Friday, December 7, 2007

Utah Governor Jon Huntsman Jr. Considering Mandatory Health Insurance For All Utahns

Apparently Mitt Romney has had more of an effect on Utah Governor Jon Huntsman Jr. (pictured at left) than many of us realized. As Governor of Massachusetts, Romney was the first governor to mandate health insurance for all his state's residents.

Alaska's got a plan crafted by one of their state senators, Hollis French, and it merely awaits the beginning of their next legislative session in January for resumption of debate and possible action.

And now Governor Huntsman wants to add Utah to the list. The governor's reform draft, which has not been released publically, calls for all Utahns to eventually get their own health insurance. Full story published December 7th, 2007 in the Salt Lake Tribune.

So what are the highlights?

- What's in it for the poor: Increased use of existing aid.
- What's in it for the working poor: Financial subsidies.
- Those who can afford but shun insurance: Possible barriers to work, college.
- For everyone: A state clearinghouse to help compare plans; reasonable premiums; a ban on companies rejecting "high risk" Utahns.
- For insurers: Shared risks; permission to reward healthy consumers; state help in collecting premiums deducted from paychecks or paid by employers.

Proponents of mandatory health insurance cite rising costs, limited availability, and excessive paperwork as justification to change the system. An article in the November 2004 issue of Reason magazine lays out a coherent case in favor of mandatory health insurance:

The current system poses three main problems. First, it's expensive. In 2003 total spending on health care was $1.7 trillion, some $5,800 for every man, woman, and child in the nation, accounting for more than 15 percent of the U.S. gross domestic product (and up from 14.1 percent of GDP in 2002).

Second, despite all the spending, many Americans don't have health insurance. A May 2003 Congressional Budget Office study estimated that 59 million Americans are uninsured at some point in the course of a year, while 21 million to 31 million are uninsured for the whole year. According to a June 2003 report from the Institute of Medicine, the U.S. loses between $65 billion and $130 billion annually as a result of poor health and early death due to lack of insurance. The uninsured impose costs on the rest of us, too: A 2003 Kaiser Commission report to the Urban Institute estimated that uninsured Americans each year receive about $34.5 billion in uncompensated health care while paying $26.4 billion out of their own pockets.

Third, health care is a paperwork nightmare for patients, doctors, insurers, and employers. In 1999 The New England Journal of Medicine published a study that found it cost $300 billion annually to administer various health insurance plans. It takes some 3 million clerks and managers to run our health care system; that's nearly four times the number of doctors practicing medicine in the United States. It costs between $8 and $18 to file each insurance claim, and a third of them have to be refiled. In a survey published last year by the American Hospital Association's Trendwatch, 64 percent of doctors said they were either extremely or very concerned about the level of paperwork and administration they have to deal with.

While the article is three years old, not only have the problems NOT been alleviated, but the cited costs have risen - exponentially, in some cases.

In contrast, Richard Ralston lays out a case in opposition to mandatory health insurance in a December 5th article posted on the Capitalism Magazine website. Here's a snippet:

When talking about health insurance, "mandatory" is an increasingly popular term among politicians of both major parties, including presidential candidates. What do they really mean by it? Put simply, being uninsured would no longer be a misfortune or a choice, but a crime. And for the insured, the issue is much more complicated.

No politician is going to use the force of law to require you to buy insurance without going further to specify in detail exactly the kind of insurance and what it must cover. Many states now have a long list of requirements for all insurance policies, and that list is sure to get longer if insurance becomes mandatory. And sure to follow will be regulations governing who the insurance companies may, may not or must sell to, and when. A mandate forcing millions more to buy these policies with so many things requiring coverage will create a tremendous magnet for any special interest with an agenda to pile on even more requirements. Then, as costs of such policies go into orbit, more government intervention will be called for to subsidize those increasing costs.

Once all of the regulations are in place, there is plenty of opportunity for regulators or politicians to expand on what mandates can really mean. For example, Senator John Edwards says that his plan for national mandatory insurance would require every individual to take regular physical examinations. What kind of examinations? That would not be left up to you either. After all, if you cannot be trusted to go see a doctor, you cannot be allowed to decide which ailments and which body parts you should be examined for. Women would not be urged but required by law, says Senator Edwards, to get regular mammograms.

It is fascinating to speculate about how the federal government would enforce these mandatory examinations. Perhaps all of your newly computerized medical records will be regularly forwarded to government officials for inspection. Or perhaps you will have to attach the results of your mammogram or prostate exam to your IRS tax return every year.

According to an article published December 4th, 2007 in, mandatory health insurance schemes may not have the desired effect. While the U.S. health- care system is in dire need of reform, the nation's health insurers say consumers can't count on them to cut premiums even with mandatory coverage, which is geared to bring more people into the insurance pool to cut costs.

In addition, many observers are skeptical of mandatory coverage, as it's sure to line the pockets of health carriers by delivering to them a captive constituency as all the nation's uninsured will have to comply or face tax penalties.

Insurers say that won't necessarily be a good thing. They say that while a number of uninsured pose very little or no risk there also are a significant number of those who do. And they aren't promising a slowdown in double-digit annual premium increases. "Some premiums will go up, but people will get insurance that didn't get it before," said David Olson, spokesman for insurer Health Net Inc. (HNT)

And here's the kicker; one state already tried it - and abandoned it. Mohit Ghose, spokesman for America's Health Insurance Plans, an industry trade group that represents major carriers, pointed out mandatory coverage was enacted in Washington state and modeled on the Clinton Administration's 1993 health plan. It was quickly repealed in the mid-1990s when it resulted in higher costs and fewer choices.

Commentary: But the biggest problem with mandatory health insurance is that it forces another unfunded mandate upon people. According to an article in a Dallas newspaper, one family of four was paying over $11,000 per year for full-coverage health insurance. Another person, who was in the gray zone between not rich enough and too rich to qualify for assistance, was delaying mortgage payments in order to meet health insurance costs. It's ironic that those who are the most enthusiastic about mandatory health insurance are those who will either incur no additional financial obligation, or whose health care costs will decline as a result. Isn't it ironic that the rich are always making the rules, and the poor have to pay the most for them?

We need to try some intermediate solutions first:

(1) Discriminate between therapeutic care vs. elective care. Therapeutic care, or care necessary to sustain life and basic health, should be the only care subsidized. Elective care should never be subsidized.

(2) More self-medication and use of over-the-counter remedies. People need to be re-directed more towards self-care for minor ailments. If your kid skins his knee, he DOESN'T need to go to the doctor. Pour some hydrogen peroxide on the wound, swab it with Neosporin, then slap a bandaid on it. Repeat ever 12 hours for a couple of days. Don't go to the doctor just for the sniffles, either. Become familiar with Internet medical resources like Web MD.

(3) Get the frigging illegal aliens out of our country now! They clog up our emergency rooms because they don't have insurance. We have no obligation to minister to criminals.

(4) Tort reform. Get rid of punitive damages. Actual damages only. This will reduce the cost of malpractice insurance, which will in turn help flatten rising health costs.

(5) A minor detail, but worth mentioning. No organ transplants for prisoners serving a life sentence. If an organ goes bad, dope them up and let them slip away naturally.

Until we can create a society that offers ALL citizens an opportunity to succeed once again, we cannot afford to be dumping more unfunded mandates on the population.

No comments: