Saturday, June 16, 2007

Labor AND Business Behind Gov't HealthCare; The Logic of Continuous Increases

We've mentioned this before, with specific reference to both Silicon Valley and Detroit's "Big Three." There are a lot of business entities which are perfectly comfy with the idea that taxpayers should pay for ALL healthcare. Natch, the Labor folks are on board.

UPDATE: See Milwaukee JS (6/17/07) article on this issue. Note three plans advanced...

So sayeth David Hogberg, in Human Events:

This time, however, the reform effort is different in one important respect. In 1993-94, many industry groups opposed the attempt to nationalize America’s health care system. In 2007, industry groups are tripping over each other in their rush to endorse plans for more government involvement.

Membership in HCCU, which is the Families USA coalition, is a very select assembly of 16 “signatory organizations.” It includes AARP, the liberal lobby that poses as a seniors’ advocacy group. Insurance giants Blue Cross Blue Shield, Kaiser Permanente, and UnitedHealth Group have also signed on, along with America’s Health Insurance Plans, the trade association for health insurers, and pharmaceutical giant Pfizer.

But guess what? The U.S. Chamber of Commerce also backs HCCU. So does the American Academy of Family Physicians, the American Hospital Association, the American Medical Association, the American Public Health Association, the Catholic Health Association, the Federation of American Hospitals, the Healthcare Leadership Council and the medical products conglomerate Johnson & Johnson.

One detects a 'marketing ploy' by Pfizer and J&J. Slap me before I get more cynical.

Another group,

BHCT includes the Communications Workers of America and the Center for American Progress, a liberal Washington, D.C. think tank. But BHCT also has its own business supporters, including AT&T, Intel and Kelly Services, Inc., as well as the business-backed Committee for Economic Development. That these corporations would enlist in a union-sponsored lobbying effort is odd enough, but jaws dropped with the announcement that Wal-Mart had joined the SEIU partnership

Uhhhnnn--why did "jaws drop"? WallyWorld would LOVE to avoid benefits-cost.

If you wonder why DarthDoyle stubbornly refuses to make HSA's tax-deductible in Wisconsin, wonder no more. He's drinking the Kool Ade from these guys:

Despite the failure of the Clinton health package, Families USA [HCCU, above] has continued as a high-profile player in the battle over health care reform. Since George W. Bush became President, it has strongly criticized market-oriented reforms such as Health Savings Accounts and proposals to permit consumers to buy health care insurance out of state

You see more evidence based on how Doyle's budget-priorities line up with theirs:

The HCCU goal, announced on the Families USA website, is “to cover as many people as possible, as quickly as possible.” The strategy focuses first on children. HCCU proposes to expand two programs: Medicaid, the state/federal health insurance program for the poor, and the State Children’s Health Insurance Program (S-CHIP)

"It's for The Children" (except the ones which Darth would kill by ESCR, "Plan B" chemical abortions, or just abortions in general...)

Next are uninsured adults. The coalition proposes to increase Medicaid funding so that all poor adults have government health insurance, and it gives a tax credit to adults who don’t qualify for Medicaid but earn up to 300% of the poverty level, which is currently about $28,000 for a single adult.

It’s not hard to figure out why some HCCU members favor these proposals: They know that Medicaid and S-CHIP often have the lowest reimbursement rates among health insurance programs, whether public or private. According to the American Hospital Association, Medicaid reimburses only 87 cents for every dollar hospitals spend on Medicaid patients. Funneling more tax dollars into these programs would increase reimbursements to doctors and hospitals and probably encourage more prospective patients to seek medical care.

Both business and labor groups utilize The Big Myth to argue their case:

they all focus on one point of concern: “the uninsured.” The “fact that 47 million of our neighbors lack health insurance is a national disgrace,”

...which happens to be the "Global Warming" of healthcare myths.

These figures are constantly repeated, but they exaggerate the problem. For instance, they don’t distinguish between people, many of them young and healthy, who are between jobs for brief periods from those who are “chronically” uninsured (i.e. for a year or more.) When the Congressional Budget Office (CBO) took that factor into account, it tabulated the uninsured at between 21 and 31 million. In addition, people who make enough money to afford health insurance but don’t buy it are counted as uninsured, and so are those who could be included in their employer-based coverage but for various reasons choose not to do so. Further, the Census Bureau and the CBO fail to take into consideration people who are eligible for Medicaid but have not enrolled in it as well as people who receive Medicaid, but don’t admit it. All these groups are dumped into the “uninsured” category. Health policy analysts who have taken these factors into account conclude that the true number of uninsured is more likely between 8 and 10 million.

