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For Local Providers, Federal Health-Care Reform Not a Cure-All
Local health-care providers have one eye on Washington, D.C., as they contemplate the inherent changes coming with the passage of health-care reform legislation.
The newly enacted measure pledges coverage to millions of previously uninsured people and prohibits insurance companies from denying coverage to those with pre-existing conditions. It also will allow more people to qualify for Medicare and Medicaid.
There is likely to be a significant amount of change for all providers, said Michele Mickiewicz, public information officer with the Santa Barbara County Public Health Department. The effects — including reimbursement and patient load — are likely to be different for private, public and nonprofit organizations given the differences in patient payment methods.
As it stands now for Cottage Health System, a private nonprofit organization, there is cost shifting from those with government-paid insurance to those with private insurance, which people are “not happy about,” said Janet O’Neill, Cottage’s director of public affairs.
With about two-thirds of patients paying through government programs, and the eligibility requirements changing to allow more to qualify, there could be “quite an impact” on reimbursement, she said. It’s too soon to know specifics, but if more patients revert to payment through programs such as Medicare — which pays hospitals 72 cents on the dollar — it could financially hurt hospitals, she said.
Cottage Health System spent $14.5 million in charity care last year, and it supports the movement to make positive changes in coverage and the way patients get care, O’Neill said.
The Public Health Department’s caseload also is mostly made up of Medicare and MediCal patients, and it’s eager to know what will happen to the other 30 percent — those who self-pay and those who qualify for public programs such as Healthy Kids, Healthy Families and the Medically Indigent Adult Program.
Mickiewicz said that the 20 percent, or so, of people who self-pay are most likely watching to see if they become eligible for government programs — or private insurance — in 2014.
“There are lots of positive things (about the legislation),” she said. “There’s not a doctor or hospital out there that thinks the current system works.”
Countywide, there are 40,000 to 50,000 uninsured people, and Mickiewicz said it will be interesting to see what kinds of insurance become available to them.
The Public Health Department planned to meet Tuesday to discuss the issue and put possible changes in perspective to the care already provided.
More than 20 percent of Californians are uninsured, according to research by the California HealthCare Foundation, with many of them expected to qualify for insurance under the new legislation. Dealing in volume — regardless of whether it’s public or private insurance — could improve on the current reimbursement system since more insured people would mean at least “some payment for everybody that you see,” Mickiewicz said.
She said increased access most likely will lead to more seeking care, which perhaps could cause demand to overwhelm private institutions and even cause strain on existing county resources.
“We’re rushing to find out what it means,” Mickiewicz said of the legislation’s implications.
Nonprofit provider Santa Barbara Neighborhood Clinics has the most to gain from the bill’s passage, since most of its patients are uninsured and payments don’t come near covering the cost of care — so any insurance plans will be an improvement.
The Isla Vista, Eastside and Westside locations offer primary care, dentistry and counseling, and the organization has collaborated with other local medical providers to expand its care after having its budget slashed by the state.
An average visits costs the organization $154, while the average reimbursement is $62. The remaining gap is what the fundraising department tries to fill, deputy director Bonnie Campbell said.
Besides state and federal funds, county contracts and patient self-pay fees (which are calculated on a sliding scale based on income), the organization relies on grants and donations to sustain its budget of about $7 million per year.
Beyond supporting the health-care legislation from a morality standpoint — the group’s mission is to provide access to all regardless of ability to pay — the changes could financially benefit the clinics.
Of the nearly 16,000 total unduplicated patients in 2009, 91 percent fell below the federal poverty level. The clinics get less reimbursement from uninsured patients who self-pay than from insurance companies, so the increased eligibility provided by the health-care legislation is likely to bring in more money.
Campbell said having young people remain on their parents’ insurance until age 26 — which is also included in the bill — would factor in, since most state-funded medical programs end at age 19.
“Maybe some current patients who don’t qualify will be covered and give a decent amount back,” executive director Cynder Sinclair said. “We’re excited about it.”
The clinics also have their eyes set on the money said to be set aside for community clinics, which they say should be the model for all health-care providers.
Clinics remove barriers to access and work to deliver care in an efficient, inexpensive and mission-driven way, Sinclair said.
“We’re not asking for a river of revenue, just a stream,” Campbell said.
— Noozhawk staff writer Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address).
