-Care Chaos
by Michael F. Cannon
To hear the media tell it, comprehensive health care reform is a done deal. Democrats control both ends of Pennsylvania Avenue. Business, labor and the insurance industry are on board. The lion has lain down with the lamb.
In reality, reform could crater for the same reasons it did in 1994: The leading Democratic plans include radical changes that would tax and disrupt the health care of millions. With a minimum price tag of $120 billion, universal health insurance coverage will require taxing the middle class during a recession, further expanding a $1 trillion deficit, or having the government deny medical care to patients. An estimated 30 million Americans would lose their current coverage under Barack Obama's plan. Millions could lose established relationships with their doctors.
by Michael F. Cannon
To hear the media tell it, comprehensive health care reform is a done deal. Democrats control both ends of Pennsylvania Avenue. Business, labor and the insurance industry are on board. The lion has lain down with the lamb.
In reality, reform could crater for the same reasons it did in 1994: The leading Democratic plans include radical changes that would tax and disrupt the health care of millions. With a minimum price tag of $120 billion, universal health insurance coverage will require taxing the middle class during a recession, further expanding a $1 trillion deficit, or having the government deny medical care to patients. An estimated 30 million Americans would lose their current coverage under Barack Obama's plan. Millions could lose established relationships with their doctors.
Obamacare to Come: Seven Bad Ideas for Health Care Reform
by Michael D. Tanner
President Obama has made it clear that reforming the American health care system will be one of his top priorities. In response, congressional leaders have promised to introduce legislation by this summer, and they hope for an initial vote in the Senate before the Labor Day recess.
While the Obama administration has not, and does not seem likely to, put forward a specific reform plan, it is possible to discern the key components of any plan likely to emerge from Congress:
* At a time of rising unemployment, the government would raise the cost of hiring workers by requiring employers to provide health insurance to their workers or pay a fee (tax) to subsidize government coverage.
* Every American would be required to buy an insurance policy that meets certain government requirements. Even individuals who are currently insured — and happy with their insurance — will have to switch to insurance that meets the government's definition of "acceptable insurance."
* A government-run plan similar to Medicare would be set up in competition with private insurance, with people able to choose either private insurance or the taxpayer-subsidized public plan. Subsidies and cost-shifting would encourage Americans to shift to the government plan.
* The government would undertake comparative-effectiveness research and cost-effectiveness research, and use the results of that research to impose practice guidelines on providers — initially, in government programs such as Medicare and Medicaid, but possibly eventually extending such rationing to private insurance plans.
* Private insurance would face a host of new regulations, including a requirement to insure all applicants and a prohibition on pricing premiums on the basis of risk.
* Subsidies would be available to help middle-income people purchase insurance, while government programs such as Medicare and Medicaid would be expanded.
* Finally, the government would subsidize and manage the development of a national system of electronic medical records.
Taken individually, each of these proposals would be a bad idea. Taken collectively, they would dramatically transform the American health care system in a way that would harm taxpayers, health care providers, and — most importantly — the quality and range of care given to patients.
by Michael D. Tanner
President Obama has made it clear that reforming the American health care system will be one of his top priorities. In response, congressional leaders have promised to introduce legislation by this summer, and they hope for an initial vote in the Senate before the Labor Day recess.
While the Obama administration has not, and does not seem likely to, put forward a specific reform plan, it is possible to discern the key components of any plan likely to emerge from Congress:
* At a time of rising unemployment, the government would raise the cost of hiring workers by requiring employers to provide health insurance to their workers or pay a fee (tax) to subsidize government coverage.
* Every American would be required to buy an insurance policy that meets certain government requirements. Even individuals who are currently insured — and happy with their insurance — will have to switch to insurance that meets the government's definition of "acceptable insurance."
* A government-run plan similar to Medicare would be set up in competition with private insurance, with people able to choose either private insurance or the taxpayer-subsidized public plan. Subsidies and cost-shifting would encourage Americans to shift to the government plan.
