Alternatives to Obama Healthcare

[Sefarst]

The following is an excerpt from the Wall Street Journal Europe, May 30, 2008-June 1, 2008 and is titled "The Florida Revelation":

.....

The Sunshine State has about 3.8 million people without insurance, or about 21% of the population, the fourth highest rate in the country. The "Cover Florida" plan hopes to improve those numbers by offering access to more affordable policies. As even Barack Obama says, the main reason people are uninsured isn't because they don't want to be; it's because coverage is too expensive.

But the Florida reform, which both houses of the legislature approved unanimously, renounces Mr. Obama's favored remedy: it nudges the government out of the health-care marketplace. Insurance companies will be permitted to sell stripped-down, no-frills policies exempted from the more than 50 mandates that Flordia otherwise imposes, including acupuncture and chiropractics. The new plans will be designed to cost as little as $150 a month, or less.

Mr. Crist observed that state regulations increase the cost of health coverage, and thus rightly decided to do away with at least some of them. It's hard to believe, but this qualifies as a revelation in the policy world of health insurance. The new benefit packages will be introduced sometime next year and include minimum coverage for primary care and catastrophic expenses for major illness.

.....

Some 13 states currently offer bare-bones policies on a full or trial-run basis. While not a cure-all, they're movement in the right direction -- expecially as the states can't do anything about the continuing tax bias for employer-provided health insurance. That kind of much-needed change can only come from Washington, as John McCain is proposing.

As the election will undoubtedly focus a great deal on healthcare and the best ways to see that as many people are covered as possible, will this be a viable free market alternative and counter argument to Barack Obama's plan? Is this a better alternative and should McCain make it a talking point to expand Florida's plan to the rest of the country?

[Hokulele]

More information on this reform.

http://www.forbes.com/feeds/ap/2008/05/21/ap5035322.html

My two concerns with this are the response of employers who are required to enroll employees in the more expensive plans, and the fact that it appears to cover treatment, but not prevention (such as certain type of screenings).

I am not exactly sure what McCain's proposal would do in terms of addressing the employer side of the equation. Time for me to do some more homework.

[Sefarst]

My two concerns with this are the response of employers who are required to enroll employees in the more expensive plans, and the fact that it appears to cover treatment, but not prevention (such as certain type of screenings).

According to this article: http://www.sun-sentinel.com/business/sfl-flfhealth0503sbmay03,0,1207424.story, the plan will cover screenings, doctor's visits and office surgeries, but would not cover anything that requires a specialist or that would require a long hospital stay.

I don't think the response from employers will be bad. I can't imagine them dropping coverage for their employees as a result of this legislation. Is that what you're worried about?

[Puppycow]

While I'm 100% for not mandating coverage for quackery such as chiropractic and acupuncture, you could end up with a situation where the people who need coverage the most can't get it. Sure, if you are healthy this will probably allow you to get cheaper insurance. If not, you'll be paying more than ever. Or that stripped down insurance might not cover certain conditions, so make sure you don't get the wrong disease.

[David Wong]

OK, I admit I need an education on the subject.


But the Florida reform, which both houses of the legislature approved unanimously, renounces Mr. Obama's favored remedy: it nudges the government out of the health-care marketplace. Insurance companies will be permitted to sell stripped-down, no-frills policies exempted from the more than 50 mandates that Flordia otherwise imposes, including acupuncture and chiropractics. The new plans will be designed to cost as little as $150 a month, or less.


But isn't the issue that no one is going to get those cheap policies if they have some kind of pre-existing condition or are a member of some other high-risk group?

Isn't the heart of the issue that many people will simply never be profitable to insure? And that no one wants to absorb the cost of insuring/treating them?

In other words, the people who don't have coverage right now who themselves are young, healthy non-smokers, can't they get fairly cheap policies for themselves already?

Doesn't the problem start when you have a single mom with four kids, one of whom has asthma, and she has a chronic condition of her own? And works in there service industry where her employer offers no coverage?

