Right Wing Nut House



Filed under: Government, National Health Insurance, Politics — Rick Moran @ 1:47 pm

The state health insurance plan passed by Massachusetts back in 2006 was supposed to be a model for the rest of the country. It was touted at the time as a solution to both covering the uninsured and improving services.

Spare us, please.

This editorial in the Examiner shows the nightmare that mandated health insurance systems can be, fulfilling all the dire predictions ever said about them:

To much fanfare from both right and left in 2006, Massachusetts became the first state in the nation to require all residents to buy health insurance. A new state health insurance clearinghouse was created, with taxpayers subsidizing those who couldn’t afford to buy coverage. Then Gov. Mitt Romney, a Republican, promised that “every uninsured citizen in Massachusetts will soon have affordable health insurance.” Yet just two years later, Romney’s much-heralded “solution” - touted by many as the model for a national program - has become an embarrassing flop.Just a year after the universal coverage law passed, The New York Times reported, state insurers were already jacking up rates to twice the national average. According to Dr. Paul Hsieh, a physician and founding member of Freedom and Individual Rights in Medicine, 43 mandatory benefits - including those that many people did not want or need, such as invitro fertilization - raised the costs of coverage for  Massachusetts residents by as much as 56 percent, depending upon an individual’s income status. So much for “affordable” health care.

Small businesses with more than 10 employees were required to provide health insurance or pay an extra fee to subsidize uninsured low-income residents, yet the overall costs of the program increased more than $400 million - 85 percent higher than original projections. To make up the difference, payments to health care providers were slashed, so many doctors and dentists in Massachusetts began refusing to take on new patients. In the state with the highest physician/patient ratio in the nation, some people now have to wait more than a year for a simple physical exam.

The irony is that Massachusetts officials reluctantly admitted that, despite increased enrollment, the state is still far from universal coverage - the original goal of the landmark law. To make matters worse, Massachusetts is grappling with a multibillion-dollar deficit while Democratic Gov. Deval Patrick desperately tries to slow down those still-spiraling health care costs, which he said last week were “not sustainable.”

If this sounds just like Canadian-style socialized medicine, that’s because it is. Massachusetts residents now pay more for less access to health care, yet their state still has an uninsured problem!

Imagine this boondoggle tried on the rest of the country. When even a liberal Democratic governor says the increases in costs to the state or “not sustainable” you can imagine the nightmare of an Obama plan.

Most of the plans circulating on Capitol Hill require mandated participation in the system - that is, the government will force you to buy health insurance whether you want to or not. The Democrats swear that this will result in lower insurance premiums and better coverage but how is that possible? Unless the government takes enforcement seriously - which means employing the IRS as collection agent for healt insurance premiums - the chances that millions will still be uninsured regardless of any mandate are pretty good.

You also place doctors and hospitals in the position of being agents of the IRS as any citizen seeking health care who is not insured will have to be reported and forced to purchase the government plan or some private plan. Already buried in forms, you can imagine how much doctors and clinics are going to love that.

Eventually, of course, such a system will require the rationing of health care and price controls - a big step toward a complete government takeover of the health care system. The Democrats will swear until they are blue in the face that this will never happen. But one look at what is going on in Massachusetts will convince anyone that the Democrats plan to nationalize health insurance will only lead to skyrocketing costs and a loss of choice by health care consumers.


  1. Even an imbecile can see this is a bad idea. Hopefully, one day, Democrats can become as smart as imbeciles.

    Republicans are almost there already.

    Comment by Two Dogs — 1/11/2009 @ 2:06 pm

  2. The choice argument is a curious one.

    The typical example is of the young person choosing not to pay for health insurance. They’re early in their careers so they lack the money to purchase health insurance and tend to be healthy so they don’t need it. Sounds reasonable until an uninsured 20-something needs major health care.

    In the state I’m in (I assume it’s typical) they can’t be refused emergency treatment in a hospital. You complain that universal health care forces the medical profession to work for the IRS. In this case, they get to be a collection agency. Problem is, there’s legal limits on collections, again in my state, and, as a practical matter, I understand from a friend who used to work for a medical billing subcontractor these costs are often absorbed by the hospital. Which is to say, it’s passed onto insured folks like myself.

