Posts tagged with: health care reform

7figuresA new survey by NPR and Harvard University reports the self-reported experiences of health care consumers across the country, in states that have (New Jersey, Ohio, Oregon) and have not (Florida, Kansas, Texas) expanded Medicaid, and in one (Wisconsin) that did not have to expand Medicare.

Here are seven figures you should know from the report:

1. When asked about its effects on the people of their state, more than a third (35 percent) of adults say they believe national health reform has directly helped residents, while a similar proportion (27 percent) say they believe the law has directly harmed residents. On a more personal level, most (56 percent) Americans do not believe the Affordable Healthcare Act (i.e., Obamacare) has directly impacted them. Among those who believe it had an impact, more say it has directly hurt them (25 percent), as individuals, than those who say national health reform has directly helped them (15 percent).

2. One-third (33 percent) of adults in the U.S. believe the health care they receive is excellent and just under half (46 percent) say their care is good, while just over one in six (18 percent) say it is fair or poor.

3. Nearly three-fourths (74 percent) of adults in the U.S. believe the health care they receive has stayed about the same over the past two years, while less than a quarter (23 percent) believe it has gotten better or worse.
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single-payerA plurality of Americans support “Medicare for All”, legislation endorsed by Bernie Sanders and other Democrats that would establish a universal single-payer health care system in the U.S. At least they do until they find out what “single-payer” really means.

A recent AP poll found that 39 percent support and 33 oppose replacing the current private health insurance system in the U.S. with a single government-run and taxpayer-funded plan like Medicare for all Americans that would cover medical, dental, vision, and long-term care services. (Another 26 percent neither support nor oppose the change.)

But the same percentage (39 percent) opposed single-payer when it was found that it would cause their own taxes to increase or they’d need to give up other coverage, like health insurance provided by their employers. In both cases, about 4 out of 10 flipped to opposition when they discovered that caveat.

Even higher numbers opposed the plan if it would lead to longer wait-times for non-emergency medical services (47 percent) or if it took longer for new drugs and treatments to become available (51 percent).

“People say they believe in a principle, but when you describe the policy, it often loses support because they don’t like that there are side effects,” said Robert Blendon, a professor who tracks public opinion on health care at the Harvard T.H. Chan School of Public Health.

So what exactly would an American version of single-payer plan look like?
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church busImages of Mississippi needing federal assistance are iconic. Robert F. Kennedy’s 1967 trip to Mississippi’s Delta region produced images of poverty not unlike LBJ’s War on Poverty tour. Jennifer Haberkorn has written a piece at Politico titled, “Obamacare enrollment rides a bus into the Mississippi Delta.” Her snooty lede to the story reads: “In the poorest state in the nation, where supper is fried, bars allow smoking, chronic disease is rampant and doctors are hard to come by, Obamacare rolls into town in a lime green bus.”

It appears the author believes Obamacare could bring the good news of salvation if only Mississippians skeptical of the federal government would let it. Haberkorn writes:

The effort in Mississippi illustrates the obstacles the health law must overcome in many parts of the country, particularly in deeply conservative areas where antipathy toward Washington mixes with challenges of geography, education and general skepticism or ignorance of the Affordable Care Act. High rates of poverty and disease — which mark much of this state — don’t necessarily aid recruitment. Add the strident opposition of GOP leaders and enrollment gets that much tougher.

Haberkorn cherry picks a couple of positive stories where heavily subsidized consumers will save money under the Obamacare program, but totally ignores a major component of all the skepticism with the plan. Obamacare premiums in Mississippi are the third highest in the nation, only surpassed by Alaska and Wyoming. As of September 2013, a mid range plan cost $448 monthly, with costs expected to rise. (more…)

Blog author: ehilton
Friday, March 14, 2014
By

Todd Wilemon

Todd Wilemon

Admittedly, “stop being poor” sounds a bit like “let them eat cake.” The remark was made by Todd Wilemon, a managing director at NYSE Euronext, when he was asked what people should do if they could not afford health insurance. “Stop being poor,” was his answer.

Callous? Crude? Mean? Not really. Kevin D. Williamson explains how the ineptly-named Affordable Care Act isn’t providing insurance for all who can’t afford it.

Appropriating a certain amount of money and labeling it “health care for the poor” is not the same thing as providing poor people with access to doctors, hospitals, and medicine. It is easy to move money from one pocket to another, which is how we manage to spend a figure approaching a half-trillion dollars per annum on Medicaid with very little to show for it in terms of better health outcomes for poor people. In Tennessee, Medicaid alone spends about $10,000 annually for every poor person in the state, and poor Tennesseans of retirement age or older already have access to Medicare.

We spend the money, but we do not get the health care.

Why not? Because there aren’t enough doctors, there are too many doctors who won’t accept Medicare, and all the subsidies and mandates in the world aren’t going to fix that. The solution? Stop being poor.

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In my blog post yesterday about our statist healthcare system and the need for more economic freedom, I referenced a NYT piece by Scott Gottleib and Zeke Emmanuel and argued that if their rosy view of America’s healthcare future has any chance of coming true, we’ll need far more economic freedom in the system than currently exists. Now Greg Scandlen has a sobering essay at the Federalist challenging the NYT piece, taking particular issue with their pointing to Massachusetts as a hopeful model and for suggesting that nurse practitioners will help make up the difference once Obamacare starts driving up demand for healthcare services.

Gottleib’s and Emmanuel’s argument had other elements, including a call for increased economic freedom for the healthcare industry, but on the Massachusetts point, Scandlen’s response appears devastating. In a nutshell, he notes that Massachusetts passed Obamacare-style reforms beginning seven years ago and now has much longer appointment waiting times than the rest of the country, despite having far more physicians per capita than the national average. Read the piece and the helpful data tables here.

The official White House website says that all Americans will now have access to affordable medical care, and that small business owners need not worry about rising costs:Unemployment-line-640x245

The proposal will also provide tens of billions in tax credits for small business owners to make insurance coverage more affordable. Small businesses will also have a new option of purchasing insurance through the exchanges. By pooling their resources in the new insurance marketplace, small business owners will lower their costs and have the same choices that big corporations and unions enjoy.

That’s all well and good, but as the National Bureau of Economic Research sees it, we may end up with less people working. In a paper published this month, three of the think tank’s researchers concluded, “Our results appear to indicate that the soon-to-be-enacted health-care reform may cause substantial declines in aggregate employment.” What does that mean? Small businesses aren’t going to go for the “pooling” option; they’ll just hire less people, and provide less people with health insurance. (more…)

The Affordable Care Act, more commonly known as “Obamacare”, is a strange law from the perspective of economic theories of insurance markets. Still, one can see where its designers were starting from. The individual mandate may be onerous from a liberty standpoint, but it makes sense if you understand that insurance markets are vulnerable to a phenomenon known as the “death spiral.”

The idea behind the death spiral is based on the recognition that insurance is a risk management scheme. Insurance companies, despite their best efforts, are less knowledgeable about its customers’ health than are their customers. As such, the prices an insurance company charges are based on the average risk that a customer will need care. (more…)