August 29, 2014
Consider health care. If any issue might suggest an Obama vision, this would be it. But what, really, is Obamacare? It is quite unlike Medicare or Social Security. Both programs—despite their shortcomings—are conscientious mixes of policy ideals and political realities, crafted by men with clear visions. Look carefully at both programs, and you can see that vision, not only of what the proper policy is, but how to get it through Congress and build public support.
Obamacare exhibits none of these qualities. It is a bizarre Rube Goldberg contraption with no clear idea at its core. The exchanges are intended to promote competition while the Medicaid expansion doubles down on single payer. It reins in the insurance companies while the risk corridor program shovels billions to them in bailout cash. It expands coverage for prescription drugs for seniors while simultaneously granting drug companies some exceedingly generous rents.It is almost as if it were written with no White House input except, “Get me a bill to sign!”
via What If There’s No There There? | The Weekly Standard.
August 29, 2014
We won’t rehash the debate here over whether or not it’s a good thing for the welfare state to provide so much that people will choose not to work – but it’s pretty undeniable at this point that ACA is disincentivizing work for Americans in an era where we’re wondering if the decline in labor force participation is the new normal.
via CBO Report: Obamacare Denting Labor Force – Kevin Glass.
August 28, 2014
Insurers can no longer reject customers with expensive medical conditions thanks to the health care overhaul. But consumer advocates warn that companies are still using wiggle room to discourage the sickest – and costliest – patients from enrolling.
Some insurers are excluding well-known cancer centers from the list of providers they cover under a plan; requiring patients to make large, initial payments for HIV medications; or delaying participation in public insurance exchanges created by the overhaul.
Advocates and industry insiders say these practices may dissuade the neediest from signing up and make it likelier that the customers these insurers do serve will be healthier — and less expensive.
via Winston-Salem Journal: Winston-Salem News, Sports, Entertainment, Politics, Classifieds.
August 27, 2014
In theory, a universal basic income offers an intriguing alternative to our current dysfunctional welfare state. But a closer look raises several questions about whether and how a UBI could be implemented in a way that doesn’t create more problems than it solves.
I set aside the question of whether redistribution – for that is what UBI really is – is ever justified. Matt Zwolinski makes a solid case in favor of such efforts, and certainly a limited amount of redistribution has been supported in the past by prominent libertarians, including Hayek, Nozick, and Friedman among others. On the other hand, as Michael Huemer points out, UBI will, of necessity, violate the Nonaggression Principle at the heart of much of modern libertarianism. Yet, as interesting as such debates are, there will be some form of government-imposed redistribution for the foreseeable future. The real question therefore is whether UBI offers a better way to fight poverty.
via The Basic Income Guarantee: Simplicity, but at What Cost? | Cato Unbound.
August 26, 2014
The Medicare Trustees issued their annual report on the program’s long-term financing outlook last month, and their findings were greeted by the Obama administration as evidence that the Affordable Care Act is working. This is nonsense.
The general slowdown in health spending remains largely a phenomenon of economic conditions related to the deep recession of 2007-2009 and factors outside the realm of the ACA. Among other things, it is noteworthy that health spending growth rates have moderated across the developed world in recent years, as measured by the OECD. Even Obamacare’s most enthusiastic apologists might be sheepish about claiming the law somehow caused a global health transformation.
A close examination of the ACA’s provisions, especially those related to Medicare, also produces nothing that would lead one to expect large-scale spending moderation. The main provisions of the ACA provide substantial new subsidies for health insurance, through Medicaid and the federal and state exchanges. The Congressional Budget Office CBO estimates that these provisions will cost about $1.8 trillion over the period 2015 to 2024. The main effect of this massive increase in subsidization of insurance will be to increase demand for services and thus put upward pressure on prices and costs. This is simple economics. It may take some time for these pressures to emerge, but they will eventually emerge.
via A closer look at Medicare – Health – AEI.
August 25, 2014
A new analysis from PricewaterhouseCoopers projects that average premiums for policies sold through Obamacare’s exchanges will increase 7.5 percent in 2015.In nearly one-third of the 29 states that PwC investigated, premiums will rise by double digits. In Indiana, the average increase will be 15.4 percent. In Kansas, it’s 13.6 percent. Florida’s insurance commissioner says premiums are set to climb 13.2 percent.
via Obamacare’s Death of a Thousand Rate Hikes.
August 25, 2014
an examination of the rating system by The New York Times has found that Rosewood and many other top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors and others about conditions at the homes.The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify. Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.
via Medicare Star Ratings Allow Nursing Homes to Game the System – NYTimes.com.