* The government would undertake comparative-effectiveness research and cost-effectiveness research, and use the results of that research to impose practice guidelines on providers — initially, in government programs such as Medicare and Medicaid, but possibly eventually extending such rationing to private insurance plans.
* Private insurance would face a host of new regulations, including a requirement to insure all applicants and a prohibition on pricing premiums on the basis of risk.
* Subsidies would be available to help middle-income people purchase insurance, while government programs such as Medicare and Medicaid would be expanded.
* Finally, the government would subsidize and manage the development of a national system of electronic medical records.
Taken individually, each of these proposals would be a bad idea. Taken collectively, they would dramatically transform the American health care system in a way that would harm taxpayers, health care providers, and — most importantly — the quality and range of care given to patients.
The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World
by Michael D. Tanner
Critics of the U.S. health care system frequently point to other countries as models for reform. They point out that many countries spend far less on health care than the United States yet seem to enjoy better health outcomes. The United States should follow the lead of those countries, the critics say, and adopt a government- run, national health care system.
However, a closer look shows that nearly all health care systems worldwide are wrestling with problems of rising costs and lack of access to care. There is no single international model for national health care, of course. Countries vary dramatically in the degree of central control, regulation, and cost sharing they impose, and in the role of private insurance. Still, overall trends from national health care systems around the world suggest the following:
* Health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have long waiting lists for treatment.
* Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the United States on health care, both as a percentage of GDP and per capita, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
* In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
* Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control.
Although no country with a national health care system is contemplating abandoning universal coverage, the broad and growing trend is to move away from centralized government control and to introduce more market-oriented features.
The answer then to America’s health care problems lies not in heading down the road to national health care but in learning from the experiences of other countries, which demonstrate the failure of centralized command and control and the benefits of increasing consumer incentives and choice.
by Michael D. Tanner
Critics of the U.S. health care system frequently point to other countries as models for reform. They point out that many countries spend far less on health care than the United States yet seem to enjoy better health outcomes. The United States should follow the lead of those countries, the critics say, and adopt a government- run, national health care system.
However, a closer look shows that nearly all health care systems worldwide are wrestling with problems of rising costs and lack of access to care. There is no single international model for national health care, of course. Countries vary dramatically in the degree of central control, regulation, and cost sharing they impose, and in the role of private insurance. Still, overall trends from national health care systems around the world suggest the following:
* Health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have long waiting lists for treatment.
* Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the United States on health care, both as a percentage of GDP and per capita, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
* In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
* Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control.
Although no country with a national health care system is contemplating abandoning universal coverage, the broad and growing trend is to move away from centralized government control and to introduce more market-oriented features.
The answer then to America’s health care problems lies not in heading down the road to national health care but in learning from the experiences of other countries, which demonstrate the failure of centralized command and control and the benefits of increasing consumer incentives and choice.
Down with the health insurers
By Timothy P. Carney
August 14, 2009
Dear conservatives: Health insurance companies are not your friends. Keep opposing a new government-run insurer, a single-payer plan, and new regulations on the HMOs. But grant that Speaker of the House Nancy Pelosi is correct on this: Insurance companies are villains.
Insurance companies lobby for big-government regulations, subsidies, mandates, and tax-code distortions that funnel them money, keep out competition, and stultify innovation. These policies preserve the employer-based health-care system that mocks the idea of free-market competition. Then they cry "unfair competition" when government threatens to encroach on their government-protected monopolies.
But they're not just lobbying against a government option. Today, health insurers are lobbying to force you and me to buy their product or face a tax hike (the individual mandate).
By Timothy P. Carney
August 14, 2009
Dear conservatives: Health insurance companies are not your friends. Keep opposing a new government-run insurer, a single-payer plan, and new regulations on the HMOs. But grant that Speaker of the House Nancy Pelosi is correct on this: Insurance companies are villains.
Insurance companies lobby for big-government regulations, subsidies, mandates, and tax-code distortions that funnel them money, keep out competition, and stultify innovation. These policies preserve the employer-based health-care system that mocks the idea of free-market competition. Then they cry "unfair competition" when government threatens to encroach on their government-protected monopolies.