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» on 03.24.10 @ 07:19 AM
Excellent article Noozhawk and top notch reporting Giana. See what happens when real news organizations send reporters into the field to gather facts and interview people directly involved in a public policy issue? An interesting, nuanced and thought provoking storyline emerges. I am sure all your readers look forward to more in-the-field coverage of the unfolding narrative as the health care reform legislation takes effect. In one well written and thoughtful article today you have produced more professional journalistic content about this issue than Fox News has broadcast during the entire debate over the past year.
» on 03.24.10 @ 09:56 AM
Note the comments re Cottage Hospital. They are at present reimbursed at 72 cents on the dollar for Medicare patients, meaning that the other 28 cents is paid by those with private insurance (one of many reasons why private insurance premiums are so high). There are some good things in the new health care plan, but the BIG LIE is that its cost will be partially funded by further reducing Medicare reimbursements. In other words, those with private insurance will pick up even more of Medicare’s actual expenses, further driving private premiums up. If one considers all the drivers behind health care cost increases, flattening or reducing costs depends mostly on three things: reducing unnecessary or unreasonable procedures (like hip replacements for 90 year old Uncle Fred), reducing insurance company profits (fat chance), and tort reform. None of these are addressed in the new plan.
» on 03.24.10 @ 10:01 AM
Dear Emptynewsroom,
You are aptly named. No offense intended to Noozhawk reporter, but here’s a real take on “healthcare” reform:
...President Obama has crossed the Rubicon with the health care vote. The bill was not really about medicine; after all, a moderately priced, relatively small federal program could offer the poorer not now insured, presently not on Medicare or state programs like Medicaid or Medical, a basic medical plan.
We have no interest in stopping trial lawyers from milking the system for billions. And we don’t want to address in any meaningful way the individual’s responsibility in some cases (drink, drugs, violence, dangerous sex, bad diet, sloth, etc.) for costly and chronic health procedures…
FOR REST GO TO:
http://pajamasmedia.com/victordavishanson/weve-crossed-the-rubicom/
» on 03.24.10 @ 10:11 AM
So far we have seen only the tip EmptySuit. Yes, let’s hope for once the left wing media does a thorough job exploring in vivid detail the graft, back door dealing, payoffs, lies, distortions and corruption that brought us the bill no one wanted. Let’s hope that for once the democrat propaganda machine formerly known as the mainstream media decides to see what foul garbage Barack Obama and his Chicago mobsters have hidden under that rock they crawled out from under.
Keep in mind my gentle, sweet and innocent little flower children, the very first people killed and imprisoned by socialists are intellectuals and artists, can’t have free thought or expression while you’re trying to ram every square peg through your round little hole. What we saw Sunday was the most horrible display of tyranny since FDR rounded up Japanese-Americans and sent them off to internment camps, only Sunday it was the White house Chief of Staff rounding up poor democrats who stood in his way.
The only thing more sickening than EmptySuit’s ignorance and stupidity is how much he loves how screwed he is going to be.
» on 03.24.10 @ 10:46 AM
Ah, the anguish of seeing the nation turn away from the thievery of the Nixon-Reagan-Bush Republican deception that has robbed the taxpayer and the middle class blind for over four decades. I feel sorry that you are so fearful to see America finally grow up and join the rest of the industrialized world with public policy that serves the interests of the many instead of the few, but get over it. Are you folks who continue to support the GOP lies about health care reform personally extremely wealthy? Of course not. You’re clinging to the pitiful hope that somehow, someday the Republican policies that are clearly AGAINST YOUR OWN INTERESTS will eventually pay dividends to you. They won’t and to think otherwise is willful ignorance. I praised this Noozhawk article because it is balanced and points out that nothing is perfect, including the current effort to bring our health care system into the modern age. Did you miss the comment Michele Mickiewicz, public information officer with the Santa Barbara County Public Health Department made? “There are lots of positive things (about the legislation). There’s not a doctor or hospital out there that thinks the current system works.” Stop joining in on the hissy fit the GOP is throwing. Grow up and quit all the fake “patriotism” and fantasies about the “founding fathers”. You embarrass yourselves with your infantile idealism about an America that never existed. Funny how right wingers are basically clueless about history and the political sciences. If you feel so strongly about “socialism”, a concept you clearly do not understand, then fight against Social Security, Medicare, public education and don’t pay your federal and state taxes. See what kind of world of hurt that kind of childishness will bring upon you. I have yet to meet ONE Republican who doesn’t happily cash government checks or will refuse Medicare benefits, including GOPers in Congress and the Senate. Hypocrites.
