Sick things – whether people or systems – need cures, not sedation, not palliation, and certainly not snake oil.
The Medicare program was sedation. It lulled us in thinking we could prepay the government for health care and then get whatever we needed when we needed it. Now, Medicare is going broke and Congress is “saving it” by cutting payments which means cutting services. They are saving Medicare by making care unavailable to seniors.
Both HIPAA (Health Insurance Portability and Accountability Act) and UMRA (Unfunded Mandate Reconciliation Act) were palliation. They made us feel better temporarily but fixed nothing. So, people don’t have an insurance portability problem, because they don’t have insurance. Unfunded mandates are still unfunded, so hospitals must steal from insured patients to pay for care they must give to the uninsured for “free.”
Snake oil used to be sold in the U.S. by smooth-talking salesmen claiming it could instantly cure all sorts of medical conditions, from abdominal colic through “men’s complaint” (erectile dysfunction) to rheumatism. Snake oil had no medicinal properties and the salesmen wisely rode out of town before their mendacity led them to the hanging tree.
Today’s snake oil – with which Washington is liberally dosing America – is PPACA (Patient Protection and Affordable Care Act). The supposedly active ingredients are the individual mandate to buy insurance and the health [insurance] exchange.
Discussing the individual mandate is a waste of time until the Supreme Court decides to uphold it or strike it down.
Health exchanges are touted as the use of market competition to reduce costs and improve access. The “American Experiment” called the U.S. proved that in a free market, consumers can get better or cheaper, usually both.
Look at what free market competition did for Lasik (corrective eye) surgery. Availability went up. Prices plummeted and the success rate now approaches 100%. The Washington salesmen promised We The Patients the same results from the health exchanges: better and cheaper.
Free market competition, emphasis on “free,” means that various sellers of products or services are allowed unrestricted competition based on quality, such as benefits, availability, or features, as well as on price. In a free market, consumers pay their own, hard-earned money for goods or services. Consumers decide for themselves what is their best value. By choosing some sellers over others, they decide on winners and losers in the marketplace.
A health [insurance] exchange is the exact opposite .
- Sellers (of insurance) cannot compete based on benefits. They are strictly regulated as to what benefits they can and cannot offer.
- Sellers (of insurance) are forbidden to compete across State lines. Imagine selling cars or potatoes under these circumstances.
- Sellers (of insurance) cannot compete on what they pay their suppliers (doctors). They follow the Medicare Reimbursement schedule. Thus, they cannot compete on price to the consumer.
- Consumers (of health care) have no data on which to judge value of goods and services they are buying. Imagine purchasing a car without knowing what mileage it gets, how much the maintenance schedule will cost, or what the resale value will be, what features the car has, or even what it will cost!
- Consumers (of health care) do not control (spend) their own money. Thus, the moral hazard applies.
- Consumers (of health care) cannot choose among competing insurance sellers. The sellers do not compete (see above). Most Americans get their insurance through their employer, which gives the workers a very short list of insurance options. For the unemployed, there is no “market” of competing insurers.
Since there is no free market competition, how can consumers – We The Patients – get better and/or cheaper? Answer: we can’t.
Wisconsin studied the PPACA exchange and found that PPACA constrains competition, makes consumers pay more for insurance, and 100,000 of their residents “will be involuntarily dropped from employer sponsored health insurance” (Press Release of August 24, 2011). No wonder Governors Walker (WI) and Susanna Martinez (NM) rejected implementing a health exchange.
Supporters of such exchanges have offered both carrot and stick. The carrots are sizable grants for the Federal government to defray set-up costs. The stick is the threat that States will lose their Medicaid funding if they fail to create PPACA exchanges.
Both the carrot and the stick are more snake oil. The grants are one-time allocations but the exchanges will have ongoing costs along with the “hidden tax” as described in the Gruber Report on Wisconsin and PPACA.
The sticks (punishments for failing to set up an insurance) are much worse. First, there is the threat of “loss of Federal matching funds.” Governor “Butch” Otter first announced that he had not only garnered $37 million in Federal funding for Idaho but also saved over $300 million in Medicaid money that would have been lost if he did not set up an exchange. Then quite publicly, he had to retract the latter because it just wasn’t true.
A second PPACA stick is suppression of competition. Each State exchange must follow Federal rules and regulations that virtually eliminate any real, free market competition. Governor Haler Barbour said on national television that his State of Mississippi already had a vibrant, competitive health insurance market, and that PPACA exchanges would destroy it. .
Throughout the nation, private insurance premiums – already beyond many citizens’ ability to pay – are escalating an additional 30% or more. Employers are being forced to drop health coverage for employees.
So much for “cheaper” as a result of having health exchanges. What about “better?”
The bureaucratic costs of health exchanges are enormous, both for the States and for the Federal government. At the same time as it spends money (Medicaid grants) for set-up, Washington “saves money” by reducing payments to providers. This stick directly hurts patients.