But they're not just lobbying against a government option. Today, health insurers are lobbying to force you and me to buy their product or face a tax hike (the individual mandate).
Health-Reform Malpractice
by Michael D. Tanner
With unemployment rapidly approaching 10 percent, one would think it would be a priority for Congress to make it easier for businesses to hire workers. But the health-care bill unveiled by House Democrats on Tuesday goes in exactly the opposite direction, actually making it more expensive to hire workers.
The bill would require all but the very smallest businesses to provide health insurance to their workers. Employers would have to pay 72.5 percent of the premium for individual coverage and 65 percent for family coverage. Those businesses that don't comply would be assessed a penalty or tax equal to 8 percent of their payroll.
Such a mandate is simply a disguised tax on employment. And while it might be politically appealing to claim that business will bear the new tax burden, nearly all economists see it quite differently.
by Michael D. Tanner
With unemployment rapidly approaching 10 percent, one would think it would be a priority for Congress to make it easier for businesses to hire workers. But the health-care bill unveiled by House Democrats on Tuesday goes in exactly the opposite direction, actually making it more expensive to hire workers.
The bill would require all but the very smallest businesses to provide health insurance to their workers. Employers would have to pay 72.5 percent of the premium for individual coverage and 65 percent for family coverage. Those businesses that don't comply would be assessed a penalty or tax equal to 8 percent of their payroll.
Such a mandate is simply a disguised tax on employment. And while it might be politically appealing to claim that business will bear the new tax burden, nearly all economists see it quite differently.
Obama Kills Health Competition
by Michael D. Tanner
President Obama has repeatedly said that one of his "reform" goals is to increase "competition and choice" in the US health-care system -- but the policies he's pursuing would actually reduce competition and give consumers fewer choices. Meanwhile, he's ignoring reforms that would bring more choices and competition.
The nation now has some 1,300 insurance companies, but most consumers actually have far fewer choices. An American Medical Association survey found that in 299 of 313 largest metro areas, one insurer controls at least 30 percent of the market.
In New York, just two insurers, GHI and Empire Blue Cross, represent 47 percent of the market. In New Jersey, a single insurer, Horizon Blue Cross and Blue Shield, controls 43 percent of the market. And in Connecticut, Wellpoint holds an astounding 55 percent.
There's nothing inherently wrong with one company earning a large market share, but the lack of significant competition helps contribute to higher insurance costs and poorer service. Moreover, this market concentration hasn't necessarily flowed from consumer preference in a free market, but results in good part from barriers to entry erected by state insurance regulation.
Obama's answer to this problem is to set up a new government-run insurance plan to compete with private insurers. But such a plan will ultimately result in less competition, not more.
by Michael D. Tanner
President Obama has repeatedly said that one of his "reform" goals is to increase "competition and choice" in the US health-care system -- but the policies he's pursuing would actually reduce competition and give consumers fewer choices. Meanwhile, he's ignoring reforms that would bring more choices and competition.
The nation now has some 1,300 insurance companies, but most consumers actually have far fewer choices. An American Medical Association survey found that in 299 of 313 largest metro areas, one insurer controls at least 30 percent of the market.
In New York, just two insurers, GHI and Empire Blue Cross, represent 47 percent of the market. In New Jersey, a single insurer, Horizon Blue Cross and Blue Shield, controls 43 percent of the market. And in Connecticut, Wellpoint holds an astounding 55 percent.
There's nothing inherently wrong with one company earning a large market share, but the lack of significant competition helps contribute to higher insurance costs and poorer service. Moreover, this market concentration hasn't necessarily flowed from consumer preference in a free market, but results in good part from barriers to entry erected by state insurance regulation.
Obama's answer to this problem is to set up a new government-run insurance plan to compete with private insurers. But such a plan will ultimately result in less competition, not more.
Senate Deal: Change a Few Names
by Michael D. Tanner
The "compromise" health-care reform being negotiated by six members of the Senate Finance Committee is shaping up as a classic warning of the dangers of bipartisanship without principles: It looks like they'll keep the worst features of other ObamaCare bills — but simply change the names.