» on 03.24.10 @ 11:29 AM
Hey Empty,
You are calling Victor Davis Hanson clueless???
Yikes. THAT is ignorant. But O’s your man… hope you get some of his “stash.” Bet you won’t… and that’s the point!
NO ONE WILL - it is all based on lies.
Yes, we needed some reform.
Not a TAKEOVER.
» on 03.24.10 @ 11:51 AM
Sbnative: I didn’t read Mr. Hanson’s little article or click through to the fascist news site Underwear Media but if memory serves me correctly Victor was and remains a fervent Bush toady which tells me he has a slippery grip on reality at best. So, which of YOUR relatives is currently opting out of Social Security, Medicare and isn’t paying taxes? As a staunch Libertarian-Tea Bagger I assume you’re also a secessionist? Palin-Cheney 2012!
» on 03.24.10 @ 12:02 PM
Here we go Empty. Let’s not be factual, let’s just throw out the word FACIST and blame it all on Bush.
Enough said.
If you talk to any actual physicians you’ll hear all about how wonderful Medicare reimbursements are (NOT) and we all know Social Security will be there for us (NOT) and never mind the huge unfunded mandates dumped on states (like CA) which have NO MONEY to pay for “healthcare” reform.
Why do you think health insurance stocks are RISING??? Because this is payback to yet another big corporate donor/sponsor of the Obamanation.
Has your empty head put it together yet?
PS - I like tea. But I also like coffee. I like FREE CHOICE.
» on 03.24.10 @ 12:25 PM
Sbnative: I agree with you - a single payer, public option universal health care system would have been preferable to the current legislation. Glad we agree on something. However, you have to keep in mind President Obama has been hamstrung by a totally disingenuous, uncooperative Republican Party, hundreds of millions dollars spent lobbying against ANY reform at all and a generally poorly informed public. The U.S. is playing catch up in so many areas right now that I think his administration should be congratulated for this reasonably good first pass at reforming our enormously inefficient and far too costly health care “system”. Refinements will be made over time and with any luck we’ll end up with an approach similar to that of Israel, a highly regarded universal health care system that we largely pay for with our tax dollars - http://en.wikipedia.org/wiki/Health_care_in_Israel
» on 03.24.10 @ 01:59 PM
Good, timely article.
The secret will be in the (many) details, and how they play out, over time, in real
life, local situations.
CA health insurance costs have recently been rising at 10-20 times the overall inflation rate.
Millions of citizens are dealing with chronic or catastrophic illnesses that private insurance often will not cover.
So perhaps, even with all its uncertainties, this experiment Congress and the White House are trying may be worth the risk.
Certainly, many cannot sustain the spiking cost/price curve now exacted by for-
profit insurers.
» on 03.24.10 @ 08:16 PM
A news flash to all bloggers. Being against the health plan that was just passed does not make one a Republican, a Tea Party member (I’ll forgo the porn-referring version of the name - must be a lot of porn-watching lefties out there given how they refer to the Tea Party people), a terrorist, Bush-lover, stupid, uncaring, or any of the other invectives that some of you have thrown out. This country is supposed to be about freedom of speech and open civil debate - the real terrorists among us are those who can’t abide any view other than their own. And some people just may think this health care bill is not the right way to go. And some of them are Democrats. So grow up. And realize that at least one part of the bill - saving expenses by cutting Medicare reimbursements - is simply a ploy to move more of the cost to those who pay for private health insurance.
» on 03.25.10 @ 07:10 AM
Yes, a preview of the financially crushing result of the desire to make health care a right, not a privilege. This is the new American ethos: because I exist the society owes me a living.
» on 03.25.10 @ 09:00 AM
Funny how right wingers never, EVER complain or even notice the insane defense expenditures of theie presidents like St. Ronnie the Corporate Shill and King George the Annointed. Well intelligent people do add it all up and over $1 trillion PER YEAR on war and the military is a disgrace. Settle back and watch responsible leadership repurpose some of those tax dollars so for once taxpayers get SOMETHING for their money. You’re going to enjoy it in the long run, just like you love your Social Security, 40 hour work week, Medicare and everthing else the Democrats have provided you with, not that you appreciate any of it.