    People not in my state may not be so lucky regarding collections. We’ve all heard the horror stories of folks losing their houses and driven into bankruptcy by medical bill collectors. I personally know a man who, despite being protected under the law, became mired in debt giving into medical bill collectors hounding him for tens of thousands of dollars in claims - he was ignorant of his legal rights.

    When complaining about the “skyrocketing” costs in Massachusetts you pretend the current system isn’t suffering from serious medical inflation. Why not ask the question if it’s worse in Massachusetts is it fixable?

    Reading the Examiner editorial, one problem appears to be the Massachusetts plan includes unnecessary treatments. Perhaps part of the fix is to offer through private insurers a ‘cafeteria’ range of plans so low-income and young people can opt into a minimal catastrophic plan.

    Ideally, all people from the elderly under Medicare to young people in perfect health just joining the work force would be covered in a universal plan. As a practical matter, I’m not sure we get there because the real issue is that health care in America is insanely expensive regardless the approach we take.

    Which leaves us with the ‘choice’ of the status quo where millions are uninsured, a number that’s likely to grow over time, and most of the rest pray their employers keep eating the high rate of medical inflation or offer health insurance at all OR we dramatically raise taxes to cover subsidies for the millions who can’t afford premiums under any system.

    This week I heard that the quality of health care in America for those who are insured ranks 30-something in the world based upon outcomes. Yet, we’re at or near the top in costs. So, essentially, the status quo is very high price, so-so quality. Odd that this is the system you choose to defend.

    I personally have a history of cancer. So if I get laid off, I’ll never find affordable health insurance. Based upon the experience of another, when you fall into that category you essentially can’t get any health care except maybe pain killers until you become so sick you end up in the emergency ward.

    Keep shilling for the status quo. I guess it’s a logical extension of the right-wing ideology of destructive capitalism.

    Thank you for proving my point so spectacularly. “Passing on the costs to the insured” will cause the premiums offered by the government to either go up substantially or cause the government to invest the difference. Within 5 years of the introduction of any national health insurance program, costs will have doubled.

    And who said anything about maintaining the “status quo?” There are a variety of plans and they all deal with reforming the current government mess - largely responsible for skyrocketing costs in the first place - and substituting tax credits (about twice what McCain was offering) and, for those who are uninsured but want health insurance, a government run group plan that would include individuals and small businesses administered by a consortium of private carriers but estimated to cost about 1/5 of what the Democratic plans are topping out at. What’s important is to stop the precipiate rise in the cost of premiums. Any hope that any plan on earth can reduce premiums is idiotic - unless you want to ration care at the same time.

    There is no possible way that national health insurance will do what proponents say it will do nor cost what they say it will cost. To believe otherwise is to believe in the tooth fairy - cute but utterly devoid of logic and completely unaware of history.

    Face it. There’s no spin you can put on mandated plans that doesn’t involve the coercion of massive numbers of people and the certainty that the program like every single other entitlement program ever invented by government, will cost many, many times more than we are confidently told by the idiots in the Democratic party who have saddled us with so many failed social experiments.


    Comment by sknabt — 1/11/2009 @ 2:59 pm

  3. So explain to me, if it is simply impossible to have healthcare for all, how France manages to do it. They have universal health care. And they spend far less than we do. And achieve longevity numbers marginally better than our own.

    How can the French do it we can’t? Are they just smarter than we are? Are you saying Americans are less competent than Frenchmen?

    Comment by michael reynolds — 1/11/2009 @ 4:41 pm

  4. I live in GA and we have no program to help recently unemployed folks such as me to pay huge COBRA insurance premiums. On paper, COBRA looks like a good plan. In reality, most unemployed folks cannot afford the premiums.

    At least MA will reimburse you for up to 80% of COBRA premiums so that one can keep their private insurance until they find a new job.

    Perhaps MA’s plan covers too much as indicated by the 43 mandated coverages. Since I don’t know what those are, perhaps you could help us by listing them and noting which one you think should not be covered. Since you seem to know so much about the MA system, it makes sense you can post most information so that we readers can make objective conclusions instead of just taking your word for it.

    I could assert that the MA plan was badly designed because a Republican governor supported it, but I won’t inject politics into it. I could also state that the plan is being overwhelmed by the worse recession since the Great Depression, as people lose their jobs and need state healthcare. That may be closer to the truth.

    However, in the end, new entitlement plans anywhere often need fine tuning and that is probably the case in MA. Rather than throw the baby out with the bathwater, perhaps the baby just needs some better treatment.

    Social Security, for example, is the best entitlement program in American history. It prevents most older Americans from living in dire poverty and allows them to keep their dignity. 20 million retirees live almost solely on Social Security. Given the stock markets, I sure am glad Congress stood up to Dubya to prevent privatization. In any event, Social Security has been modified over the years, for example, to make the retirement age more in keeping with today’s realities. I expect this trend will continue under Obama, and I think doing so is right and fair.

    My own primary MD looks forward to both a single-payer system and streamlining medical records. Now he has to pay an agency to comb through the differing coverages and forms of many insurance companies. While a US Medicare type of system expanded to all probably allow him to drop the insurance payment service he employs.

    My MD has also started his own IT improvements by using an electronic clipboard to enter all of his notes as he is with a patient. Eventually, with proposed government help, he may be able to store the huge folders of patient information in his office, and thus have instant access to information that may save lives.

    I don’t deny that MA appears to have problems with its insurance system, but I would rather live where such benefits are available than where they aren’t, despite the problems. No unemployed in GA, I have to decide whether to pay my COBRA premium or do without health insurance at age 61 and use the emergency room if I get really sick or am injured.

    Comment by Roger Bell — 1/11/2009 @ 4:59 pm

  5. France, that bastion of health care nirvana, had >14,000 heat-related deaths in 2005:

    “The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.”.

    Whoops! Hey, most were elderly, who cares? And did not have any impact on the health-care statistics.

    Government intrusion into health care has made the costs skyrocket. Government has done nothing to help keep down costs, and in fact, I predict one way or the other will continue to contribute to a worsening of costs; Dems are in hock to the trial bar, which will make it easier to have malpractice rates and trials skyrocket again.

    Comment by Maurice — 1/11/2009 @ 8:00 pm

  6. Rick,

    Hilarious. I’m guilty of “spin” as you go on to rant about “idiots in the Democratic party” which is nothing but partisanship.

    My “spin” is traced to an insurance class I took back in college. A fundamental principle of insurance is pooling risk.

    The concept of mandating health insurance participation is that letting, say, the young healthy demographic opt out restricts the pool to heavier consumers of health care that jacks up costs. Plus, the uninsured - even under McCain’s approach - aren’t going to be refused emergency health care so the insured end up paying for much of these costs anyway. So don’t start thumping your chest I’m making your argument for you.

    Overlooked in your partisan reaction to my discussion of an idea to help fix Massachusetts’ plan is the heart of McCain’s approach follows the same strategy. I’m suggesting offering cheap, catastrophic insurance to help solve Massachusetts’ problem, an idea McCain would agree with.

    However, he gets there is a curious way more wed to conservative’s addiction to tax cuts (or, more specifically, tax credits in this case) being the universal fix-all for everything from deficits to jock itch rather than sound insurance theory.

    McCain hopes to force us all out of employer coverage by removing their tax credits for providing us coverage while substituting them with more or less offsetting tax credits. Medical savings accounts would further help ease the pain of paying for health insurance.

    The assumption is this would be enough for folks to afford catastrophic insurance policies with high deductibles. Most people would pay routine procedures out of pocket providing a greater disincentive to use health care services relative to modest co-pays typical of most employer’s plans which, in turn, would reduce medical costs for all - basic supply and demand.

    To increase competition amongst insurers, McCain will allow people to cross state borders to buy health insurance.

    You see the obvious flaw with his plan. Where’s the pooled risk in his every man, woman, and child for themselves approach? Through my employer, my health insurance is very affordable because I share the same risk pool with all employees. Under McCain’s plan I’m on my own and since I have a serious pre-existing condition I’m going to see my premiums jacked through the roof. Based upon the personal experiences of a friend with a pre-existing condition forced to look into buying a catastrophe plan in the open market, there’s a reasonable probability I’d fall into the ranks of the uninsured under McCain’s plan.

    Which brings us to the uninsured. Small businesses. The self-employed. People not in large pools need access to health insurance that’s priced based on a large risk pool. Universal plans like Massachusetts’, Clinton’s, and Obama’s hope to provide one through private insurers. Which brings us back full circle to the force them in versus choice argument.

    Now you’ll argue you’re far more generous than McCain and double the tax credit. I’m still far in the red and doesn’t that send the projected costs of the McCain play skyrocketing past, say, Obamas’?

    As we both agree, there’s no free lunch and, in the end, the costs are shifted to the insured.

    My only worry - and my larger point - is that health care in America is so expensive I’m not sure any plan is an affordable fix. Having some insight into, say, the general incompetence of many hospitals in managing their costs and accounts/receivables, I don’t share your partisan opinion of playing the stereotypical conservative who simply blames government for everything.

    Comment by sknabt — 1/11/2009 @ 8:25 pm

  7. Probably doesn’t mean anything but I’ got two health care anecdotes.

    I met a pretty girl one night at a party. She was really high energy and sexy. We became friends and I found out she was a manic/ depressive. I always thought she was lots of fun and sexy when she was manic. I know that sounds strange.

    Anyway, she had some college, but never finished. She would get jobs in offices, reception and such like. Her wages were generally between $10 and $13 an hour. She was by her own (and her psychiatrist’s) admission a little crazy, so she went through a lot of these jobs.

    Part of the problem was that the medicine she needed to stay “normal” cost about $1000.00 a month. Plus, most of these jobs had 3 to 6 month waiting periods before the health insurance would kick in. She was unmedicated and uninsured most of the time.

    I heard about Americans buying drugs in Canada for cheap prices. We lived close to the border so I took her to a Canadian pharmacy with the prescriptions. All three prescriptions cost about $120. We did this about three times until she left the state. I haven’t heard from her since.

    I was in the Czech Republic as a traveler and cut my hand pretty bad with a knife. I was not a citizen or even a resident. I found an emergency room and stitches were put in. I was not worried about cost because everything there was so cheap. A beer was about 20 cents. When I asked the doctor how much it would cost me he said there was no charge - paid by “National Health”. Later I took out the stitches myself. The cut healed fine.

    Just a couple of health care stories that probably don’t mean a thing.

    Comment by bs jones — 1/11/2009 @ 9:00 pm

  8. Maurice:

    Want to explain what the heat wave deaths had to do with the health care system?

    They don’t do air conditioning because 1) the weather is more temperate than ours, 2) They have more old buildings which are hard to retrofit and 3) the French are tightwads.

    The old people who died never made it to a hospital. They were victims of lack of air conditioning and the French obsession with August vacations. Like blaming our health care system for the number of gunshot deaths in the US. Irrelevant.

    Comment by michael reynolds — 1/11/2009 @ 9:12 pm

  9. I worked for the state of Pa. for twenty five years and took early retirement that came with state-paid BlueCross/Blue Shield. I strive to avoid ever dealing with doctors and hospitals, but it is nice to know the coverage is therte just in case I ever do need it. I’ll have to join medicare when I hit 65. I know plenty of people working for the state with families who abuse the system as much as they can. Some make extra money having doctors write them prescriptions for painkillers which the recipient turns around and sells to someone with a painkiller habit, for example.
    Now, I don’t really know what the state of Pennsylvania does to pay for it all except through taxes and that state has huge deficits.
    I’ve listened to various people complain that they have jobs which don’t provide any health insurance and are hurting when family members do get sick. You would think anyone with kids might strive to attain employment with some benefits? I expect if the government and HMOs were not involved and manadated all that BS paperwork, perhaps the cost of medical care would be lessened?