So how does the Florida solution help her?

I'm not arguing for Obama's plan either, I don't see how it's going to do anything to control costs. But it was my understanding that all of these regulations they want to remove were there to force insurers to insure people they'd rather not have as customers, so they don't get left out in the cold.

Or am I misunderstanding the regulations?

[Puppycow]

OK, I admit I need an education on the subject.


I heartily recommend The Undercover Economist (http://www.amazon.com/Undercover-Economist-Exposing-Poor-Decent/dp/0345494016)

First of all, it's fun to read, but also educational.
It explains why the problem of inside information (aka information asymmetry) makes the market for private health insurance a very inefficient market.

But isn't the issue that no one is going to get those cheap policies if they have some kind of pre-existing condition or are a member of some other high-risk group?

Isn't the heart of the issue that many people will simply never be profitable to insure? And that no one wants to absorb the cost of insuring/treating them?


Yup.

In other words, the people who don't have coverage right now who themselves are young, healthy non-smokers, can't they get fairly cheap policies for themselves already?
Not necessarily. Cheap is a relative thing. If you are healthy, your expected value from health insurance might be lower than the cost. Some healthy people decide to do without it, but people who expect to get more value out of it are more likely to enroll. This drives up costs and hence insurance rates making it even less likely for a healthy person to break even by buying insurance.

[kallsop]

The Massachusetts "universal" health plan is running off the rails in a hurry. Costs are already ballooning out of control. This is of course a "success", proving how many need the system.

[Tsukasa Buddha]

Um, so giving people stripped down policies is a good thing?

To be honest, that was one of my concerns about universal coverage.

[Sefarst]

The Massachusetts "universal" health plan is running off the rails in a hurry. Costs are already ballooning out of control. This is of course a "success", proving how many need the system.
Indeed. http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2008/03/31/righting_healthcare_reform/

Despite national attention for the 2006 reform plan, healthcare in Massachusetts has reached a crisis point. More residents now have health coverage, but the crushing costs of the program endanger its long-term viability. This crisis has been brought about by the failure to address costs while focusing almost exclusively on access. For companies that have experienced years of double-digit increases for employee health premiums, the exploding cost of the healthcare law is not surprising.

It will be interesting once the Florida plan takes effect. We will have two experiments running, a liberal one and a conservative one. It'll make it much easier to make a decision.

[David Wong]

Indeed. http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2008/03/31/righting_healthcare_reform/



It will be interesting once the Florida plan takes effect. We will have two experiments running, a liberal one and a conservative one. It'll make it much easier to make a decision.

Especially if we all agree on how to define success. Unfortunately I have a feeling that some will declare Florida a success because it costs less, and others will declare Massachusetts the success because it covers those who need it.

[Hokulele]

According to this article: http://www.sun-sentinel.com/business/sfl-flfhealth0503sbmay03,0,1207424.story, the plan will cover screenings, doctor's visits and office surgeries, but would not cover anything that requires a specialist or that would require a long hospital stay.


Thanks, that helps.

I don't think the response from employers will be bad. I can't imagine them dropping coverage for their employees as a result of this legislation. Is that what you're worried about?


No, I am more concerned that employers will push to be allowed to put their employees on the stripped down plans. Having been both an employee and a small business owner in a state which requires employers to insure employees, I can see both sides of this particular issue.

[corplinx]

this hits upon something i've thought much about

The government keeps making health care more expensive and then turns around and claims to be able to solve the problem.

[David Wong]

this hits upon something i've thought much about

The government keeps making health care more expensive and then turns around and claims to be able to solve the problem.

You believe the rising costs of health care are due to government action?

What specifically?

[Sefarst]

You believe the rising costs of health care are due to government action?

What specifically?
Generally, state-level healthcare mandates, though well intentioned, drive prices up, usually preventing small businesses from being able to offer coverage and putting it potentially out of the price ranges of lower income individuals.