» on 03.25.10 @ 10:08 AM
Note ad hominem style of emptynewsroom and sbnative: Let’s not do the facts, let’s talk about the other sides heroes who are really evil enemies. The arguments are based on personalities, not points of views. Nine Eleven did not happen; George Bush was the set up guy for crony capitalism; Hanson is a toady even though he is actually a highly respected historian of Classical Greece and warfare. It doesn’t take much of a mathematician to go huh? when someone tells you that we are going to cover everybody with health insurance and reduce the deficit. The government does not have a record of coming in under budget. That is a fact. The Republicans showed how they could be just as good at misspending as the Dems, and now sit out of power. This is a fact. War is not always the answer; war is not always not the answer. I will take a strong defense over health care becoming a basic human right. We needed health care reform, we got the Dem’s version—it looks on paper to be a future financial disaster, but this is not a fact: only time will tell.
» on 03.25.10 @ 10:23 AM
Neo-con God Bill Kristol was right: “Americans don’t deserve health care.” Roughly a third of them hate government, a third of them can barely read or write and the intelligent, enlightened remaining third get tired of trying to convince their clueless fellow citizens of the true potential of their country. Ever wonder why tourists from other nations can’t believe how horribly ametuerish U.S. news is? That’ll help explain the first two groups.
» on 03.25.10 @ 11:00 AM
http://corner.nationalreview.com/post/?q=YTk1OWNjNGNmYWJiOTIzY2E4YjYyYmJjOTJhMGQwZDg=
Verizon to Employees: We Expect Our Health-Care Costs to Rise
“...we expect that Verizon’s costs will increase in the short-term. These cost increases are primarily driven by two provisions.
The first is a provision that affects the Medicare Part D subsidy for prescription drug coverage. Because Verizon offers retiree prescription drug coverage today, the government provides a 28 percent subsidy to help offset the financial burden of offering that coverage. The subsidy was intended to help employers continue to offer prescription drug coverage for retirees so that these retirees would not have to use the Government Medicare Part D program. However, changes affecting the Part D subsidy will make it less valuable to employers, like Verizon, and as a result, may have significant implications for both retirees and employers.
Additionally, there is a provision that taxes high-value health plans expected to begin in 2018. Many of the plans that Verizon offers to employees and retirees are projected to have costs above the thresholds in the legislation and will be subject to the 40 percent excise tax.”
» on 03.25.10 @ 01:50 PM
EmptySuit your rant is as empty as your title. You simply have no concept of economics. You wail about the enormous defense budget and the enormous cost of war and then turn right around and rationalize a $6 trillion dollar entitlement by saying “well the other side is doing it”. Get a clue. We are broke and yes the defense budget is part of that. But the real reason you idiots on the left can’t have your stupid nanny state is because you already broke our means to pay for it. Yes I realize you don’t know what that means. I realize your econ professor at the state sponsored indoctrination camp (formerly known as higher education) has no clue what wealth is, being a government dependant his whole life, and taught you money grows on trees. But it doesn’t. Yes the pulp comes from trees and yes money is printed on a press and we can make as much as we want, but its value is tied to our economic wealth, the combined value of all our assets minus all our liabilities. We are upside down and going the wrong direction my friend. Not an ideal way to fund your stupid adult adolescence. Get a real job. Earn a living and balance your check book. Then apply those same simple principles to your government. When you figure out that you can have more stuff when you earn more wealth then you will understand what I am talking about.
For the rest of you take a look at the top 25 employers in SB county. 74% of those in the top 25 are government employees, 18% are working in services, like healthcare and only 8% work in revenue generating industry. So tell me how the hell you pay for a billion dollars worth of government pensions and healthcare when so little of your population is actually working outside of revenue consuming government and services and in revenue generating industry?
China, a communist country, realized 30 years ago that communism was not making their country wealthy. They saw the same thing the soviets did. They also saw that Europe, mostly socialist was fiercely protecting its manufacturing, agriculture and resource extraction industries. Hmmm, they thought. Then they looked at America, the wealthiest nation on earth and a powerful economy. “We’ll keep our government the same but open free enterprise zones and use capitalism to build wealth” they thought. It worked and at the same time the progressives in this country were doing their best to kill American competitiveness in the global markets. Getting the picture folks?
Empty can rationalize and attack all he wants but it still doesn’t pay the bill. Just blaming the other side as Earl points out doesn’t pay it either. You want your nanny state Empty? Go to Canada. You want freedom and the risk, rewards and opportunity that come with it stay here. But if you stay, quit your whining about other countries and what they do. Nanny coddling is the first step to government control of your life. It’s a slippery slope and usually as in Europe’s case there is no way to back out once you start down that slope. Staying here means taking care of yourself and your family and getting off the dole. Staying here means being an adult. You can pretend you are a grown up in France and still suckle your big nanny’s bosom, but here you are on your own.
