Tag: "SCHIP"

ObamaCare Insurance Exchange Could Cost States Health Insurance Tax Revenue

And some of their revenue to fund Medicaid and State Children’s Health Insurance Programs (SCHIP):

Federal reform could cause more people to leave state-regulated private health insurance for…federally regulated private insurance… “This will result in reduced revenues for states charging premium taxes on state-regulated health insurance…” These revenues are most important in Nevada, Hawaii, New Mexico, South Dakota, and Georgia, ranging from 12 percent to 32 percent of states’ Medicaid and SCHIP spending.

Pacific Research Institute study by John R. Graham here.

ObamaCare Has Already Driven Up Private Health Insurance Premiums

The Obama Administration has been attacking perfectly credible studies commissioned by AHIP, BCBSA, and WellPoint explaining why the proposed “reform” will drive up premiums for privately insured Americans. Yet, let’s not lose track of the fact that the Administration and the Congress have already taken steps to drive up the costs of private health care. The media have started to note that rate increases for 2010 will be higher than they need be, because of government intervention earlier this year.

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Health Reform Policy Update

What guaranteed issue and community rating mean in New York: $9,036 a year for individual coverage and $26,460 for family coverage.

Senate Finance Committee bill online with 1,502 pages: Hillary Clinton’s health care bill was only 1,342 pages.

Heritage: Under the Baucus bill, 90 million Americans will be on Medicaid/SCHIP in 2019.

CMS repeals gag order: Insurers can tell seniors about how Medicare Advantage Plans are going to be gutted.

Hawaii, with its own employer mandate, wants to opt out of health reform.

The 2% Solution

What exactly is health reform all about? Readers will be forgiven if they can't come up with a quick answer to that question. No one else can either. But during the Presidential election campaign, Barack Obama mentioned universal coverage a lot. With that in mind, consider that:

  • Uninsurance is a lot like unemployment; it happens to many people for short periods of time, but it afflicts very few people for long periods of time.
  • In fact, of all the people who are uninsured today, less than half will be uninsured a year from now.
  • Less than one in ten will be uninsured two years from now — an amount equal to less than 2% of the nonelderly population.

Let's concede for the sake of argument that these chronically uninsured people have a problem that warrants federal attention. If Congress doesn't keep its eye on the ball (and it is inconceivable that it will keep its eye on the ball) we can end up spending $1.5 trillion over the next 10 years and — at the end of the day — have no assurance that the 2% will actually have been helped!

That works out to about $325,000 for each person who may not be helped!


When logic and proportion
Have fallen sloppy dead …

Remember what the dormouse
Said: "Keep your head."

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Let Private Compete with Public Insurance

Supporters of the public option, a government run health insurance plan to compete with private insurers, say that it will make everyone better off by forcing private firms to provide health insurance for less. But if that is the case, why not allow already existing public plan options to compete with the private sector?

Give people in Medicare, state Medicaid plans, the Veterans Administration, and state SCHIP plans the choice of staying in the government run program or taking an equivalent voucher for the purchase of private health insurance and private medical care, perhaps with a health savings account option for any leftover funds.

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Why Health Reform is Bound to Fail

Why is Washington having so much trouble reforming health care?

Why, if they do pass a major overhaul, are the problems of cost, quality and access almost certain to get worse?

Answer: Because they don't understand health care. By that I mean, almost no one in Congress understands health care as a complex system. When they campaign, most politicians claim that health care problems could be solved with a few simple reforms. Now that it's time to legislate, they are discovering that health care is very, very complicated. In fact, there is no solution that even comes close to being simple or easy.

As Nobel Laureate Frederick Hayek taught us, a complex system is a structure that is so complicated, that no one person can even begin to grasp it in its entirety. The best each of us can hope for is to master the small part of it we interact with.

The economy, for example, is a complex system. To allow us to think about it — if only imperfectly — economists have developed a highly simplified model over a period of 200 years. In fact, the only reliable model that exists to understand complex social systems is the economic model. Yet we have completely suppressed normal market forces in virtually every aspect of health care. So what we are left with is almost certainly the most complicated market of all and no reliable model with which to understand it.

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Hits & Misses

These studies are from the National Bureau of Economic Research (NBER). They are all gated, but summaries are accessible.

Do Medicaid/SCHIP expansions improve child reading scores? Probably not. There is a gain of 3 points on a base of 239 in the reading (but not math) score of the 4th and 8th graders taking the National Assessment of Educational Progress.

To save the children, reduce childcare subsidies. Childcare subsidies may harm child development, increasing behavior problems and decreasing reading and math scores.

The National School Lunch Program increases childhood obesity.

Children with serious health problems make fathers turn to crime.

Who Goes to the Emergency Room?

Patients at the Emergency Room


Let's see.  Tell me again why it's good for the uninsured to enroll in Medicaid and SCHIP?

Should Public Plans Compete Against Private Plans in Health Care?

Two Wall Street Journal editorials have already tackled this issue — explaining the unfairness of public/private health insurance competition and the likely crowd-out of private insurance, based on a Lewin report. So is there anything else to say? Actually, quite a lot. Bottom line: It’s very hard to do this right; but if the advocates are intellectually honest, they can start with the State Children’s Health Insurance Program (SCHIP) and adopt a proposal Gene Steuerle and I made some years ago.

Here’s the background. Everyone is assuming that President Obama will keep his campaign promise to create a parallel system for health insurance. Those who don’t get insurance through an employer would have the opportunity to buy insurance in an Exchange. Details on how the Exchange would work are murky; and the clearer they become, the worse the whole idea sounds. But that’s not the problem. The deal-killing issue is whether one of the plans in the Exchange will be a government plan.

Two immediate questions jump to mind. What would it mean for a public plan to compete with a private plan? Why would anyone want that to happen? Let’s consider each of these in turn.

We are the Children

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Health Alert: War on the Poor

What is the worst feature of the stimulus package and other legislation being considered by Congress? It is the systematic attempt to undermine 25 years of reform of social institutions — reforms designed to liberate the lowest-income families from welfare state programs that trap them and make them perpetual wards of the state.


She Works Hard for the Money

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