Finance Committee Chairman Max Baucus (D-Mont.) and Sens. Kent Conrad (D-ND), Jeff Bingaman (D-NM) Charles Grassley (R-Iowa), Olympia Snowe (R-Me.) and Mike Enzi (R-Wyo.) are reportedly putting the final touches on a bill that may save President Obama's chances for passing health-care reform this year.
The proposed bill is forthright on still containing many of the worst aspects of ObamaCare. It would mandate that all Americans buy insurance — and not just any insurance, but a specific government-designed set of benefits, even if that package was more expensive or contained benefits that you didn't want.
It would impose costly new regulations on insurance that could drive up premiums, especially for younger and healthier Americans. It would set the stage for government interference in how doctors practice medicine. It would extend subsidies for health care well into the middle-class, making millions more Americans dependent on government. And it would pay for all this with huge tax increases on American workers and businesses.
by Michael D. Tanner
The "compromise" health-care reform being negotiated by six members of the Senate Finance Committee is shaping up as a classic warning of the dangers of bipartisanship without principles: It looks like they'll keep the worst features of other ObamaCare bills — but simply change the names.
Finance Committee Chairman Max Baucus (D-Mont.) and Sens. Kent Conrad (D-ND), Jeff Bingaman (D-NM) Charles Grassley (R-Iowa), Olympia Snowe (R-Me.) and Mike Enzi (R-Wyo.) are reportedly putting the final touches on a bill that may save President Obama's chances for passing health-care reform this year.
The proposed bill is forthright on still containing many of the worst aspects of ObamaCare. It would mandate that all Americans buy insurance — and not just any insurance, but a specific government-designed set of benefits, even if that package was more expensive or contained benefits that you didn't want.
It would impose costly new regulations on insurance that could drive up premiums, especially for younger and healthier Americans. It would set the stage for government interference in how doctors practice medicine. It would extend subsidies for health care well into the middle-class, making millions more Americans dependent on government. And it would pay for all this with huge tax increases on American workers and businesses.
Not Enough Healthcare to Go Around
by Michael D. Tanner
Some say Americans use too much healthcare, that even if reform is achieved, universal access should not mean unlimited access
Tough choices must be made.
Others worry that the most needy or least able to fight for themselves will be left waiting.
Should healthcare be rationed?
No one can fail to be moved by heartbreaking stories of people suffering and unable to get healthcare they want or need. But compassion is a sentiment, not a policy.
Healthcare is a commodity — and a finite one at that.
We tend to talk about healthcare in the philosophically abstract. "Is healthcare a right or a privilege?" goes the refrain. In reality, it is neither.
Healthcare is a commodity — and a finite one at that.
There are only so many doctors, hospitals, and, most important, money to go around. After all, every dollar spent on healthcare is one not spent on education, infrastructure, or defense.
by Michael D. Tanner
Some say Americans use too much healthcare, that even if reform is achieved, universal access should not mean unlimited access
Tough choices must be made.
Others worry that the most needy or least able to fight for themselves will be left waiting.
Should healthcare be rationed?
No one can fail to be moved by heartbreaking stories of people suffering and unable to get healthcare they want or need. But compassion is a sentiment, not a policy.
Healthcare is a commodity — and a finite one at that.
We tend to talk about healthcare in the philosophically abstract. "Is healthcare a right or a privilege?" goes the refrain. In reality, it is neither.
Healthcare is a commodity — and a finite one at that.
There are only so many doctors, hospitals, and, most important, money to go around. After all, every dollar spent on healthcare is one not spent on education, infrastructure, or defense.
Bad Reform Is Worse Than No Reform
by Michael D. Tanner
President Obama came to Cleveland yesterday to sell his health care reform plan. As usual, he was deeply eloquent in describing the problems facing the American health care system and the need for reform. But the actual reform proposal that he is pushing is a deeply flawed product that even the best salesman can't disguise.
