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• "Health-Care rationing is Inevitable": Letters in the Wall Street JournalHealth Care
  Because my annual performance review is coming up soon, I think it timely to praise an op-ed in the Wall Street Journal a couple of days ago Sally Pipes, who happens to be my employer.But while I come to praise Ms. Pipes, others came to bury her. The gist of her op-ed is that Mr. Obama will impose even more federal government control over health care than we have already, which will lead to rationing. What a ruckus it caused! Yesterday, the WSJ published four letters - two by physicians and two by PhDs - relentlessly critical of Ms. Pipes' op-ed.Incredibly, these three critics repeat claims thoroughly debunked by advocates of individual choice in health care. Inded, their claims are internally contradictory. Dr. Fred W. Frick believes that we need the federal government to decide what health care we get (via a Federal Health Board) because private health insurers deny too many claims. On the other hand, Professor Robin Clark argues in favor of government monopoly because he believes that private insurers pay for too many therapies of dubious value.So, no matter how you view the health insurers: as greedy Scrooges who would rather see patients die than spend a penny on their health care, or hapless dupes of the drug makers, the answer is the same - total government take-over of health care.Meanwhile, Dr. John Manzella is actually quite satisfied that Medicare underpays hospitals (by over 10%, according to estimates I've cited), and thinks doctors should be treated just as badly! I wonder if he says this publicly at meetings of his county medical society?Richard R. Swanson, PhD, claims to speak for the many who "have no access to care" - apparently unaware of the existence of the bloated Medicaid program, unsustainable Medicare program, or community clinics for which federal funding has increased dramatically. (Indeed, Dr. Swanson's statement is remarkable for the fact that his job title indicates that he runs such a clinic.)Professor Clark repeats the incorrect figure that 45 million Americans without health insurance are a static blob that goes from cradle to greave without any health care - debunked in Ms. Pipes new book (and previously in my analysis of California's uninsured).But the most depressing part of Prof. Clark's letter was his statement that adequate care for everyone is not possible if "based only on employer-sponsored insurance can never do this". No kidding! In fact, a large number of those 45 million uninsured lack health insurance because of the government's taking our health-care dollars away from us and giving them to employers on health benefits of their choice, rather than ours.Changing the tax code to eliminate this discriminatory treatment of health benefits is the primary objective of advocates of consumer-driven health care. The fact that a professor who advocates government-driven health care is sublimely unaware o
• Single-Payer Follies
  
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• Obama to Make Bankruptcy Easier for those with Medical Debts?Health Care
  According to the Wall Street Journal Health Blog, Obama and Biden may want to make it easier for people facing bankruptcy to eliminate those debts if medical costs were the reason for their financial distress. The blog reports that a bullet point in the Obama/Biden economic agenda says that they will...create an exemption in bankruptcy law for individuals who can prove they filed for bankruptcy because of medical expenses. This exemption will create a process that forgives the debt and lets the individuals get back on their feet.The question, of course, is whether expenses resulting from birth, death, drug or alcohol addition, loss of two weeks pay due to illness of anyone in a household, mortgaging a home to pay medical bills, or having out of pocket medical bills of $1,000 in the two years before filing will be considered medical debt, as has been the (deplorable) standard in some widely quoted academic research on medical bankruptcy. It also, given mental health parity, could potentially include loss of work due to any of the syndromes included in the DSM.Fired because you are an insufferable, self-centered, arrogant prig? In bad financial straits because you blew your income on vacations, parties, clothes, and food without saving for a rainy day? Make bankruptcy easier, get diagnosed with Narcissistic Personality Disorder. One can see the "call 1-800" bus ads already.For more on just how slippery the concept of medical debt leading to bankruptcy is, and links to references on the subject, see this post on the John Goodman health policy blog.
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• Another "Slacker Mandate" ProposedHealth Care
  New York Governor David Patterson is taking time away from pondering how to advance the Kennedy dynasty and proposing taxes on iTunes to focus on increasing regulation in the state's health insurance market. He is calling on legislators to mandate that health insurance companies provide coverage for adult children on their parents' policies. The so-called "slacker mandate" is seen as a way to cover more people without costing the government a dime. Sure, someone will pay for it, but as long as the governor can claim credit without deepening the state's deficit, he's happy.Given his history on this issue, it seems that the governor recognizes the costs of this plan but doesn't have the political courage to find the money to accomplish his goals:The proposal comes just four months after Paterson vetoed a less ambitious measure that passed the Senate and Assembly, providing short-term coverage for young adults between ages 19 and 26. One objection of Paterson to that measure was that it would have had a "detrimental impact" on two government health programs by steering healthy young adults into their parents’ policies — thereby raising the costs for those remaining in the government-backed programs. So he wants the government to mandate coverage but doesn't want the government to pay for it. I guess it's easy to do something for the "kids" (even if they are 29 years old) when you can make others shoulder the burden.Interestingly, the plan has this loophole:Insurance companies now offering dependent-care coverage would be mandated to extend the policies up to age 29. Those not offering such coverage would not face the new mandate. Anyone see the potential unintended consequence here?
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• Health-Care Rationing is Inevitable? Letters in the Wall Street JournalHealth Care
  Because my annual performance review is coming up, I thought I'd praise an op-ed that Sally Pipes (my CEO) wrote in the Wall Street Journal on December 30.But while I come to praise Ms. Pipes, others come to bury her: specifically, four letters that the WSJ published in response yesterday. Two were from doctors, and two from PhDs: all were relentlessly critical of the op-ed.What I took away from the letters was how challenging it is to communicate effective reform to health-care elites - who don't even agree between themselves what the problem is.Fred W. Frick, MD, on one hand, believes that we need a government monopoly to decide what treatment we get, because private insurers arbitrarily deny paying for care. On the other hand, Robin Clark, PhD, asserts that private insurers in the U.S. waste money on new prescription drugs that are not significantly more effective than older ones.These two gentlemen must expect very different things from Tom Daschle's proposed National Health Board: Dr. Frick thinks that it will prevent insurers from cruelly denying claims, while Prof. Clark thinks it will ensure that insurers only pay claims that the state approves.John Manzella, MD, re-iterates the longstanding criticism that despite spending more money on health care than any other country, the U.S. ranks in the middle of the pack for outcomes. Unfortunately, he uses infant mortality as an example - one long since debunked.Richard R. Swanson, PhD, believes that many Americans have "no" access to health care, a claim debunked by a recent scholarly article on the issue. Prof. Clark is also one who appears to believe that the 45 million uninsured are a static blob that constantly receives substandard health care. Ms. Pipes and I have debunked this notion frequently: in her new book, in my comparison of Sen. McCain's and Sen. Obama's presidential health proposals, and a previous analysis of California's uninsured.However, the most disturbing sentence in all three letters was Prof. Clark's criticism that "a system based only on employer-sponsored insurance can never do this." True! And there are no stronger critics of the tax law, which takes our money away from us and gives it to our employers to buy health benefits of their choice, instead of our own, than we in the movement for consumer-driven health care.The fact that Prof. Clark is unaware of the primary reform that we espouse, shows the obstacles we face in getting our message across. To put it bluntly, I am fed up with those who paint us as defenders of the status quo, and the advocates of government-monopoly health care as "reformers". We are the true reformers!
• Single-Payer Follies
  
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