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22 Dec 09

The States’ Failed Experiments: The major provisions of ObamaCare have already been tried. And they don’t look good

reason.com/...the-states-failed-experiments - Preview

United States state New York Washington Massachusetts Maine Tennessee health insurance socialism government politics

Like participants in a
national science fair, state governments have tested variants on
most of the major health care reforms Congress is considering. The
results include dramatically higher premiums in the individual
market, spiraling public costs, and reduced access to care.
Despite these state-level failures, President Barack Obama and
congressional Democrats are pushing a slate of similar reforms.
Unlike most high school science fair participants, they seem
unaware that the point of doing experiments is to identify what
actually works. Instead, they’ve identified what doesn’t—and
decided to do it again.

25 Nov 09

Health Care Reform in Massachusetts: Still a Bad Idea

reason.com/...health-care-reform-in-massachu - Preview

Massachusetts health insurance socialism cost politics

Health care reform advocates
have taken, in recent weeks, to noting that insurance premiums on
the individual market in Massachusetts—the state where a variant
on proposed national reforms is already in place—have fallen in
recent years.
In 1996,
Massachusetts passed an earlier set of reforms—community rating
and guaranteed issue
2 more annotations...
- given that the individual markets in most of
  the country are not already regulated by community rating and
  guaranteed issue provisions, this effect is unlikely to show up
  across the country. And if enough people choose to pay the
  penalty and opt out of coverage, it's possible that the effects
  of reform could actually lead to
  both premium increases and decreased coverage.
- Either way, I suspect that, as in Massachusetts, under reform
  legislation, the overall average price for premiums will rise
  significantly and overall levels of
  health care spending will grow to be even more of a problem
  than they are now.

05 Nov 09

Mandatory Savings? Requiring people to buy medical insurance will fuel health care inflation.

reason.com/...mandatory-savings - Preview

health insurance mandate Massachusetts government politics Jacob Sullum

What industry
wouldn’t welcome a law that forces everyone to buy its product?
But the insurers also argue that a mandate will help
control costs, and the president agrees. Judging from the
experience in Massachusetts, which imposed its own insurance
requirement in 2006, they’re both wrong.
There are several reasons why mandatory insurance, contrary to
Obama’s promises, has been accompanied by rapidly escalating
costs. First, when you subsidize something, people tend to
consume more of it.
2 more annotations...
- Second, despite stricter penalties, Massachusetts seems to be
  experiencing adverse selection. Tanner notes that, while the
  share of residents without insurance has shrunk from about 10
  percent to about 5 percent, the proportion of uninsured people in
  the 18-to-25 age group has increased from 30 percent to 35
  percent, indicating that “the young (and presumably more healthy)
  are less likely to comply with the mandate.”
- Third, requiring people to buy insurance entails defining the
  minimum level of coverage, which necessarily makes insurance more
  expensive than it would otherwise be. In effect, the government
  prohibits the cheapest insurance plans, the ones with the highest
  deductibles and the least generous benefits.

04 Sep 09

Pol nabbed on New Hampshire booze run

news.bostonherald.com/...view.bg - Preview

alcohol liquor taxes Massachusetts double standard politics

A Westport lawmaker who voted to hike the state sales and alcohol taxes was spotted brazenly piling booze in his car - adorned with his State House license plate - in the parking lot of a tax-free New Hampshire liquor store, the Herald has learned.
The witness, who requested anonymity, claimed he approached Rodrigues, noted his State House plate, and asked if he was on personal or official business. Rodrigues, who was loading booze into his car, snapped “mind your own business,” the witness said.
2 more annotations...
- The Westport Democrat, whose family owns a rug business, was among the lawmakers who voted in an unpopular 25 percent sales tax hike for Bay Staters. The increase pushed the sales tax to 6.25 percent and slapped that same levy on booze - the first time alcohol has been subject to retail sales tax.
- Authorities have also cracked down at the border, targeting Bay Staters seeking to avoid paying state taxes by crossing into New Hampshire to shop.

18 Jul 09

Pay for care a new way, state is urged

Massachusetts politicians all but admit that their experiment in health insurance socialism has failed. Costs are out of control, so now they're going to set predetermined limits on spending per patient per ailment.

www.boston.com/..._care_a_new_way_state_is_urged - Preview

Massachusetts health insurance socialism government politics

The 10-member commission, which includes key legislators and members of Governor Deval Patrick’s administration, voted unanimously to largely scrap the current system, in which insurers typically pay doctors and hospitals a negotiated fee for each individual procedure or visit. That arrangement is widely seen as leading to unneeded tests and procedures.

Instead, the group wants private insurers and the state and federal Medicaid program to pay providers a set payment for each patient that covers all that person’s care for an entire year and to make the radical shift within five years. Providers would have to work within a predetermined budget, forcing them to better coordinate patients’ care, which could improve quality and reduce costs.
They are afraid that a new payment system could create serious financial problems for providers if the yearly fees are too low and if they are not adjusted upward for patients who are very sick or at risk of serious disease and require more care. Low payments were one reason for the downfall of a similar payment system (called capitation) tried in the 1990s, providers said.
- If only there were some way individuals could choose the amount of coverage they had. Oh well. - on 2009-07-18
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