We are the last great place where and individual can still be free. Free to succeed and free to fail. If a life of slavery to the state is your cup of tea then leave us alone and go join your fellow slaves elsewhere. I personally don’t give a crap what other countries think about it either and it is sad that so many of you on the left do. Grow a pair, grow up and get back to work. At least pay back what you owe before begging for more.
» on 03.25.10 @ 02:36 PM
America never used to be a nation synonomous with words like “afraid”, “mistrustful” and “small minded”, but institutions such as the GOP, Fox News, the Heritage Foundation, Focus on the Family and the Hoover Institution have given us all that and so much more. The whole world is wrong and doomed and we’re the only ones on the shining path. (Wonder why there is so much anger, bitterness and hatred here, though?)
» on 03.25.10 @ 03:41 PM
Nice come back Empty, living up to your name.
I plagiarized this from a colleague who plagiarized it from someone else. None-the-less it about sums up what we are all afraid of Empty.
“Let me get this straight. We’re going to be gifted with a health care plan written by a committee whose chairman says he doesn’t understand it, passed by a Congress that hasn’t read it but exempts themselves from it, to be signed by a president who also hasn’t read it and who smokes, with funding administered by a treasury chief who didn’t pay his taxes, to be overseen by a surgeon general who needs to lose weight, and financed by a country that’s broke.
What the world could possibly go wrong?
Ok, get it now?
» on 03.25.10 @ 05:53 PM
You’re right. The intelligent thing would have been to copy the excellent single payer universal health care systems that have proliferated throughout almost all major modern democracies. Don’t know why as a nation we have such an aversion to learning from the public policies of other countries. We’d also be better off with a parliamentary system with much more transparancy than our bought-off, back room dealing democracy, but that’s another issue.
» on 03.25.10 @ 06:22 PM
emptyhead: I find you to be “afraid”, “mistrustful” and “small minded”. Objecting to the current situation does not mean defense of Bush or whatever other misdirection you want to throw out instead of actually debating issues. But, hey, I’ll bet you think the moon landing was staged in the Utah desert and 9/11 was a US government plot, doncha…
» on 03.25.10 @ 10:22 PM
Okay, okay, you’ve all convinced me. Yes, we should have moved directly to a universal, single payer health care system instead of the half measure Obama has signed; No, not all people who oppose the just-passed health care reform bill are right wing, tea bagger morons; and although government can’t be trusted, its OUR government and it would be unpatriotic to hate it as an institution. You see, when you move away from shrill nationalism and use logical arguments based on a mature worldview, even a dim witted progressive such as myself can be brought over to your side of the fence. Now let’s all rally behind our president and his agenda to return America to the people. Coffee, anyone?
» on 03.26.10 @ 09:54 AM
Thanks, emptynewsroom, that was much more pleasant and reasonable. And for the record, in spite of being one not terribly trusting in big government, I do think there should have been a public option in the health care bill.
» on 03.27.10 @ 08:49 AM
Let’s stop hurling invective and threats at one another over attempts to improve health care in America.
Being upset about the process in Congress is understandable. Were some members influenced by money from lobbyists? Were some motivated by partisan malice? Did some have the attitude of “I’ve got mine, Jack, you’re on your own”? Probably, and that’s shameful. But let’s look beyond Congress to ourselves.
We must ask: what sort of society do we want? Are we who currently have access to good medical care willing to help those who are desperate because they do not? Are we willing to protect those who have led admirable, productive lives from suddenly being thrown into bankruptcy and poverty? Will we insist “We can’t afford it” instead of reducing spending on our military bases in 140 countries?
After ignoring the need for decades, America is now attempting to be more humane. Let’s work with one another to become as good as we want to think we are.
» on 03.28.10 @ 09:47 AM
WWonka, wonderful post and I generally agree, even though I am one of the millions who will find their health care costs increasing due to the not-truly-admitted cost of this program.
One thought, though, before attacking defense spending in “140 countries”. Many of those countries depend on the US to maintain their freedoms. Should we charge them for that? You bet! Or maybe just let them sink…..
