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Want to be taxed $5 to save just $1? Expect this kind of health care “reform” from those claiming to protect you from what’s called the “uninsured cost-shift.”
Minimizing cost-shifting is the most common argument against Colorado Amendment 63, and for mandatory insurance. It’s not only flawed, but hypocritical. The argument is that mandatory insurance is needed because the uninsured don’t pay their medical bills, which results in higher premiums for the insured. As I have explained in a previous post, this argument collapses on itself. By outlawing affordable insurance and forcing everyone to buy bloated expensive health plans, mandatory insurance imposes a much larger cost-shift.
There’s more to this story. Supporters of mandatory insurance only claim to oppose cost-shifting. In practice, they support policies that, like mandatory insurance, add to the very cost-shifting they claim to object to.
Consider arguments by Edie Sonn, Public Affairs Director for the Colorado Medical Society. While opposing Amendment 63 on Colorado Public Television, she said that when uninsured people “need care, they often end up in emergency rooms [and] can’t pay for that care. All of us who do have insurance end up paying that. That’s called the cost-shift.” It’s a superficially appealing argument.
The problem with her argument is not only that mandatory insurance imposes a larger cost-shift. It’s also that the CMS supports policies that increase cost-shifting.
For example, earlier this year the CMS supported HB 10-1021, which requires all individual health plans to cover maternity care and contraception. You may not ever want or benefit from such coverage, but the CMS wants to make you pay extra for it.
How much? Coverage for contraceptives and maternity each account for 1-3% of insurance premiums, reports the Council for Affordable Health Insurance. These mandates amount to between $60 and $180 annually for a $3000 policy.
For all its bemoaning of cost-shifting, last year the CMS supported Colorado HB 1293, a tax for Medicaid expansion, even though Medicaid involves large cost-shifts. Medicaid, like Medicare, underpays hospitals. To recoup these expenses, hospitals increase what they charge insurers.
For a family of four, which already pays taxes for Medicare and Medicaid, the cost-shift from them adds $1788 to its annual insurance premiums. So says a 2008 study by the Milliman actuarial firm, which concludes that “if there were no cost shift commercial hospital and physician costs would be 15% lower.” Compare this amount to the cost-shift from the uninsured, which is at most “1.7% of private insurance premiums,” concludes a Kaiser Family Foundation report.
Edie Sonn scapegoats the uninsured for using emergency departments and not paying. But again, Medicaid is more to blame. In 2008 Reuters reported that the uninsured pay more of their medical bills than Medicaid does for its participants. Further, the National Center for Health Statistics found that people “with Medicaid coverage were more likely to have had multiple visits to [emergency departments] … than those with private insurance and the uninsured.” As for the misuse of emergency departments, the uninsured are no more guilty than others. The study found that those with no insurance, private insurance, or Medicaid used emergency departments for non-urgent care at “similar rates.”
Back to the $5 tax to save $1. Sonn says it’s “important” the Colorado politicians can force everyone to buy politically-approved insurance. The “important” example she mentions is the state’s “Blue Ribbon” Commission on Healthcare Reform. According to the Commission-sponsored study, the annual cost-shift from the uninsured was just $85 per insured Coloradan. But the Commission’s policy recommendation, echoed by a Senate Bill, was mandatory insurance bundled with Medicaid expansion and tax subsidies. This would have cost $400 per insured Coloradan.
Despite the cost-shifting the Colorado Medical Society supports, Edie Sonn accused Amendment 63 of being the “cost-shift protection act” and expects that “Coloradans will see through” it. Instead, voters should see through the hypocrisy of consistently supporting cost-shifting while telling voters you’re opposing it.
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This article was published at the Huffington Post.
Colorado politicians and candidates for officer can show their support for freedom and individual rights in medicine in at least two ways. One is to endorse Colorado Amendment 63. The other is to sign the Repeal Pledge.
From the Wall Street Journal:
Republicans are promising to “repeal and replace” ObamaCare, and more than a few Democrats seem to be running on—or at least from—the same issue. And it’s a good campaign platform given the rising unpopularity and toxic side effects of one of the worst pieces of legislation Congress has ever passed. …
The “repeal pledge” is a project modeled after the famous taxpayer-protection pledge of Americans for Tax Reform, under which incumbents and candidates make a public promise to vote against tax increases. The tax pledge debuted in 1986 with the endorsement of Ronald Reagan and has helped to steel opposition to antigrowth policies. The repeal pledge aims to do the same for ObamaCare.