Writing in January 2012, Jaime Leopold , the Director of the Arizona Breast Cancer Society wrote, “We have had over 45 people since September [2011] that have had their coverage cut mid-treatment.” That means money is being taken away from treating cancer patients to pay for new bureaucrats. To whom should we complain about this grotesque cost – really revenue – shifting? Clearly PPACA exchanges fail to make health care either “better” or “cheaper.”
The State of Utah did set up a PPACA-like exchange. Of the over one hundred thousand people eligible to sign up for their State’s “free insurance,” five thousand did. Apparently, Americans know snake oil when they encounter it. Health exchanges are a liberal application of the smelly stuff.
Sick things – whether people or systems – need cures, not sedation, not palliation, and certainly not snake oil.
The Medicare program was sedation. It lulled us in thinking we could prepay the government for health care and then get whatever we needed when we needed it. Now, Medicare is going broke and Congress is “saving it” by cutting payments which means cutting services. They are saving Medicare by making care unavailable to seniors.
Both HIPAA (Health Insurance Portability and Accountability Act) and UMRA (Unfunded Mandate Reconciliation Act) were palliation. They made us feel better temporarily but fixed nothing. So, people don’t have an insurance portability problem, because they don’t have insurance. Unfunded mandates are still unfunded, so hospitals must steal from insured patients to pay for care they must give to the uninsured for “free.”
Snake oil used to be sold in the U.S. by smooth-talking salesmen claiming it could instantly cure all sorts of medical conditions, from abdominal colic through “men’s complaint” (erectile dysfunction) to rheumatism. Snake oil had no medicinal properties and the salesmen wisely rode out of town before their mendacity led them to the hanging tree.
Today’s snake oil – with which Washington is liberally dosing America – is PPACA (Patient Protection and Affordable Care Act). The supposedly active ingredients are the individual mandate to buy insurance and the health [insurance] exchange.
Discussing the individual mandate is a waste of time until the Supreme Court decides to uphold it or strike it down.
Health exchanges are touted as the use of market competition to reduce costs and improve access. The “American Experiment” called the U.S. proved that in a free market, consumers can get better or cheaper, usually both.
Look at what free market competition did for Lasik (corrective eye) surgery. Availability went up. Prices plummeted and the success rate now approaches 100%. The Washington salesmen promised We The Patients the same results from the health exchanges: better and cheaper.
Free market competition, emphasis on “free,” means that various sellers of products or services are allowed unrestricted competition based on quality, such as benefits, availability, or features, as well as on price. In a free market, consumers pay their own, hard-earned money for goods or services. Consumers decide for themselves what is their best value. By choosing some sellers over others, they decide on winners and losers in the marketplace.
A health [insurance] exchange is the exact opposite .
Since there is no free market competition, how can consumers – We The Patients – get better and/or cheaper? Answer: we can’t.
Wisconsin studied the PPACA exchange and found that PPACA constrains competition, makes consumers pay more for insurance, and 100,000 of their residents “will be involuntarily dropped from employer sponsored health insurance” (Press Release of August 24, 2011). No wonder Governors Walker (WI) and Susanna Martinez (NM) rejected implementing a health exchange.
Supporters of such exchanges have offered both carrot and stick. The carrots are sizable grants for the Federal government to defray set-up costs. The stick is the threat that States will lose their Medicaid funding if they fail to create PPACA exchanges.
Both the carrot and the stick are more snake oil. The grants are one-time allocations but the exchanges will have ongoing costs along with the “hidden tax” as described in the Gruber Report on Wisconsin and PPACA.
The sticks (punishments for failing to set up an insurance) are much worse. First, there is the threat of “loss of Federal matching funds.” Governor “Butch” Otter first announced that he had not only garnered $37 million in Federal funding for Idaho but also saved over $300 million in Medicaid money that would have been lost if he did not set up an exchange. Then quite publicly, he had to retract the latter because it just wasn’t true.
A second PPACA stick is suppression of competition. Each State exchange must follow Federal rules and regulations that virtually eliminate any real, free market competition. Governor Haler Barbour said on national television that his State of Mississippi already had a vibrant, competitive health insurance market, and that PPACA exchanges would destroy it. .
Throughout the nation, private insurance premiums – already beyond many citizens’ ability to pay – are escalating an additional 30% or more. Employers are being forced to drop health coverage for employees.
So much for “cheaper” as a result of having health exchanges. What about “better?”
The bureaucratic costs of health exchanges are enormous, both for the States and for the Federal government. At the same time as it spends money (Medicaid grants) for set-up, Washington “saves money” by reducing payments to providers. This stick directly hurts patients.
Writing in January 2012, Jaime Leopold , the Director of the Arizona Breast Cancer Society wrote, “We have had over 45 people since September [2011] that have had their coverage cut mid-treatment.” That means money is being taken away from treating cancer patients to pay for new bureaucrats. To whom should we complain about this grotesque cost – really revenue – shifting? Clearly PPACA exchanges fail to make health care either “better” or “cheaper.”
The State of Utah did set up a PPACA-like exchange. Of the over one hundred thousand people eligible to sign up for their State’s “free insurance,” five thousand did. Apparently, Americans know snake oil when they encounter it. Health exchanges are a liberal application of the smelly stuff.