    Comment by aoibhneas — 1/11/2009 @ 11:27 pm

  10. “In the state I’m in (I assume it’s typical) they can’t be refused emergency treatment in a hospital.”

    The obvious corrective would be to change this law.
    We could also then pass a law to lower the regulations/mandates on health insurance and allow bare-bones catastrophic heath insurance coverage.
    Then maybe the young folks wont go around without coverage.

    “Yet, we’re at or near the top in costs. So, essentially, the status quo is very high price, so-so quality. Odd that this is the system you choose to defend.”
    Odd that you are accussing someone else of defending the ’status quo’ when in fact the status quo is one of mandages, rules, etc. that drives costs up. The Mass plan is now the ’status quo’.

    Comment by Travis Monitor — 1/12/2009 @ 12:02 am

  11. One thing you can say about a democrat, they are firm in their beliefs and will never admit they were wrong no matter how many citizens die. Down in hillbilly country we call it being hard headed or stubborn, but people will still die because of it.

    Comment by Scrapiron — 1/12/2009 @ 12:04 am

  12. Michael Reynolds:

    If it works in France, then by all means, lets copy it. I honestly don’t know. What I do know is that my brother-in-law lives in France, has access to the French healthcare system, and flys back to the U.S. to see doctors or dentists- he says that the doctor’s offices in France are both crowded and dirty. I suppose I could tolerate crowded doctors offices, but dirty?

    I admit that I have only that one anecdotal evidentiary point, but it is a real one. Have you had a different experience with healthcare there?

    Comment by lionheart — 1/12/2009 @ 8:34 am

  13. Lionheart:

    The French seem happy with their system generally. (No one’s 100% happy about anything, least of all the Fench.) But the French people I know think we are either idiots or crazy on the subject of health care. I tend to agree with them.

    Lose your job in France you don’t lose your health care. In this country you do. So we’ve built a system that kicks you when you’re down. Not only do you lose your job, now you can’t get your meds. It’s absurd.

    I can’t speak to whether French doctor’s offices are dirtier. When I lived in France as a kid I was under the US military health care system. And while living in Italy recently I didn’t happen to get sick at any point.

    But we may be comparing apples and oranges. Since I’m a relatively affluent American I see doctors who typically have very nice offices. (A cost they pass along to me, by the way.) But a poor or working class or unemployed American gets his medical care most often at a clinic or an emergency room. Having been to emergency rooms on occasion, I can tell you they aren’t quite as swank as my kid’s pediatrician’s offices.

    We accept as normal all sorts of bizarre issues of American health care. We accept as normal that emergency rooms are overwhelmed by poor people getting non-emergency care. (Poor people often take their kids to emergency rooms that cost thousands of dollars to treat routine ear infections a pediatrician deals with for $50.) We accept as normal that losing your job means your kids can’t see a doctor. We accept as normal that every medical practice in the country has to hire employees whose sole job is negotiating the bureaucracy of private medical insurance. And we accept as normal that the course of a sick person’s treatment is a function of stock dividends at insurance companies. These are not logical or defensible. They are idiocies built into our system.

    Comment by michael reynolds — 1/12/2009 @ 11:52 am

  14. Michael:

    Yes, the U.S. healthcare system is retarded. For once we agree- my wife developed M.S. a few years ago, so I’m tied to this shit job so she can have health insurance.

    How can the French do it and we can’t? Are they just smarter than we are? Are you saying Americans are less competent than Frenchmen?

    I hate to admit it, but they must be smarter… Rick’s post clearly demonstrates that we can’t seem to implement universal healthcare without increasing the cost, and decreasing the quality.

    Comment by lionheart — 1/12/2009 @ 1:19 pm

  15. Two more anecdotes:

    I knew a British girl who was a nanny. She went to Chicago with her nanny girlfriends for New Years Eve. She collapsed/had a seizure when she was leaving a department store and was taken to a hospital for tests and observation.

