Sunday, September 27, 2009
Second, individuals should get the same tax break that companies get when they supply health insurance for their employees. All policy payments should be tax deductible, either to the company or the individual.
Third, health insurance should be portable. Companies should help their employees own their own insurance so that it travels with them from job to job, state to state, and is under their control.
Fourth, Congress should enact tort reform so that doctors can do what is best for their patients instead of practicing costly legal defensive medicine.
And finally, let people purchase insurance that meets their needs, rather than requiring intrusive, one-size-fits-all federal government mandates."
But as Mr. Obama is fond of saying, that simply is not true.
While Americans may have a lower life expectancy than other affluent countries, the disparity is mainly due to Americans' poor personal health-care practices -- not to any flaw in health-care treatment. 'The U.S. actually does a pretty good job of identifying and treating the major diseases. The international comparisons don't show we're in dire straits,' says University of Pennsylvania's Dr. Samuel Preston, a researcher who has studied the matter.
The real problem, it turns out, is that Americans are accident-prone, health unconscious slobs. Until the mid-1980s, the U.S. had the highest per capita cigarette consumption in the developed world, and the U.S.'s obesity rate today is more than twice that of Canada and ten times that of Japan. These aren't problems of the health care system (i.e. in the diagnosis and treatment of disease). These are problems of behavior. Adjust that data for the higher U.S. incidence of homicide and obesity, and Americans actually have the highest life expectancy in the developed world.
This is the kind of inconvenient truth that the somewhat lax Mr. Moore is accustomed to overlooking. A svelte gym rat like Mr. Obama should know better"
Sunday, September 20, 2009
Wednesday, September 16, 2009
Once upon a time, grown-ups had no illlusions about arbitrary government power.
By Thomas Sowell
Many years ago, as a small child, I was told one of those old-fashioned fables for children. It was about a dog with a bone in his mouth, who was walking on a log across a stream.
The dog looked down into the water and saw his reflection. He thought it was another dog with a bone in his mouth — and it seemed to him that the other dog’s bone was bigger than his. He decided that he was going to take the other dog’s bone away and opened his mouth to attack. The result was that his own bone fell into the water and was lost.
At the time, I didn’t like that story and wished they hadn’t told it to me. But the passing years and decades have made me realize how important that story was, because it wasn’t really about dogs.
Today, the president of the United States is telling us that he is going to help us take that other dog’s bone away — and the end result is likely to be very much like what it was in that children’s fable.
Whether we are supposed to take that bone away from the doctors, the hospitals, the pharmaceutical companies, or the insurance companies, the net result is likely to be the same — most of us will end up with worse medical care than we have available today. We will have opened our mouth and dropped a very big bone into the water.
While I was told a story in my childhood to help me understand something about the real world, today adults are being told things to reduce them to childish thinking.
The most childish of all the things being said in the august setting of a joint session of Congress last week was that millions of people can be added to the government’s health-insurance plan without increasing the federal deficit at all.
If the president of the United States could do that, it is hard to imagine what he would do as an encore. Walking on water would be an anticlimax.
What is equally childish is the notion that the great majority of Americans who have medical insurance, and who say they are satisfied with it, should be panicked and stampeded into supporting vast increases in the arbitrary power of Washington bureaucrats to take medical decisions out of the hands of doctors — ostensibly because a minority of Americans do not have medical insurance.
There was a time, within living memory, when most Americans did not have health insurance — and it was not the end of the world, as so many in politics and the media seem to depict it today.
As someone who lived through that era, and who spent decades without medical insurance, I find it hard to be panicked and stampeded into bigger and worse problems because some people do not have medical insurance, including many who could afford it if they chose to.
What did we do, back during the years when most Americans had no medical insurance? I did what most people did. I depended on a “single payer” — myself. When I didn’t have the money, I paid off my medical bills in installments.
The birth of my first child was not covered by medical insurance. I paid off the bill, month by month, until the time finally came when I could tell my wife that the baby was now ours, free and clear.
In a country where everything imaginable is bought and paid for on credit, why is it suddenly a national crisis if some people cannot pay cash up front for medical treatment?
That is not the best way to do things for all people and all medical treatments, which is why most Americans today choose to have medical insurance. But millions of other people choose not to — often young and healthy people, sometimes deadbeats who use emergency rooms and don’t pay at all.
Is this ideal? No. But if every deviation from the ideal is a reason to be panicked and stampeded into putting dangerous arbitrary powers into the hands of government, then go directly to totalitarianism, do not pass “Go,” do not collect $200.
And go ahead and drop your bone in the water, in hopes that you can get somebody else’s bigger bone.
— Thomas Sowell is a senior fellow at the Hoover Institution. © 2009 Creators Syndicate, Inc."
Tuesday, September 15, 2009
Monday, September 14, 2009
Fact-Checking the President on Health Insurance
His tales of abuse don't stand scrutiny.
In his speech to Congress last week, President Barack Obama attempted to sell a reform agenda by demonizing the private health-insurance industry, which many people love to hate. He opened the attack by asserting: "More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day."
Clearly, this should never happen to anyone who is in good standing with his insurance company and has abided by the terms of the policy. But the president's examples of people "dropped" by their insurance companies involve the rescission of policies based on misrepresentation or concealment of information in applications for coverage. Private health insurance cannot function if people buy insurance only after they become seriously ill, or if they knowingly conceal health conditions that might affect their policy.
