More On Buying Health Insurance Across State Lines

I’ve expressed a real lack of enthusiasm for the Republican proposal that Congress should pass a law allowing groups to go jurisdiction-shopping for health insurance, especially in the absence of eliminating the prejudice against individual ownership of health insurance.

One correspondent chided me for allowing states’ “geographic monopolies” to stand in the way of competition. But isn’t that a fundamental characteristic of a state — that it has a monopoly over state laws within its own boundaries? If you don’t like it, vote in a new legislature or move to another state. I live in California, where personal income taxes are way too high and harmful to our welfare. But I’ve never heard a Republican politician propose that Congress pass a law allowing individuals to choose which state’s rate of income tax they pay, so Californians could opt to pay zero income tax by choosing Florida’s tax rates.

In any case, this is irrelevant: States can just go ahead and allow interstate purchasing of health insurance themselves. Here’s a bill in Washington State to allow just that; and here’s one in Georgia. So, just get on with it. There’s no need to wait for Congress to act.

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.

When “Free” Health Care is Unaffordable

The state of Washington has a heavily subsidized health program called “Washington Basic.” It might do you some good–if you can actually enroll.

But there are more people on the waiting list than are actually enrolled in the program.

There’s no escaping scarcity, especially if A is paying for something on behalf of B.

Pelosi Visit Seattle, Says Nothing

Nancy Pelosi made a victory lap in the Pacific Northwest yesterday, and Piper Scott of the Evergreen Freedom Foundation was there to record the event, which he dubbed more of a campaign rally than a press conference.

“A summary of her remarks would be: blah, blah, blah, health care for all, blah, blah, blah, Pres. Obama promised it to us, blah, blah, blah, it will lower costs and reduce the deficit, blah, blah, blah, it’s all the fault of ‘the previous administration,’ blah, blah, blah.”

Scott commends a local reporter who gave her trouble for refusing to say whether people who refuse to buy insurance will be sent to prison.

Will Spokane Residents Vote for “Free” Health Care?

I never thought of Spokane, Washington, as a place filled with utopians, but maybe I was wrong. Next month, residents will vote on a proposed “Spokane Community Bill of Rights.” Like many such documents, the “Bill of Rights” is actually a laundry list of proposed new government programs. Carl Gipson, director of the Center for Small Business at the Washington Policy Center, warns about the open-ended obligation that the law would create:

Perhaps one of the more financially risky elements of the proposal is the stipulation that citizens are entitled to affordable and preventative health care. If the city is determined to cover those costs, and assuming Spokane’s 23,000 uninsured (Envision Spokane’s numbers) are covered using a very perfunctory preventative plan, the costs to the city would still be in the millions of dollars. Supporters of this plan want to implement a fee-for-service model, but under the lax way the statute is written any citizen could file a complaint against the city claiming that the nominal fee is unaffordable.

The center has produced a short review (PDF) of the ballot measure, which would affect not only health care but also the full range of daily life.

Washington Supreme Court Throws out Med Mal Reform

The Washington Supreme Court has struck down a law in that state meant to curb the number of medical malpractice lawsuits.

As an AP account put it, "The state Supreme Court has unanimously thrown out a 2006 law that requires an injured patient to get a certificate of merit from an expert before they can sue for medical malpractice."

In its opinion, the court said " We hold [the law] is unconstitutional because it unduly burdens the right of access to courts and violates the separation of powers."

One alternative, suggested by the Cato Institute, would be to let patients enact tort reform by contract [PDF], which might be better than state-level restrictions on a person's ability to address a grievance through the courts. In turn, state-level restrictions would be better (on the grounds of federalism, among other things), than getting Congress into the act.

Open Wallet, Get Less

One accomplishment of American health care is the development of vaccines for a number of diseases. The Washington Policy Center sends along this announcement about vaccinations and public policy:

Did you know that Washington offers universal child vaccination to people regardless of income, but has one of the lowest vaccination rates in the country?

In 1965, the United States government assured that all children would receive access to vaccines for common childhood diseases through the passage of the Vaccination Assistance Act. The law created a program that provides federal grants to local authorities for preventive health services, including immunizations.

Nearly three decades later, the federal government expanded the plan by creating the Vaccines for Children (VFC) program, enacted as part of the Omnibus Reconciliation Act of 1993.

A new WPC study looks at how the Vaccines for Children program works, reviews Washington's low child immunization rate, describes vaccination reimbursement policies, analyzes market distortions that affect the cost and supply of vaccines, and presents three practical recommendations for improving the viability of the public immunization program and the protection of children from serious diseases.

Read "Guarding Against Disease: Improving Washington's Child Vaccination Program" online here

There are some lessons in there about cost-shifting, payments from Medicaid plans, and the dangers of government being the dominant purchaser of health care.

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.

Washington Governor: We’ll Insure All Children

A columnist at SeattlePI.com reports that officials in the state of Washington say they are, contrary to statements he made online, on track to "insure all kids." State officials credit an influx of federal money.

Think Tank in the Other Washington Analyzes Federal Health Care Policy

The Washington Policy Center, of Seattle, announces an initiative to study health care policy initiatives being discussed in Washington, DC. that's a good thing; the future of health care is too important to be left to people in one region of the country (NOVA/DC/MD), especially one that is so dominated by the political world.

The center's press release says "health care reform must be focused on patients, allowing more access to more treatments and more doctors with less interference from insurance companies, politicians, and special interests. A balanced, common sense approach that provides assistance to those who truly need it and keeps health care patient-centered rather than government-centered for everyone."