If one totals up all the new taxes in the House Democratic health reform bill–the income tax surtax, the penalties on businesses that fail to provide and individuals who fail to buy the governments prescribed health care plan, as well as other frees and taxes–the cost to American taxpayers will top $800 billion. On top of that, studies suggest that the plan could increase insurance premiums by 75-95 percent.
Combined with President Obama's plan to allow President Bush's tax cuts to expire and state taxes, Ohio residents would face a top marginal tax rate of 51.2 percent. That's a big price tag for a health care plan that will likely lead to Americans receiving less and lower quality health care.
by Michael D. Tanner
President Obama came to Cleveland yesterday to sell his health care reform plan. As usual, he was deeply eloquent in describing the problems facing the American health care system and the need for reform. But the actual reform proposal that he is pushing is a deeply flawed product that even the best salesman can't disguise.
If one totals up all the new taxes in the House Democratic health reform bill–the income tax surtax, the penalties on businesses that fail to provide and individuals who fail to buy the governments prescribed health care plan, as well as other frees and taxes–the cost to American taxpayers will top $800 billion. On top of that, studies suggest that the plan could increase insurance premiums by 75-95 percent.
Combined with President Obama's plan to allow President Bush's tax cuts to expire and state taxes, Ohio residents would face a top marginal tax rate of 51.2 percent. That's a big price tag for a health care plan that will likely lead to Americans receiving less and lower quality health care.
Perils of Obamacare: The Three Big Lies
by Michael D. Tanner
In making his case for a government takeover of the US health-care system, President Obama is going far beyond the usual Washington truth-stretching.
Take a look at just a few of the most common claims:
"If you like your current health-care plan, you can keep it." Even White House spokesmen have said that Obama's oft-repeated pledge that you can keep your current insurance isn't meant to be taken literally. The reality is that millions of Americans — perhaps most Americans — will be forced to change insurance plans.
. . .
"You will pay less." The Congressional Budget Office has made it clear that the reform plans now being debated will increase overall health-care costs, yet President Obama on Friday repeatedly said that his reform would reduce costs and save Americans money.
. . .
"Quality will improve." Anyone who thinks a government takeover of the health-care system will improve quality of care has only to look at the health-care programs the government already runs: The Veterans Administration is overwhelmed with problems, Medicaid is notorious for providing poor quality at a high cost — and Medicare has huge gaps in coverage.
by Michael D. Tanner
In making his case for a government takeover of the US health-care system, President Obama is going far beyond the usual Washington truth-stretching.
Take a look at just a few of the most common claims:
"If you like your current health-care plan, you can keep it." Even White House spokesmen have said that Obama's oft-repeated pledge that you can keep your current insurance isn't meant to be taken literally. The reality is that millions of Americans — perhaps most Americans — will be forced to change insurance plans.
. . .
"You will pay less." The Congressional Budget Office has made it clear that the reform plans now being debated will increase overall health-care costs, yet President Obama on Friday repeatedly said that his reform would reduce costs and save Americans money.
. . .
"Quality will improve." Anyone who thinks a government takeover of the health-care system will improve quality of care has only to look at the health-care programs the government already runs: The Veterans Administration is overwhelmed with problems, Medicaid is notorious for providing poor quality at a high cost — and Medicare has huge gaps in coverage.
Massachusetts Miracle or Massachusetts Miserable: What the Failure of the "Massachusetts Model" Tells Us about Health Care Reform
by Michael D. Tanner
When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true:
Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.
Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average.
New regulations and bureaucracy are limiting consumer choice and adding to health care costs.
Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending—with its attendant rationing.
A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.
With the "Massachusetts model" frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
by Michael D. Tanner
When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true:
Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.
Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average.
New regulations and bureaucracy are limiting consumer choice and adding to health care costs.
Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending—with its attendant rationing.
A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.
With the "Massachusetts model" frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
Obama's Senior Moment
Wall Street Journal
Why the elderly are right to worry when the government rations medical care
Elderly Americans are turning out in droves to fight ObamaCare, and President Obama is arguing back that they have nothing to worry about. Allow us to referee. While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.