Traditional practice, governed by decades of common law, statute and regulation is for insurers to rely in underwriting and pricing on the truthfulness of the information provided by applicants about their health, without conducting a costly investigation of each applicant's health history. Instead, companies engage in a certain degree of ex post auditing—conducting more detailed and costly reviews of a subset of applications following policy issue—including when expensive treatment is sought soon after a policy is issued.
This practice offers substantial cost savings and lower premiums compared to trying to verify every application before issuing a policy, or simply paying all claims, regardless of the accuracy and completeness of the applicant's disclosure. Some states restrict insurer rescission rights to instances where the misrepresented or concealed information is directly related to the illness that produced the claim. Most states do not.
To highlight abusive practices, Mr. Obama referred to an Illinois man who "lost his coverage in the middle of chemotherapy because his insurer found he hadn't reported gallstones that he didn't even know about." The president continued: "They delayed his treatment, and he died because of it."
Although the president has used this example previously, his conclusion is contradicted by the transcript of a June 16 hearing on industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."
The president's second example was a Texas woman "about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne." He said that "By the time she had her insurance reinstated, her breast cancer more than doubled in size."
The woman's testimony at the June 16 hearing confirms that her surgery was delayed several months. It also suggests that the dermatologist's chart may have described her skin condition as precancerous, that the insurer also took issue with an apparent failure to disclose an earlier problem with an irregular heartbeat, and that she knowingly underreported her weight on the application.
These two cases are presumably among the most egregious identified by Congressional staffers' analysis of 116,000 pages of documents from three large health insurers, which identified a total of about 20,000 rescissions from millions of policies issued by the insurers over a five-year period. Company representatives testified that less than one half of one percent of policies were rescinded (less than 0.1% for one of the companies).
If existing laws and litigation governing rescission are inadequate, there clearly are a variety of ways that the states or federal government could target abuses without adopting the president's agenda for federal control of health insurance, or the creation of a government health insurer.
Later in his speech, the president used Alabama to buttress his call for a government insurer to enhance competition in health insurance. He asserted that 90% of the Alabama health-insurance market is controlled by one insurer, and that high market concentration "makes it easier for insurance companies to treat their customers badly—by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates."
In fact, the Birmingham News reported immediately following the speech that the state's largest health insurer, the nonprofit Blue Cross and Blue Shield of Alabama, has about a 75% market share. A representative of the company indicated that its "profit" averaged only 0.6% of premiums the past decade, and that its administrative expense ratio is 7% of premiums, the fourth lowest among 39 Blue Cross and Blue Shield plans nationwide.
Similarly, a Dec. 31, 2007, report by the Alabama Department of Insurance indicates that the insurer's ratio of medical-claim costs to premiums for the year was 92%, with an administrative expense ratio (including claims settlement expenses) of 7.5%. Its net income, including investment income, was equivalent to 2% of premiums in that year.
In addition to these consumer friendly numbers, a survey in Consumer Reports this month reported that Blue Cross and Blue Shield of Alabama ranked second nationally in customer satisfaction among 41 preferred provider organization health plans. The insurer's apparent efficiency may explain its dominance, as opposed to a lack of competition—especially since there are no obvious barriers to entry or expansion in Alabama faced by large national health insurers such as United Healthcare and Aetna.
Responsible reform requires careful analysis of the underlying causes of problems in health insurance and informed debate over the benefits and costs of targeted remedies. The president's continued demonization of private health insurance in pursuit of his broad agenda of government expansion is inconsistent with that objective.
Mr. Harrington is professor of health-care management and insurance and risk management at the University of Pennsylvania's Wharton School and an adjunct scholar at the American Enterprise Institute.http://online.wsj.com/article/SB10001424052970203440104574409501904118682.html?mod=djemEditorialPage
Sunday, September 13, 2009
Saturday, September 12, 2009
John Kerry, the former junior Senator from Massachusetts, was back in Boston Wednesday, urging the state legislature to change the law governing U.S. Senate vacancies. The seat held by Edward Kennedy from 1962 until his death last month is to be filled in a January special election. Mr. Kerry, echoing a letter Kennedy wrote not long before he died, asked lawmakers to enact legislation allowing Governor Deval Patrick to appoint a Senator to serve in the interim.
"What Ted proposed is a plan that is hardly radical," Mr. Kerry declared in his prepared testimony. "It's hardly even unprecedented, even in Massachusetts." That's for sure. The law in the Bay State provided for interim appointment by the Governor as recently as 2004. That, of course, was the year that Mr. Kerry won the Democratic nomination for President. Just in case he won, the state legislature changed the law to strip the Governor of this power. That change also came at Senator Kennedy's urging.
What changed in the ensuing five years? In 2004, the Governor, Mitt Romney, was a Republican. Mr. Patrick is a Democrat. So are the overwhelming number of state lawmakers, who overrode Mr. Romney's veto. Raw partisan advantage explains why Mr. Kerry, like his departed colleague, was for the 2004 change before he was against it.
Ha! ...so idiotic, only Kerry has the balls of steel to walk with a straight face.
One day, the people will put an end to stuff like this, and it won't be pretty.
...then again, if one looks at an average American, we know we are doomed.
in the political discourse.
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