Guaranteed Issue, Community Rating Lead to High Premiums

Reason Magazine takes a look at the dismal track record of state “reform” efforts to date. It cites New York as “exhibit A” for its guaranteed issue and community rating provisions. It says, “In 1994 just under 752,000 individuals were enrolled in individual insurance plans, about 4.7%  of the nonelderly population. This put New York roughly in line with the rest of the U.S. Today that figure has dropped to just 0.2%. By contrast, between 1994 and 2007 the total number of people insured in the individual market across the U.S. rose from 4.5% to 5.5%.”

It adds Washington state as another example.”In 1996 similar reforms in Washington state preceded massive premium spikes in the individual market. Some premiums increased as much as 78% in the first three years of the reforms-10 times the rate of medical inflation.” And it cites a Health Affairs study as saying, “in addition to Washington and New York, the individual insurance markets in Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, and Vermont “deteriorated” after the enactment of guaranteed issue.”

It also notes about Massachusetts that, “Health insurance premiums in the Bay State have risen significantly faster than the national average, according to the Commonwealth Fund, a nonprofit health foundation. At an average of $13,788, the state’s family plans are now the nation’s most expensive.”

The Responsibility President and Health Insurance

The Bluegrass Institute for Public Policy Solutions compares the personal insurance mandate with a requirement to buy auto insurance, and finds there’s no comparison:

Automotive insurers can deny coverage based on a driver’s pre-existing record. Someone who gets multiple speeding tickets, DUIs or too many accidents may be forced to hoof it. If that person finds an insurer willing to risk giving them coverage, he pays more. But eat all the fast-food you can, engage in all the risky health behavior you want, forget exercising or taking care of yourself – you can always get health insurance at the same rate as gym rats and marathon runners.

Hold on, Mr. President. I thought this was about all people doing “their part.” Yet, your plan allows those living recklessly the same perks as those who care for their health.

Remember: Voters can demand change in auto insurance laws within states or move to another state with less-burdensome regulations. However, as [Steven J.] DuBord writes: “Federal law allows for no escape other than leaving the country.”

Kentucky House Republicans: Cornhusker Kickback is “Unacceptable”

Attorneys general from 13 states have protested special treatment given to Louisiana and  especially Nebraska in the Senate health care bill.  Kentucky may be the next, if the Republican caucus in the state’s legislature has its way.

According to the Bluegrass Institute for Public Policy Solutions, “All 35 House Republicans signed the letter in which Hoover wrote that it was “unacceptable” that Kentuckians would be forced to pay for “sweetheart deals” offered Sen. Ben Nelson, D-Neb., and Sen. Mary Landrieu, D-La., in exchange for their votes on the legislation.”

Kentucky Narcotics Cops Call for Crackdown on … Allergy Meds

When you’ve got a failed policy, there’s nothing like doubling down on it.

Kentucky is now “on track to have a record number of meth labs this year despite having various controls in place.” These controls include making people show an ID and register in an electronic log if they wish to buy a simple product to fight seasonal allergies.

Now the professional drug fighters–the Kentucky Narcotics Officers’ Association–wants more. It’s calling for the state to require prescriptions for allergy meds containing pseudoephedrine, a common ingredient that is also abused, in the making of methamphetamine.

This move would increase health care spending (getting a prescription requires a visit to a doctor). It’s also likely to increase the use of health insurance for predictable, minor, conditions, thereby increasing the warped way in which we pre-purchase medical spending and call it “health insurance.”

In addition, the criminal production of meth will continue (and perhaps become more lucrative), while thousands of ordinary, law-abiding citizens will be harassed.

And the “war on drugs” will continue to inflict collateral damage.

Louisville Company Gets the Gag Order

Should a company that’s a government contractor be able to tell its customers what it thinks of proposed legislation, especially if that legislation might affect the customer’s health? Not in the world of one powerful U.S. Senator.

Humana, a company based out of Louisville, Kentucky, does a brisk business in Medicare Advantage, a version of Medicare that a significant minority of senior citizens actively chose to participate in. The company doesn’t think much of congressional Democrats’ plans for Medicare Advantage (hint: they see it as a cash cow for a universal-coverage scheme), and told its customers they might not like what Congress does to their benefits.

Jim Waters, of the Kentucky-based Bluegrass Institute for Public Policy Solutions, sees what happened next as an ominous sign of things to come:  Sen. Max Baucus (D-Mont.) told Humana to stop talking to its customers about congressional plans.

Says Waters, “The same big-government types swearing up and down the halls of each hospital that any government health care plan would have to compete with the private sector are the same folks censoring a privately owned company from offering its side of the story to their customers?”

No wonder he says “The beginning of the end of our health care freedom is underway in Washington.”