Efforts like these can be gimmicks, though when well done they educate the public and encourage politicians to commit to specific policy goals while drawing bright-line contrasts with their opponents. Pledges also help define electoral mandates. The 2010 campaign is already a referendum on the Obama Presidency, but if the repeal pledge gains currency it would allow voters to remonstrate this bill in particular and add momentum to the “repeal and replace” movement.
Launched a week ago by the nonprofit outfits Independent Women’s Voice and American Majority Action, the repeal pledge has been signed so far by 43 Republicans. Its sponsors are about to name a board of outside policy experts to evaluate all votes and let the public track how Members shake out on health care. The pledge applies beyond repeal per se to interim steps like discharge petitions to allow certain up-or-down votes in Congress on partial repeal, stripping funding from some ObamaCare subsidy or enforcement programs, and repealing certain regulations.
Read the whole article: The Repeal Pledge: Holding politicians to their promise to replace ObamaCare.
(Via Linda Gorman)
Should Colorado mandate that each car owner buy a comprehensive lifetime vehicle warranty? By the logic of a common argument against Colorado Amendment 63 and for mandatory medical insurance, the answer is “Yes.” Mandatory insurance treats your body as a means to political ends, rather than respecting your rights as an individual.
An editorial in the Boulder Daily Camera provides an example. It states:
The individual mandate widens the pool of people with bodies — bodies that, inevitably and without fail, need some medical care at some point — that pay for health insurance. The mix of the extremely healthy, the healthy, the sick and the acutely ill is one way to make our health care system healthier.
Read the rest of this article at the Huffington Post: Amendment 63’s Foes Only Want You for Your Body.
Suppose the government required everyone to purchase their meals from state-run restaurants. The government would also select the menu items. If you liked spinach but their vegetable choice was broccoli, then tough luck. Everyone would also have to purchase dessert, whether they wanted it or not. And if some customers couldn’t afford the overpriced meals, you’d have to cover their tab.
Most Coloradans would be outraged at such a violation of their basic freedoms. But this is precisely what ObamaCare does with health insurance — and which the “Right To Health Care Choice” Initiative (Amendment 63) would help prevent.
The ObamaCare plan is essentially a national version of the failed Massachusetts system of mandatory health insurance — a plan that has led to skyrocketing costs and worsening health care. …Coloradans can avoid the mistakes of Massachusetts, save money, and protect their health care freedoms by voting for Amendment 63. What more could one ask for?
Read the whole article: The “Right To Health Care Choice” is right for Colorado.
Economist Linda Gorman writes:
People who need to spend $100,000 to interpret 90 words of a ballot initiative, that the Blue Book interprets for free, shouldn’t have much credibility when it comes to controlling health care costs.
That’s how much the campaign against the health care choice amendment, Amendment 63, spent on fancy campaign consultants. The money came from union headquarters in Washington, D.C. …
Other donors include self-interested providers [who] like health insurance mandates because mandates will force you spend more on health care and they will get part of your money. …
Opponents argue that mandates are necessary to help people with pre-existing conditions get insurance. In fact, Colorado has been offering subsidized health insurance for people with pre-existing conditions for a decade, and will continue to be able to do so with Amendment 63 in the Colorado Constitution.
Read the whole article in either the:
- Denver Daily News: DC unions bankroll Colorado campaign against health care choice (Amendment 63)
- Denver Business Journal: D.C. unions fund the campaign against health care choice (Amendment 63)
From the Denver Daily News:
Dr. Brent Keeler, president-elect of the Colorado Medical Society, said in a statement yesterday that Amendment 63 might “interfere with the state’s ability to regulate the practice of medicine.”
Dr. Brent Keeler’s statement about Amendment 63 and licensing is absurd. He might as well argue that the Colorado Constitution supports the right of violent criminals to be armed. Read my article refuting the Dr.’s claims in the Denver Daily News: “Legacy media echo reckless distortion about Amendment 63” and Amendment 63 vs. the Unlicensed Vampire Alarmists in the Huffington Post.