“If you don’t find out what the old polices have done, it’s a prescription for bad policy going forward,” says Steffie Woolhandler, one of the Cambridge study authors. Woolhandler and her colleagues offered suggestions for improvement like increasing employer incentives to cover a greater portion of premium costs, reducing cost-sharing for low-wage workers, and making the enrollment process easier. William Woo, who was the editor of the St. Louis Post Dispatch, once told me there’s a master narrative the press follows. Examining the shortcomings of Massachusetts health reform doesn’t fit the master narrative—at least so far.
For more from Trudy Lieberman on the Massachusetts health reform law and its national implications, click here.
Trudy wrote: "...fragmentation still exists in a system built on employer-sponsored coverage".
padikiller responds: Of course it does.
Why shift the responsibility to paying insuring premiums to employers? I mean, aside from furthering the commie/liberal "wealth redistribution" agenda? Why is this a good health idea? Or a good financial idea? Or a good social policy?
Any system wherein the consumer does not pay for the product will become fragmented, inefficient, expensive and downright crappy.
When people paid their own doctor's bills out of their own pockets, there was no problem. Costs were reasonable and care was good. When health insurance rolled around (as a result of wartime interference with the free market) then things started getting worse.
When the government got into the health care equation through Medicare and Medicaid, then the system became a pure boondoggle. Medicare wastes many times more money in fraud and abuse than the combined profits of all of the health insurance companies.
When "somebody else" is paying the bill, who gives a crap about costs? What motivation does the consumer have to reduce costs? What motivation does a provider have to reduce costs? The system becomes corrupted - transformed from a free market system where costs are moderated by market forces into a system built to circumvent or exploit policies - a system wherein the providers game the loopholes and surf the regulations to squeeze as much money as they can from "somebody else" while providing services to consumers who don't give a rat's ass about costs.
The commie thing just doesn't work. As Margaret Thatcher said, the problem with socialism that socialists always run out of other people's money.
#1 Posted by padikiller, CJR on Wed 28 Sep 2011 at 06:38 PM
Furthermore...
Having "somebody else" pay the medical bill is inherently less efficient and more expensive than having consumers pay expenses directly. It's just another bureaucracy and another regulatory authority added into the mix to be paid for.
If I were able to craft an insurance law it would be this:
Every family would be entitled to purchase a family catastrophic insurance plan with a $10,000 family deductible. This plan would cover $10 million in lifetime benefits and would require insurers to pay every single penny of medically necessary treatment over the $10,000 deductible. Regulated insurers who want to do business in the state would have to offer high-risk policies under an assigned risk program. Low income families who can't afford the plan would qualify for subsidized premiums on a sliding scale (ultimately obviated by Medicaid for the truly indigent)
Such a plan would cost about $200-$300 per month (I have a similar plan and that's what it costs me).
After this... Do what you want.
You want to run the risk of bankruptcy without coverage? Go for it. You want Cadillac insurance to beat the $10,000 deductible? Buy it. Your employer offers such insurance? Take it if you want. Or don't. Whatever.
Worst case scenario for those insured in my proposed system - two family members get really sick and need expensive treatment - the family's covered. The most they will pay is $10,000 a year in the deductible plus another $3600 in premiums. $13,600 total.
In a good year where everyone is healthy, they'll pay the $3600 in premiums plus the cost of routine visits (for my family, under $1200 last year). Around $5000 total.
Compare that to what we have under Obamacare -where premiums on family plans just jumped NINE PERCENT to more that $15,000 on average! (so much for the commie/liberal "Obamacare will reduce premium costs by $2500 per year" lie).
My proposal would provide voluntary universal coverage that would be available to cover every single person who wants it, regardless of preexisting conditions, the maximum cost of this plan would be less than than the current average cost of more restrictive health plans and the average cost of my proposed plan would be less than half of the current cost of the average family plan.
The plan works by making consumers responsible for out-of-pocket expenses for routine treatment.
You implement a plan like this, and the system will fix itself immediately.
#2 Posted by padikiller, CJR on Wed 28 Sep 2011 at 07:14 PM
Interesting article. However, your conclusion that there are relatively few 'free riders' (6%) is based on a biased sample. Since the survey was done in the ER department of a safety net hospital, the individuals surveyed are likely low income and have health issues. If the same survey of the uninsured was done at a Patriot's game, I am sure the results would be significantly different, and likely skewed in the other direction.
#3 Posted by observer, CJR on Fri 30 Sep 2011 at 07:58 AM