» on 03.30.10 @ 09:20 AM
Health premiums may rise 17% for young adults buying own insurance
http://www.usatoday.com/news/health/2010-03-29-insurance-premiums_N.htm
Under the health care overhaul, young adults who buy their own insurance will carry a heavier burden of the medical costs of older Americans— a shift expected to raise insurance premiums for young people when the plan takes full effect.
Insurers typically charge six or seven times as much to older customers as to younger ones in states with no restrictions. The new law limits the ratio to 3-to-1, meaning a 50-year-old could be charged only three times as much as a 20-year-old.
The rest will be shouldered by young people in the form of higher premiums.
Higdon wonders how his peers, already scrambling to start careers during a recession, will react to paying more so older people can get cheaper coverage.
» on 03.30.10 @ 09:39 AM
My health care premiums, paid by me personally, not some corporation or government giveaway program, have gone up anywhere from 12% on the low side, to 28% on the high side, every year for the past 10 years. And this is AFTER reducing coverage and increasing deductibles and copays. So 1) I’m not weeping for a one-time 17% increase in premiums for younger people and 2) get ready, people, for many, many increases for everyone thanks to the structure of the health care bill (not that we don’t need a health care bill, but we need one that recognizes the real cost and doesn’t try to hide it in political BS).
» on 03.30.10 @ 11:50 AM
Yep Johnny, costs keep going up. Why? Because we want longer lives, that are disease free, while base jumping, eating ice-cream and yacking on our cell phone in traffic. The point is this, we have disconnected the cost of our lifestyles from the cost of the upkeep. How many motocross riders would dare take that jump if they had to pay the full cost of treatment for a broken wrist and a punctured lung? Likewise you health nuts out there, would you drink that unpasteurized organic milk if you had to pay the full cost of treating that deadly bacterial infection that left you dehydrated and emaciated?
You see we think healthcare is a right now. But it’s a right we don’t want to pay for. Yep it’s an expensive costly right we want for free. As cruel and heartless as a real free market system may be it insures that you will prioritize your life according to what you can afford. You will assess the risks involved in everything you do so that you don’t have unexpected costs. Businesses already do that, but we private citizens can’t be bothered. We want our cake and eat it too. So, Johnny we buy insurance that covers the unexpected. Then we do things we wouldn’t normally do if we were exposed to the risk to our health because our insurance covers that risk. Then we complain because the whole system is too expensive, because we are all engaging in costly behaviors that our insurance covers.
It all comes down to freedom and responsibility. We as a nation are rapidly trading our freedom away for less personal responsibility. That is the issue plain and simple. It is reverse adulthood where we go back to being a fully functional adolescent with no authority over our own lives. I know paying your own hospital bills is very expensive. But for the unexpected, that which you have no control over, you can buy catastrophic insurance at a much lower cost and have peace of mind that the aneurism you had is covered. However, you crash your car and get injured because you were too busy talking on your cell phone to see that red light and guess what? No medical insurance coverage. The bills on you. Now if you want insurance coverage to cover your irresponsible lifestyle then you can buy it. It would be very expensive but available. Imagine what such a system would do to medical costs. Costs would plummet as demand fell through the floor. Yet for those who got sick they are still covered, inexpensively and the demand on the entire system is minimal.
You can have your cake, but if you want to eat you have to pay.
» on 03.31.10 @ 09:28 AM
ANnie: If you’re lecturing me you should know by now that you’re preaching to the choir. I do question, however, whether it is appropriate that 15% of health care costs go to insurance company profits and do wonder, in spite of my namesake and general political leanings, whether health insurance should be regulated more like utilities.
» on 04.03.10 @ 02:01 PM
No lecture intended John; I just come off preachy sometimes (Ok most times). I have also toyed with the notion of utilitizing the insurance business. It is really hard to say how much of the profit taking is due to an already overregulated insurance market that is well protected by government (allowing for collusion and greed) or the effect I mentioned above where risk and costs are disconnected at the user end. So if we afford insurance companies even more protected status as a utility then we have to invite government in to control every aspect of the business.
We could try to go the other way though. Loosen up interstate commerce in the HC insurance business and see if the added competition that would deliver would help control costs. But really Johnny, HC insurance is not a wealth generator but a consumer. In fact the entire HC industry is a wealth consumer so any expansion of HC, whether through less costly coverage or increased medical supply is at the expense of some other part or parts of the economy. I just can’t get that message across to the liberals. They are totally off the reservation when it comes to economics and do not seem to get it, at all. Quite frustrating indeed. Ok, sorry I got preachy again.
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