Related article: http://www.getliberty.org/blog/sunshine_on_government_mandates/

The Journal points out that many of the some 1,900 mandates nationwide are the product of special interest lobbying by health care providers “because they profit from making everyone subsidize generous plans that cover, say, podiatry or infertility treatment.”

Government mandates, in everything from how cars are made to how businesses provide health coverage, create additional costs that are always passed on to consumers, increasing the prices of every item and action so regulated. Oftentimes, businesses that want to cannot provide more affordable options precisely because of such regulations.

[corplinx]

You believe the rising costs of health care are due to government action?


Of course. However, I did not say the sole reason for rising costs. Did you even read the example in the beginning of this thread where insurance has to cover alternative medicine in Florida?

Its not just at the state level either, due to federal paperwork regulations, there are 3 staff for every one doctor at the practice I visit.

I would like to actually fix the many levers that contribute to rising cost before socializing the system. If we socialize the system, it will undoubtedly cost more since the cost gets masked behind yet another tax increase.

We need reform on a grand scale before we try further socialization.

[Architect]

You need the NHS, frankly.

[corplinx]

You need the NHS, frankly.

Has the NHS stopped paying for alternative medicine? When the NHS pays for quackery, you are the one actually paying.

[Sefarst]

You need the NHS, frankly.
I've actually heard a lot of criticism about the NHS from two British friends of mine.

I also found this article about it: http://www.ananova.com/news/story/sm_2364324.html?menu=


However, Dr Jonathan Fielden, chairman of the British Medical Association's Consultants' Committee, said "excessive cuts" had been needed to achieve the surplus. He added: "While the NHS may be in credit ... the journey to balance the books has wreaked havoc on the NHS and is a return to boom and bust health economics.

"Consultants are desperate to lead change and introduce new treatments for patients but they are being hampered by cuts, targets and micro-management from Whitehall. Patients deserve the highest quality service and the Government needs to work with us to achieve this goal."

The Liberal Democrats said the figures hid cuts of almost 1,000 training places for medical professionals. Health spokesman Norman Lamb said: "The NHS has clawed its way out of overall debt, but at what cost? Tony Blair's true legacy on the NHS is one of boom and bust - two steps forward, one step back."

Admittedly, I know only the bare basics of the NHS, and British members of this forum could speak to it much better than I or this article could. However, are these valid criticisms? Does anyone here feel like the NHS is inadequate?

[David Wong]

Of course. However, I did not say the sole reason for rising costs. Did you even read the example in the beginning of this thread where insurance has to cover alternative medicine in Florida?


So you believe coverage of alternative treatments is the cause of the rising costs? Do you know what percentage goes to such treatments? I would assume that would be an extremely minor cost in the grand scheme of things.

[corplinx]

So you believe coverage of alternative treatments is the cause of the rising costs?

Why are you so intent to put words in my mouth and what does that expose about how you feel about the subject?

[Blue Mountain]

Admittedly, I know only the bare basics of the NHS, and British members of this forum could speak to it much better than I or this article could. However, are these valid criticisms? Does anyone here feel like the NHS is inadequate?
At the risk of resurrecting something that's better left sleeping, here's a thread that talks a fair bit about about Britain's NHS and Canada's healthcare systems, and how they compare with the American one: "This is the Government that You Want to Run Health-care? (http://forums.randi.org/showthread.php?t=106255)" The thread runs 24 pages; discussion of the NHS starts on page 3.

[Architect]

Has the NHS stopped paying for alternative medicine? When the NHS pays for quackery, you are the one actually paying.


Still costs less than the current US system for comparable standards of treatment.

[Architect]

I've actually heard a lot of criticism about the NHS from two British friends of mine.


ANy attempt to cut back inevitably leads to great publicity and much public flogging of the politicians concerned. However the point I was making was that one of the posters seemed to have a problem with the effectiveness of socialised medicine which bore scant regard to the successful regimes outside the US. Like the NHS, for example.