When Transparency Means “Government Sees You”

Transparency is the buzz of the day, and usually it means efforts to make the work of government more visible to the public. But like many good words, it occasionally gets hijacked for other purposes. In this case, it’s being used to promote a health-related law that would cause the state of Colorado to create a database of everything about you that might have some bearing on your health. Jon Caldara, of the Independence Institute, has more:

House Bill 1330 would create an “all-payer health claims database” in Colorado. Bill supporters claim government can reduce health care costs through “transparent public reporting of health care information.” In fact, the bill is a transparency Trojan Horse. It will make your most personal actions transparent to government officials, officials who have no business keeping track of what kind of health care you buy or what you pay for it. Health Care Policy Center Director Linda Gorman sits down with Transparency Czarina Amy Oliver to discuss this privacy-smashing bit of legislation. Give a listen here.

You can also read Linda Gorman’s take on this in an op-ed.

Expect More Tantrums in Colorado

The Colorado Senate has approved a tax on soda pop and candy. I’m guessing that part of the appeal is that it can be sold as an anti-obesity move, and work its way through to lower insurance costs for everyone.

My favorite response to this came from the daughter of Jon Caldara.  She said, and I’m paraphrasing since I can’t find the specific quote: “If they raise taxes on candy, it will be more expensive. Parents will buy less candy, which means that children will have to throw more tantrums.”

That child has a bright future as an economist.

Removing Insurance Anti-trust Exemption is Misguided

The Denver Business Journal reports:

A recent salvo against the insurance industry came in a missive from U.S. Rep. Betsy Markey, D-Colorado. From an email her office sent out Monday:

“For too many years the health insurance industry has been allowed to fix prices, collude with each other and wield monopoly control over us without fear of investigation.

“This week I’m introducing a piece of legislation removing the anti-trust exemption from the insurance industry. I’m proud to stand up for the patients against the kind of profiteering the insurance industry has so long enjoyed.”

The Denver Post reported this last week, and I submitted the following letter to the editor:

Instead of scapegoating a narrow antitrust exemption for paltry insurance competition, Representative Betsy Markey should confess to how she and her political allies have prevented competitive insurance markets in the first place.

The Post reports that Markey’s bill would “remove the antitrust exemption now enjoyed by health-insurance companies” (Feb. 5). This is misleading. The exemption, codified by the McCarran-Ferguson Act, applies only to practices constituting “the business of insurance,” that are “regulated by State law” and lack “an agreement to boycott, coerce, or intimidate.” The federal government can already restrict allegedly anti-competitive insurance company practices such as mergers and group boycotts.

Blame politicians for protecting insurers from competition. Because the tax code chains you to our employer’s plans, changing your insurance provider entails changing jobs or paying a stiff tax penalty. Further, politicians forbid consumers from buying more affordable policies available in other states. Repealing these controls would greatly benefit consumers.

For more, see:

Government Accountability Office, Legal Principles Defining the Scope of the Federal Antitrust Exemption for Insurance, March 4, 2005.

Eliminating Antitrust Exemption Will Kill Health Care Competition, Gregory Conko & Kevin Hilferty, Investors Business Daily, Novemer 4 2009,
and a well-referenced report by the same authors: Congressional Misdiagnosis: Why Repealing McCarran-Ferguson Will Harm Competition in Health Insurance Markets.

Health Care Rally in Colorado

The left-leaning Colorado Independent reports on the state’s Health Care Freedom Rally, which was held yesterday. I was slightly amused at the story’s mention, in the second paragraph, of the “vastly profitable and expanding health-care sector of the economy.”

They say that as if that’s somehow bad. An expanding sector? Well yes, we’ve got some people called baby boomers who are getting old. They’ve been used to getting everything they want. Why wouldn’t they want to demand more in health care services as they enter a time of life when … people tend to have more health problems? (As for profitability, the reporter must have ignored the AP wire story of last year that showed the health sector–or at least the health insurance sector, I don’t recall exactly–as NOT one of the most profitable sectors around.)

Of course the Independent replays a tired meme, which is “Supporters of health reform argue that government involvement is the only effective way to repair a broken and exploitative system …”

Stop. Right. There. Is reform necessary? Of course. I suspect that point gets near-universal agreement. The question is what sorts of reforms and to what ends? Top down–government bureaucrats and politicians–or a messy and unpredictable world in which people make their own decisions in a commercial marketplace, charitable organizations and, yes, some role for government? To say that the people at the rally–and yes, I’ll say that some of them are friends of mine–are in “anti-health reform” is either baldfaced propaganda, intellectual laziness, or both.

The story also plays the card of “Whose your daddy?,” suggesting that people who oppose nationalization of health care are puppets of “insurance and health-care corporations” (if they’re not afflicted with false consciousness). It quickly adds that “in the months surrounding the 2008 election, health-care groups contributed roughly $102 million to state political campaigns across the country.”

