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Wednesday, September 20, 2017

Let states run health insurance again

For more than 60 years, states regulated health insurance -- hospitalization -- and all was good. More than 90 percent of the populace was covered, and most who were not were either illegal aliens or they did not want health insurance.

In 2010, the federal government decided to take over. What a mess.



The healthiest people in the world -- young Americans in their 20s -- suddenly had to buy something they didn't need at prices inflated to subsidize older people who did need it. This was inter-generational theft.

The law was used to harass the Little Sisters of the Poor.

Instead of a big cut in premiums that Washington promised, the federal government's plan saw premiums soar.

They did not know economics. Increasing demand without increasing supply increases prices. Oh, they had babbled on about the economies of scale, as if there were no diseconomies of scale as well. Besides, that has to do with cost, not price.

Now Republican Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana have a plan to divest Washington of its takeover of health insurance.

Instead of a straight repeal of the enabling legislation -- Obamacare -- we get a retreat designed by Rube Goldberg.. A straight repeal would admit failure.

The key to this is the elimination of Medicaid expansion. For some reason, Congress would still pay for this by giving states the subsidies, just not requiring them to

Well, we know the reason. Money is power and Congress wants to retain the power over the states. The states will jump through congressional hoops -- likely constructed by unseen bureaucrats in the bowels of government.

The same concept that allows President Trump to withhold police money to sanctuary cities would apply to this.

Still, it is a half loaf.

***

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17 comments:

  1. I have been saying this for some time. The U.S. Constitution does not give the federal government authority to regulate healthcare or health insurance, except possibly across state lines (interstate commerce). Congress has totally screwed things up. The states are laboratories of democracy. If a state devises a good healthcare system the other states can choose to emulate it or not. Sooner or later better plans will emerge. With Congress it's one size fits all madness. Even the insurers know that's a mess, especially for them and their actuaries. - Elric

    ReplyDelete
    Replies
    1. I don't seem to hear of any health insurance companies going out of business over the past few years. They just stop covering people and areas.
      So, if the insurers see it as a mess, they finagle it to be a profitable mess.

      Delete
    2. If a state devises a good healthcare system the other states can choose to emulate it or not.

      Sorry Elric, but that's not how it works.

      States that use less dollars will not be emulated - rather, their budgets will be cut. That's the way government works. Use up your budget or lose it. States that are inefficient and therefore demand more dollars will have their reps politic for the additional monies.

      - Ken

      Delete
  2. Half a loaf of bread is better than no bread. And much, much better than hanging onto ObamaCare until the cries for single payer become impossible to ignore.

    -Mikey NTH

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  3. I know I'm preaching to the choir here, but...

    State governments do better by their people than the federal government.

    Local governments, unless you live in SF or College Park MD, do better by their people than state governments.

    My wife does better by me than local governments.

    Maybe a rethink of our entire structure is in order. Nah, fuck that. Let's stick with what we've got and repair some rotting wood. MAGA.

    ReplyDelete
  4. "The law was used to harass the Little Sisters of the Poor."

    Never mess with nuns. Just remember who they're the brides of.

    ReplyDelete
    Replies
    1. BOOM. I say again, BOOM. Dave, I award you honorary membership in the DubVee Lumber Company.

      Delete
  5. 1. The positive is that 3 states - California, NY, and Mass - get 37% of Obamacare dollars. Illegals being treated for free raises health costs for legals in the state to pay.

    Sharing the tax dollars fairly will prevent the abuses in states that harbor large amounts of illegals. Then again, it may simply get the illegals to leave those and move to other states.

    2. As Scott Adams pointed out today - it's a lot easier and cheaper to buy 50 state politicians and workers then it is to buy off a majority of 535 Federal reps and federal bureaucrats then their counterparts around state governments. So the question he asks is - where do the lobbyists stand on this proposal? Is it telling that we have not heard one "journalist" look into that and/or report on it.

    3. Milton Friedman famously once said - "If the government was in charge of the Sahara Desert, within 5 years there would be a shortage of sand".

    The reason health care costs - like college tuition - are out of control, is because of government involvement guaranteeing more dollars each year. There is no incentive to cut costs and improve the product, but rather to create more highly paid bureaucrats / administrators that add little if anything to the end product, and cutting quality to pay for them.

    So shuffling the palmed pea from supposedly being under one cup to being under another means the house still wins and the sucker paying still loses.

    There will remain no free market forces in delivering American health care.

    - Ken

    ReplyDelete
  6. "The reason health care costs - like college tuition - are out of control, is because of government involvement guaranteeing more dollars each year."

    No. Government involvement tends to increase the amount of money that is spent, but the reason why healthcare costs keep rising is because people are living longer and the cost of keeping them alive in order to satisfy their frequently unrealistic expectations keeps rising.

    ReplyDelete
    Replies
    1. Really?

      The medical field is run today with technology.

      In 1970 a mainframe computer cost $4.6 million. In 2007 a computer with similar power costs $550 - in inflated dollars.

      In speed, 1970 - 12.5 MHz vs. 1,600 MHz in 2007.

      Cost per MHz - 1970, $368,000 vs. $0.34 in 2007.

      Ten years after 2007, all computers are faster, more powerful, and cheaper still.

      Technology used to harvest raw materials for prescriptions and subsequently manufacturing them has come down radically in cost, as had the total cost of manufacturing the drugs.

      Yes, as Americans are living longer, it costs more to keep us alive. But ask any doctor that started practicing in the 1960's-70's about cost-contained advances in medicine today, and they'll tell you they almost cannot believe the advancements.

      The problem is government. I have doctor friends that retired or are about to. None of them can believe the government and insurance company interference, and the cost of malpractice insurance due to frivolous lawsuits. None can believe the amount of money insurance company reps, government reps and lawyers take out of their practice (far more then they make often working 50-70 hour weeks). It is the reason many retired 5-10 years early, even though they loved being doctors. And add to that the cost of the inept young doctors that cannot analyze patients problems correctly (there is a documented epidemic going on). Next time you visit a doctor that has been practicing for 30 or more years, ask them why costs are so out of control. And you also might ask why so many have voluntarily retired since Obamacare was passed......and why since it was passed life expectancy in the US has gone down.

      - Ken

      Delete
    2. I would guess you have never had major surgery. 30-40 years ago, how many people were having cataract surgery? How many were having knee or hip replacements? Today these are common procedures. A full knee replacement costs about $25 K for the operation and the post-op care.

      Delete
    3. 30-40 years ago Medicare was receiving nowhere close to the tax revenues people pay in today.

      - Ken

      Delete
  7. I have nothing against your proposal, but you already know what I think. Abolish licensing.

    One other thing. If the states were still running the senate this would have a better chance of becoming a viable solution. Repealing whatever amendment that made it a popular vote senate is in order. The popular vote thing basically put senate seats up for sale to the highest out of state pocketbook who wanted to spend the money.

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  9. It is a half a loaf, Don, and better than none.

    I have a small bone to pick on states running the health insurance show, however. We need competition across state lines and uniform rules to create and sustain a healthy competitive market. That will never happen with 50 state insurance commissioners.

    ReplyDelete
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