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Less than a year ago, Massachusetts governor Mitt Romney unveiled a universal health-care insurance plan for his state. The premimums were predicted to be $200/month/person. That stacks up to $9600/yr for a family of four, still pretty damn steep for those who lack health insurance due to income constraints, but a bargain as health insurance goes.
Now the bids on coverages are in, and the REAL price tag is (wait for it...) just a wee bit higher. As in almost DOUBLE the projection, or $380/month/person. For the mathematically disinclined, that's $18,240 a year for a family of four.
But it's not a tax, even though there would be some pretty stiff penalties for not carrying health insurance. Namely, a fine amounting to half the annual premium cost.
Hey, Ahnuld! Are you taking notes?
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playing out as farce
Yup. When they floated a $200 cost, there was no way anyone could have believed it unless they were innumerate or ignorant. Then the pola floated $400 in order to straighten people up, maybe to make them feel grateful if they could later get it down closer to $300. The Globe reported that an industry report said they felt $300 could be achieved.
Meanwhile, Romney helped pass this as a feather in his cap, and now he's pointing out that he can't be held responsible for what folks do with it after he moved on. Sorry Mitt, I just don't believe you were unaware that the 2005-2006 math was unrealistic. You used to be a venture capitalist. You're not a dummy.
People currently unable or unwilling to buy insurance just aren't going to opt in unless it's at virtual gunpoint. It's too expensive. How many folks in borderline financial situations have even an extra $100 per month laying around, never mind 2 or 3 or 4? I've been hoping all along that this plan would collapse before it actually took effect. The biggest obvious risk to average folks is that the only way the state can make it affordable is via large state subsidies, in other words, additional taxes for many folks.
Don't even get me started on heading down the road of proposed punitive measures for folks who don't opt in voluntarily. That promises to be a WICKED nightmare.
A few weeks ago, Dave
A few weeks ago, Dave Schuler drew attention to something that's rarely mentioned in the health care debate- the lack of increase in supply vis-a-vis the demand increase that invariably results when government expands health coverage. Dave's focus on this reality is well-taken, regardless of the methods and means used to expand coverage.
I've said many times that
I've said many times that pumping more money into the system has extremely predictable results, but the lowering of overall system costs is not one of them, nor is the lowering of prices. This applies whether it's new funding for existing coverage, or for expanded coverage. Seen it again and again.
Expanded coverage equals greater demand equals greater supply if additional funding comes into the system. But demand is essentially unlimited, so prices go up a bit, supply goes up a bit, but overall system cost does not (can not) reduce--it expands to capture all available funding. (If you get expanded coverage without expanded funding, rationing gets tighter--supply remains static but the average amount of supply per patient decreases. Straight mathematical entity.)
You do indeed get more supply with additional fnding. What you don't get is an increase in supply proportionally equal to the increase in resources from baseline. Instead, prices go up a bit as well. Applies right up to the point where demand levels off--which doesn't happen in health care.
We see the same thing in the college tuition spiral. People complain about the cost of tuition, government expands funding sources, and colleges raise their tuition rates to capture share of the additional funding. More supply at higher prices.
what can be done?
Makes sense, Tully. How do we meaningfully address the supply side of the equation? Because it seems that, irrespective of whether the government intervenes, we still face a limited supply to meet an ever-increasing demand even among insured users.
What always tends to happen
What always tends to happen in the global economy when you have an overpriced service monopoly within your borders. People (and payors) start going out of borders for their services.
Domestic supply is not the only supply. As the pharmaceutical market has been busily proving for the last few years.
schuler on healthcare
So true. By the way, here are Dave Schuler's bullet points on healthcare. The contradictions are daunting and self-evident:
*any reform adopted should be simultaneously politically possible and practically effective (a tall order)
*completely abandoning all government subsidies for healthcare is simultaneously heartless and politically impossible
*reports of a market in healthcare are highly exaggerated
*the highly touted benefits of our present healthcare system are a consequence of our system of healthcare finance. They do not occur despite our system.
*our present system of healthcare finance is not sustainable
*increasing the demand for healthcare (universal coverage does this; so do government subsidies) without increasing the supply of healthcare will result in increases in healthcare costs
*cutting insurance companies out of the healthcare pie (single-payer) will result in a very small reduction in costs, possibly 10% or less, without addressing the cause of the rate of increase in healthcare costs
*a single-payer system that does not address the causes of the rate of increase in healthcare costs is neither politically nor economically sustainable (that was the experience with TennCare)
*a fully socialized system is politically impossible