***
Far from being a scare tactic, this is a logical conclusion based on experience and common-sense. Once health care is a "free good" that government pays for, demand will soar and government costs will soar too. When the public finally reaches its taxing limit, something will have to give on the care and spending side. In a word, care will be rationed by politics.
Mr. Obama's reply is that private insurance companies already ration, by deciding which treatments are covered and which aren't. However, there's an ocean of difference between coverage decisions made under millions of voluntary private contracts and rationing via government. An Atlantic Ocean, in fact. Virtually every European government with "universal" health care restricts access in one way or another to control costs, and it isn't pretty.
Wall Street Journal
Why the elderly are right to worry when the government rations medical care
Elderly Americans are turning out in droves to fight ObamaCare, and President Obama is arguing back that they have nothing to worry about. Allow us to referee. While claims about euthanasia and "death panels" are over the top, senior fears have exposed a fundamental truth about what Mr. Obama is proposing: Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted.
***
Far from being a scare tactic, this is a logical conclusion based on experience and common-sense. Once health care is a "free good" that government pays for, demand will soar and government costs will soar too. When the public finally reaches its taxing limit, something will have to give on the care and spending side. In a word, care will be rationed by politics.
Mr. Obama's reply is that private insurance companies already ration, by deciding which treatments are covered and which aren't. However, there's an ocean of difference between coverage decisions made under millions of voluntary private contracts and rationing via government. An Atlantic Ocean, in fact. Virtually every European government with "universal" health care restricts access in one way or another to control costs, and it isn't pretty.
Health Insurance
Mandates in the States 2009
Victoria Craig Bunce, Director of Research and Policy
JP Wieske, Director of State Affairs
A State-by-State Breakdown of
Health Insurance Mandates and Their Costs
A health insurance “mandate” is a requirement that an insurance company or health plan cover (or offer coverage for) common— but sometimes not so common — health care providers, benefits and patient populations. They include:
• Providers such as chiropractors and podiatrists, but also social workers and massage therapists;
• Benefits such as mammograms, well-child care and even drug and alcohol abuse treatment, but also acupuncture and hair prostheses (wigs); and,
• Populations such as adopted and non-custodial children.
For almost every health care product or service, there is someone who wants insurance to cover it so that those who sell theproducts and services get more business and those who use the products and services don’t have to pay out of pocket forthem.
The Impact of Mandates. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets. We estimate that mandated benefits currently increase the cost of basic health coverage from a little less than 20% to perhaps 50%, depending on the number of mandates, the benefit design and the cost of the initial premium. Mandating benefits is like saying to someone in the market for a new car, if you can’t afford a Cadillac loaded with options, you have to walk. Having that Cadillac would be nice, as would having a health insurance policy that covers everything one might want. But drivers with less money can find many other affordable car options; whereas when the price of health insurance soars, few other options exist.
Why Is the Number of Mandates Growing? Elected representatives find it difficult to oppose any legislation that promises
enhanced care to potentially motivated voters. The sponsors of mandates know this fact of political life. As a result, government interference in and control of the health care system is steadily increasing. So too is the cost of health insurance.
By the late 1960s, state legislatures had passed only a handful of mandated benefits; today, the Council for Affordable HealthInsurance (CAHI) has identified 2,133 mandated benefits and providers. And more are on their way.
How do state legislators justify their actions? One way is to deny a mandate is a mandate. For example, legislators may claim that requiring health insurance to cover a type of provider — such as a chiropractor, podiatrist, midwife or naturopath — is not a mandate because they aren’t requiring insurance to pay for a particular therapy. But that’s a distinction without a difference; if insurance is required to cover the provider, it must pay for the service provided. (read more)
Mandates in the States 2009
Victoria Craig Bunce, Director of Research and Policy
JP Wieske, Director of State Affairs
A State-by-State Breakdown of
Health Insurance Mandates and Their Costs
A health insurance “mandate” is a requirement that an insurance company or health plan cover (or offer coverage for) common— but sometimes not so common — health care providers, benefits and patient populations. They include:
• Providers such as chiropractors and podiatrists, but also social workers and massage therapists;
• Benefits such as mammograms, well-child care and even drug and alcohol abuse treatment, but also acupuncture and hair prostheses (wigs); and,
• Populations such as adopted and non-custodial children.
For almost every health care product or service, there is someone who wants insurance to cover it so that those who sell theproducts and services get more business and those who use the products and services don’t have to pay out of pocket forthem.
The Impact of Mandates. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets. We estimate that mandated benefits currently increase the cost of basic health coverage from a little less than 20% to perhaps 50%, depending on the number of mandates, the benefit design and the cost of the initial premium. Mandating benefits is like saying to someone in the market for a new car, if you can’t afford a Cadillac loaded with options, you have to walk. Having that Cadillac would be nice, as would having a health insurance policy that covers everything one might want. But drivers with less money can find many other affordable car options; whereas when the price of health insurance soars, few other options exist.
Why Is the Number of Mandates Growing? Elected representatives find it difficult to oppose any legislation that promises
enhanced care to potentially motivated voters. The sponsors of mandates know this fact of political life. As a result, government interference in and control of the health care system is steadily increasing. So too is the cost of health insurance.
By the late 1960s, state legislatures had passed only a handful of mandated benefits; today, the Council for Affordable HealthInsurance (CAHI) has identified 2,133 mandated benefits and providers. And more are on their way.
How do state legislators justify their actions? One way is to deny a mandate is a mandate. For example, legislators may claim that requiring health insurance to cover a type of provider — such as a chiropractor, podiatrist, midwife or naturopath — is not a mandate because they aren’t requiring insurance to pay for a particular therapy. But that’s a distinction without a difference; if insurance is required to cover the provider, it must pay for the service provided. (read more)
Cato Policy Report, September/October 2007
Hazards of the Individual Health Care Mandate
By Glen Whitman
Glen Whitman is associate professor of economics at California State University, Northridge.
The latest fad in health care reform is the "individual mandate" — a law that requires individuals to purchase health insurance and threatens punishment for those who don't. Massachusetts, under the governorship of presidential hopeful Mitt Romney, has already created a health care policy with an individual mandate as its centerpiece. Gov. Arnold Schwarzenegger has proposed a similar plan for California. And politicians are not alone, as analysts from across the political spectrum have jumped on board. Even analysts who usually favor markets over regulation — like economist Gary Becker, legal scholar Richard Posner, Ron Bailey of Reason magazine, and Robert Moffit of the Heritage Foundation — have voiced support for the individual mandate.
Their support, however, is unjustified. The individual mandate will do little, if anything, to solve the problem of "free riders" whose health expenses are paid for by the rest of us. The mandate will do nothing to decrease the actual cost of health services. Worst of all, the mandate will create a set of political incentives that will likely drive up the cost of health insurance while impeding the adoption of more effective reforms. (read more)
Hazards of the Individual Health Care Mandate
By Glen Whitman
Glen Whitman is associate professor of economics at California State University, Northridge.
The latest fad in health care reform is the "individual mandate" — a law that requires individuals to purchase health insurance and threatens punishment for those who don't. Massachusetts, under the governorship of presidential hopeful Mitt Romney, has already created a health care policy with an individual mandate as its centerpiece. Gov. Arnold Schwarzenegger has proposed a similar plan for California. And politicians are not alone, as analysts from across the political spectrum have jumped on board. Even analysts who usually favor markets over regulation — like economist Gary Becker, legal scholar Richard Posner, Ron Bailey of Reason magazine, and Robert Moffit of the Heritage Foundation — have voiced support for the individual mandate.
Their support, however, is unjustified. The individual mandate will do little, if anything, to solve the problem of "free riders" whose health expenses are paid for by the rest of us. The mandate will do nothing to decrease the actual cost of health services. Worst of all, the mandate will create a set of political incentives that will likely drive up the cost of health insurance while impeding the adoption of more effective reforms. (read more)
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