Hey, Colorado Independent, do you think that all that money went to politicians opposing ObamaCare? Ever hear of the terms “hush money,” “buying a seat at the table,” or “rent-seeking?” Certainly a big chunk of that $102 million was actually spent on your side.

A side note on the question of insurance companies making money by “denying service to millions of Americans”: If an insurer fails to deliver what it promised to deliver in the contract it set up with the customer, it should be subject to rigorous legal action, period. In other words, government already has a role. In the view of the Independent, it’s not doing its job. Why then would it do a better job with expanded power?

Rally for Health Care Freedom in Colorado

If you’re around Denver today, check out the Free our Health Care Rally, to be held at the Capitol.

Colorado Legislature Helps Insurers by Mandating Wasteful Preventive Care Coverage

From the Denver Post:

A new state law makes some forms of preventative health care more affordable to people who are insured in Colorado.

The law, which took effect Friday, assures that services such as screenings for breast and cervical cancer, cholesterol levels andcolorectal cancer; childhood immunizations and flu vaccines; and programs to help manage alcohol misuse and quit smoking are available at low cost to clients, even when the insured have not met their deductibles. …

State Rep. Tom Massey, R-Poncha Springs, co- sponsored the bill with Sen. Betty Boyd, D-Lakewood.

“It’s amazing that it went so smoothly,” Massey said. “I’ll credit the fact that the insurers were all very proactive in working through this.”

They realized “the long-term benefits and savings” of catching health problems in the early stages, he said.

Rep. Tom Massey marvels at how “smoothly” the process was, and that the insurers were “proactive.”  Duh!  Insurers benefit from this mandate, as it forces people to buy more expensive policies, whether they want it or not.

The Post’s Colleen O’Connor does not mention that this will likely increase insurance premiums.  It will also increase demand for such services, as they will appear “free” to the patient.  Hence, providers won’t compete much on price and patients will have tests they may not be necessary.

Speaking of which, how useful is preventive care?  Does it have “long-term savings”?  An article in the New England Journal of Medicine concludes:

Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective).

Also, as John Goodman notes, an article last year in Health Affairs says:

Over the four decades since cost-effectiveness analysis was first applied to health and medicine, hundreds of studies have shown that prevention usually adds to medical costs instead of reducing them. Medications for hypertension and elevated cholesterol, diet and exercise to prevent diabetes, and screening and early treatment for cancer all add more to medical costs than they save. Careful choices about frequency, groups to target, and component costs can increase the likelihood that interventions will be highly cost-effective or even cost-saving.

I bet that if patients are paying for the preventative care, or even non-trivial fraction of it, they will make sure the treatment or test is necessary.  But so long as they’ve prepaid for it through “insurance”, there’s sure to be over-consumption.

Defend Colorado from ObamaCare

Jon Caldara, president of the Independence Institute, calls for people to defend Colorado from ObamaCare. Caldara hopes to have a referendum on the November 2010 ballot. It would, in the words of the Denver Post, “bar the state from requiring its citizens to purchase health insurance, ensure Coloradans can pay out-of-pocket for health care expenses and allow them to purchase plans from other states.”

Rep. Cindy Acree (R-Auroa) plans to offer similar legislation in the next session. She sites fiscal and civil liberties concerns.

Colorado Legislators Call for Timeout on New Mandates

Remember, mandated benefits in insurance plans are hidden taxes. They force you to pay for benefits that you may not want or need, and effectively force you to subsidize other people’s insurance. From the Denver Business Journal:

State governments ration “free” cancer screenings

When you empower government to provide “free” health care (paid by others through taxes), government gets to decide when it’s appropriate for you to receive it.  Here’s yet another example from the Associated Press:

…low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society’s Cancer Action Network. In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears.

…

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50….

At least 14 states cut budgets for free cancer screenings this year: Colorado, Montana, Illinois, Alabama, Minnesota, Connecticut, South Carolina, Utah, Missouri, Washington, Ohio, Massachusetts, Pennsylvania and Arkansas.

HR 3962 limits competition for dental benefits

Bob Mook of the Denver Business Journal describes how the House Bill (HR3962) would limit competition and force patients to give up their children’ speciality dental plans:

Kate Paul, president and CEO of Delta Dental of Colorado, said that the House’s health care reform proposal would disrupt dental coverage for more than 815,000 Colorado children, limit competition for dental benefits and splinter patient-dentist relationships all over the state.

Paul said while she applauds Congress for tackling health care reform, she takes issue with a provision in the House bill that forces families receiving government subsidies for insurance to purchase children’s dental insurance from medical insurers, not specialty dental insurers like Delta Dental.

Essentially, politicians are saying that they know what’s best for parents when it comes to how they pay for their own children’s dental care.