    After returning to her host family, she got a hospital bill for over 100,000.00. Everyone (including me) told her to ignore the bills. She did. Less than a year later, she was back in Britain. She never paid her bills.

    Later, I went to visit this girl in Britain. I had a toothache. She told me to go to a dentist and get it checked out. All I could think of was “The Big Book of British Smiles” from The Simpsons. I went anyway.

    The dentist filled my tooth. When it was time to pay, the women at reception simply said “National Health”. I was not a citizen or even a resident at the time.

    Once back in the States I went to my real dentist and asked her about the work that was done in England. She said, “We don’t use that kind of filling anymore. We use a composite. It’s newer.” However, she never replaced the filling.

    True stories. Anybody else got one?

    Comment by bs jones — 1/12/2009 @ 3:16 pm

  16. Longevity is not the same as health care.

    As noted above, the US murder rate is higher. A majority of those murders are young black males killing other black males. It has nothing to do with health care quality, but it has a major impact on longevity (a small percentage of people dying at 18 has a big negative effect on longevity than a much greater percentage of people dying a few months earlier). Of course, considering how much crime, both violent and non-violent, has increased in Europe, I’d guess that European murder rates will catch up also.

    Also, the US treats infant mortality differently. Here in the US we try to save every preemie — and we do succeed with an amazing percentage. But the failures are counted as live births even when they die within a short time period. That hurts our longevity numbers. However, in much of the world, the most extreme preemies have no chance and aren’t counted as live births.

    Finally, with national health care systems we are dealing govt. bureaucrats. The first rule of bureaucracy is to CYA. So concealment of bad information is pro forma. And unlike the US, it’s relatively easy for a national system to conceal information. There’s no lawyers to sue or citizens running to the media or their representatives or bloggers to report.

    Comment by LenS — 1/12/2009 @ 11:10 pm

  17. BS:
    Okay, if you’re going to start in with anecdotes about British nannies, I think we’re all going to want more detail. Such as: what did she look like? Do you have pictures? And did she wear white stockings? I don’t see how we can fairly evaluate the relevance of the nanny to health care unless we have a more complete picture of relevant details.

    Comment by michael reynolds — 1/13/2009 @ 1:09 am

  18. “Socialized Medicine” is primarily an ideology championed by the Democrats. However, contrary to popular belief, a nationalized health care system for all American’s has never actually been on the agenda for President Elect Obama http://healthpolicyandmarket.blogspot.com/2008/03/detailed-analysis-of-barack-obamas.html His agenda instead has always been to assist those who are rendered uninsurable and or are in need of assistance in obtaining health care coverage due to low income.

    Part of his plan is to expand the role of SCHIP and State Insurance Risk Pools so that those who are rendered “uninsurable” on the individual major medical market have guaranteed insurability through their respective State Risk Pools. Many states already have this option. However states such as Arizona and Florida do not. These states desperately need such Risk Pools. Unfortunately, until now they have not been able to receive enough Federal funding to expand this much needed role. States that do have risk pools are listed here: http://www.naschip.org/states_pools.htm

    President Elect Obama wishes to provide more Federal funding to these existing risk pools to drive the premiums down, thereby making this option more affordable for those rendered uninsurable.

    One of the reasons that a “nationalized” health care system has never been on Obama’s agenda is most likely due to the terrible failure of such programs in countries such as Canada. A common example used to further the cause of “socialized medicine” in the United States is to point out how well it is working in Canada. However, those living in Canada know full well that their government run health care program is most certainly not working.