Kentucky Congressman Won’t Face Constituents

U.S. Rep. Ben Chandler (D-Kentucky) has said he won't meet with constituents over the congressional recess. Why not? Jim Waters of the Bluegrass Institute for Public Policy Solutions says "It’s not easy to face small-business owners whose taxes under President Barack Obama’s health care proposal could, as Sen. Mitch McConnell, R-Kentucky., indicated in a floor speech, rise as much as 45%. "

Waters also cites a commentary from University of Kentucky economics professor John Garen, who says that over the last 6 years, Medicaid spending in the state has increased by 9% a year. Since Congress expects much of the "progress" in expanding health insurance to come from expanding Medicaid, there are plenty of reasons to be concerned. It's too bad the congressman isn't willing to hear out his constituents.

U.S. Index of Health Ownership 2nd Edition Is Here

Pacific Research Institute has published the 2nd edition of the U.S. Index of Health Ownership, the only ranking of health care in the states that uses criteria of individual choice.

Americans lack the basic freedom to make their own health care decisions. The Index measures the degree to which individuals, be they patients, health professionals, entrepreneurs, or taxpayers, “own” the health care in their states.

The lack of health ownership is a real problem. Almost half of the country’s health care spending is in the hands of the government, instead of patients themselves. The other half is governed by regulations inflicted upon doctors, health plans and patients.

The Index uses 24 variables to quantify how state laws and regulations affect the liberty of citizens involved in state government health plans (primarily Medicaid), the private health-insurance market, and the provision of medical services. It also assesses the effect of medical tort on people’s freedom to engage health services.

Alabama, Montana, Nebraska, North Dakota, and New Hampshire finished in the top five, as the states that allow their citizens the highest degree of health ownership. Alabama leads the pack primarily because of a lightly regulated private insurance market, and good control of state government programs. Also, the state performs well on medical tort indicators. Alabama’s regulatory environment for providers favors competition, and government health programs run more effectively than in most states.

New York, Massachusetts, Rhode Island, Vermont, and North Carolina rounded out the bottom five, as the states in which the government has taken the most undue control of health care from its citizens. This is the second year that New York was in last place. The state suffers from government health-care programs that are out of control, a grossly overregulated private-insurance market, and almost completely uncompetitive provider markets.

A full listing of all 50 states and their rankings is contained in the Index.

The Index will give concerned citizens a good basis to demand reforms from their state politicians that will put American families in charge of American health care, instead of government and special interests.

The Tragedy of the Health Care Commons

Here's another chapter in a book that could be written about public policy, called "the department of unintended consequences."

Most health care initiatives try to increase coverage and reduce costs. Unfortunately, many of these plans morph into government-provided health insurance and/or care, leading to a health care version of the “tragedy of the commons” and all the regrettable things that come with it.

 

In this case, the tragedy of the commons arises from people treating zero-priced (or under-priced), government-provided health care as free, leading to overuse, higher costs and – ultimately – limitations on an individual’s health care decisions.

That's an except of a commentary from the Bluegrass Institute for Public Policy Solutions, a Kentucky-based organization. Click here: http://www.bipps.org/article.php/2195

The Local Option for Smoking Bans

Kentucky's Bluegrass Institute for Public Policy Solutions says that a statewide smoking ban would trample on local governments that have already made their own decisions on this issue.

Jim Waters correctly observes that smoking bans violate the property rights of landowners. Then he adds a twist that I've seen elsewhere (such as debates on gun laws) but not to date on the question of smoking bans.

The city of Bowling Green has already voted to approve a partial ban. That's not good enough for advocates of a more comprehensive statewide ban, which would overturn the city's law.

As a point of law, city governments are generally creations of state governments. (I'll plead ignorance of Kentucky law.) But more importantly, decisions by local governments (if there must in fact be government decisions at all) might more appropriately reflect the circumstances and preferences of people.

Also on the topic of tobacco–taxes on which are often hiked in the name of providing health insurance for children–the Maryland Public Policy Institute says that a recent increase in cigarette taxes in Maryland has resulted in increased crime. In addition, the amount of taxes collected has fallen off, perhaps the result of increased smuggling.

It's easy to think that expanding government health care programs for children and paying for it by taxing cigarettes is a win-win-win. But as Maryland is finding out, taxing a highly mobile commodity puts the security of any funding program at risk, and creates law enforcement problems as well.

The John Locke Foundation is also writing about smoking bans these days (check out the links on the current version of their web site), given the plans by the North Carolina Legislature to enact a statewide ban. The foundation also has a video on the social costs of smoking.

When is ‘Cover the Uninsured With Less Expensive Regulations’ Week?

The Kentucky Bluegrass Institute's David Adams says "(r)epealing certificate of need regulations would be a much better approach than signing more people up for a government program we already can't afford."