    As a matter of fact, many Canadian citizens choose to hire high priced brokers to find them quality health care right here in the United States because of the terrible bureaucracy that controls all forms of health care in Canada. For more about what is really going on with the Canadian health care system please watch these short but very informative documentary videos:


    The number of actual uninsureds in the US has been grossly inflated as well. For the real numbers watch: http://www.freemarketcure.com/uninsuredinamerica.php

    The truth of the matter is we already have an enormous amount of entitlement programs available to those who find themselves unable to pay for their health care. Often times these entitlement programs are offered to those who are here legally and illegally as was the case in the State of Illinois: http://www.sbisvcs.com/healthinsuranceblog.htm

    Most recently, the State of Hawaii tried to emulate the Medicaid Expansion programs that were enacted in Illinois. It took less than 7 months to render their program bankrupt: http://www.breitbart.com/article.php?id=D93SBEUG0&show_article=1

    All things considered, the best way to offset the high cost of health care in the US is to adopt the initiatives set forth over a decade ago by Senator Bill Archer (R) of Texas. The Health Savings Account (commonly referred to as a “Medical IRA”) is a unique option that maintains high quality health insurance coverage for the policy holder whilst also building a tax deductible, tax deferred interest bearing account for the insured to use for future medical expenses. Even if these expenses would not normally be covered by the policy holder’s health insurance plan. For more about the “intelligent health insurance choice” (HSA qualified HDHP’s) please click here: http://www.sbisvcs.com/HSA%20&%20HDHP.html
    In the end consumer education and retention of existing Federal entitlement programs (via a legitimate needs assessment test) will go a long way towards not only maintaining our current health care system, but also towards keeping the bulk of our nations risk where it belongs namely, with the private health insurance sector. In light of the recent $7 Trillion “Bail Out” and many other failing corporations coming to the table with their hats in their hands (and their private jets on the tarmac) the last thing our government should do is start cutting more blind “bail out” checks in an effort to “reform” the U.S. health care system.

    Comment by C. Steven Tucker — 1/13/2009 @ 8:29 pm

  19. Medicaid Expansion Programs Buckle Under Stress of “Open Enrollment”

    I have been an insurance broker in the state of Illinois for the past 13 years and I have seen first hand what happens when an over burdened, tax funded, Government controlled, entitlement program like Medicaid is offered to everyone regardless of income. Several recent Medicaid entitlement “expansion” programs have been enacted in our State by Governor Rod Blagoyevich (Democrat) http://blogs.wsj.com/health/2008/12/18/blagojevich-a-childrens-hospital-and-medicaids-stingy-ways/ In fact, our state was the first to expand these Medicaid entitlement programs to include the “All Kids Covered” plan http://www.allkidscovered.com the “Mom’s & Babies” plan http://www.allkids.com/pregnant.html and the “Family Care” plan http://www.familycareillinois.com/

    These entitlement programs not only provide free health insurance coverage to all low income women who are currently pregnant (”Mom’s & Babies”) and all children - here legally or otherwise (”All Kids Covered”) but it also provides free health insurance to all low income mothers of children who are insured under the “All Kids Covered” program (”Family Care”). One does not need an actuarial degree to quickly conclude that these types of entitlement expansion programs simply can not work because the “All Kids Covered” program is available to any child regardless of household income levels (there is a small premium required based on a sliding scale if you are above the poverty level). Therefore, quite literally, “all kids” can enroll.

    This is most troubling, because the State of Illinois is currently $1.5 Billion (yes that’s BILLION) behind in payment of claims to medical practitioners who have provided treatment for Medicaid recipients. Furthermore, submitted claims by unpaid practitioners have “accrued a potential liability” of $81 million in interest due to payment delays over the past 8 years! http://www.mysuburbanlife.com/broadview/archive/x1874998363/Illinois-must-fix-Medicaid-woes

    Yet, we still hear the Democrats pushing for more expansion of the Federal and State Medicaid entitlement programs. In fact, Illinois was lauded as the “Flagship” state for all others to follow regarding the expansion of the Medicaid entitlement programs. If this is the template for all others to follow, then god help us all, or at least those of us that actually fund the Medicaid system through our hard earned tax dollars. Weighty decisions such as expanding the Medicaid system to all kids regardless of their actual need, simply can not be made based entirely on emotion! Prudent decision makers must weigh the DESIRE to help all mankind against the fiscal REALITY.

    There simply is not enough money to provide such irresponsible expansions of the Medicaid program. This is expressly why President Bush vetoed the expansion of the SCHIP program http://www.nytimes.com/2007/10/03/washington/03cnd-veto.html which was pushed irresponsibly forward by the Democratic Party. The Conservative side of the House shares the same concern for those in need. However, this side of the House wishes to help those who are deserving of such entitlements (e.g. legal residents of this country who actually qualify during a legitimate needs assessment).

    Expansion of these entitlement programs to anyone else is a well meaning, but a fiscally irresponsible act. One that, in the end, will end up crippling the already over burdened Medicaid system. This will especially be true when the “Baby Boomers” all start entering the assisted living arena without Long Term Care coverage to help shoulder the burden of the ever increasing cost of professional care that will, without a doubt, be needed for this gigantic population of new senior citizens.

    This can all be avoided by shifting the risk where it belongs. Namely, the private health insurance industry. This is where the money is, and always has been, to shoulder this burden. But this paradigm shift will require personal responsibility - a concept rarely spoken of during the current Democratic Presidential election. Instead, we here how broken our country is and how the current presumptive Democratic presidential candidate is going to “change” everything for the better.

    If changing everything for the better is how his party has handled things here in his home state, then this is a recipe for disaster. One that will not only cripple the current Medicaid entitlement programs, but may very well cripple the future of all other desperately needed entitlement programs that are designed to protect those who are truly deserving of such services.

    Those of us who are in need of health insurance have many options to choose from. These options are priced very affordably, most especially so if one takes advantage of the recently expanded tax incentives awarded to those who own HSA qualified HDHP’s http://www.sbisvcs.com/Health%20Insurance%20products.htm Even if one can not qualify for the aforementioned HDHP option due to underwriting restrictions, then there are many other options now available to those who have been rendered “uninsurable” in the individual health insurance market.

    These options include the following:

    1.) State Insurance Risk Pool Coverage provided under HIPAA http://www.naschip.org/states_pools.htm

    2.) Small Group or Employer Sponsored Health Insurance which contains the all important “Guaranteed Insurability” clause.


    3.) HIPAA certified “Defined Benefit” Health Insurance policies issued on an individual basis to anyone regardless of medical history http://www.sbisvcs.com/guarantee_issue.htm

    An integral part of making fiscally sound responsible decisions, means you must explore ALL of your options before leaning on a Medicaid system that is already over burdened by those deserving, and most recently, those who are undeserving.

    This is why it is always prudent to consult with a reputable and knowledgeable health insurance broker (not a captive agent who can only offer one company’s products). It does not cost a penny more to buy your health insurance using a broker than to purchase it blindly on the internet. That being said, why not take advantage of the wealth of knowledge accumulated by insurance brokers all over this great country of ours? The majority of them truly have your best interests at heart, and will do their very best to guide you in the right direction to properly secure your financial future.

    This is most important now, since one can only assume that the quality of care (e.g. ordering expensive follow up tests to properly diagnose a condition) that a Medicaid recipient receives, must inherently suffer. Simply due to the fact that the practitioner knows in advance that payment for services already rendered is behind, and payment for future services may never come! http://www.mchenrycountyblog.com/labels/Kids%20Care.html

    Comment by C. Steven Tucker — 1/14/2009 @ 9:19 am

  20. Michael;
    To respond to your initial question. Yes, we can “have a system like they do in France”. However, keep in mind:
    1) Healthcare is inextricably interwoven into the culture so “what works” in France may not work in “the US”
    2) It will cost more money
    3) We Americans spend more on health care than any other nation. And no that’s not because of insurance company greed, nor greedy doctors, greedy hospitals nor spendthrift patients. We Americans like buying healthcare, particularly the “latest” and most “technologically advanced”

    To be fair to Mass Health. They did improve the percent having health care. However, they clearly underestimated the costs.

    Given enough money getting universal coverage is easy. Managing cost is the hard part

    Comment by Chris — 1/14/2009 @ 2:11 pm

  21. And as a follow up here’s a good example of our desire for more “care” even if it provides “less” benefit. As an FYI the Dartmouth Atlas is a great resource regarding this phenomenon.


    Comment by Chris — 1/15/2009 @ 12:31 pm

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