What the Hell, it's only a 300% exaggeration. No different from the typical lies about "what I made last year..."

But there's a logical followthrough, too:

there is also reason to doubt the financial costs the uninsured impose on the rest of us. According to the most recently compiled data, the Urban Institute calculated that in 2001 the uninsured used about $34.5 billion in “uncompensated” health care (i.e. costs not paid out of pocket or by an insurer). In inflation-adjusted 2005 dollars, that would be about $40.8 billion. That’s very little in a nation that annually spends almost $2 trillion on health care.

About 2.09%, as a matter of fact.

So why ARE healthcare premiums rising?

1) [T]he U.S. tax code. Our tax laws give employees an unlimited tax break for the cost of health insurance as long as their employers provide it as a benefit. This encourages employees to select the most expensive policies that provide “comprehensive” coverage and often leads to the overuse of health care, which puts upward pressure on prices.

Employers benefit, too. They lower their salary costs by compensating workers with health insurance purchased at lower group rates. [WEAC, AFSCME, State Employees, anyone?] The losers are the self-employed or those who work for employers who don’t offer health insurance: They often pay much higher individual rates with after-tax dollars.

2) Another reason that health care is expensive is that our current health insurance system, in place since World War II, shifts responsibility from the individual to the employers and the insurer. Workers expect their employer to pay for health insurance and they expect the insurer to pay for all their health care expenses, big and small. This system has exacerbated the rise in costs. In 1965, about 48% of what Americans spent of health care was spent out of pocket. By 2006 the amount was down to just more than 12%.

And there is an "economics-logic" problem which Gummint-HealthCare advocates have:

Both Families USA and SEIU say they want to hold down the costs of health care, yet at the same time both are committed to policies that pump up demand for health care. Without recourse to the price mechanisms of the market, these promises can never be met. Increased demand raises the price of health care, which increases the price of private sector health insurance. As the price of health insurance increases, fewer people will be able to afford it, which adds to the ranks of the uninsured.

Pertinent portions of the JS article here:

Wisconsin Health Security Act - Would cover Wisconsin residents with a single, publicly financed health plan. Would create a Department of Health Planning and Finance that would administer the plan under the guidance of a policy board. Would set rates for hospitals, doctors and other providers. Funded by taxes on employers and individuals.

Wisconsin Health Care Partnership Plan - Would cover all private and public employees and their dependents. Self-employed workers, farmers and early retirees could buy insurance at cost. Funded by a payroll tax estimated at $380 a month or $2.21 an hour per worker. Overseen by a labor-management commission that would set reimbursement rates for hospitals, doctors and other providers. An analysis projected $2 billion in savings statewide in the first year. (AFL-CIO backed plan.)

Wisconsin Health Plan - Would cover nearly all Wisconsin residents, excluding those in government health programs. People would receive a "premium credit," or voucher, to buy health insurance from qualifying health plans. Plan would include health savings accounts and high deductibles. Farmers and self-employed workers could buy into the plan. Funded by an 11.55% payroll tax paid by employers, plus a 3.95% assessment on workers wages. Assumes that people will opt for HMOs. An analysis projected $8.9 billion in savings the first 10 years. (See Zlotocha article here.) This is the plan which projects that employers will REDUCE wages to implement the plan--and "projects" that "tax reductions" will make up the difference.


Karen Marie said...

Of course being insured increases demand for health care. Sick people and injured people without insurance just stay sick or injured, until they pass out in public or just can't cope any more, and show up in the ER in extremis. Insured people get to go to the doctor early, get diagnosed and treated, and don't get to extremis. I wish I'd had access to regular medical care in my childhood and youth {my childhood insurance only covered the hospital; then I was uninsured entirely for 8 years....) since my asthma and sleep apnea might have been caught and treated before the heart damage was done. Now I'm one of those very expensive disabled people.......

Dad29 said...

Insured people get to go to the doctor early, get diagnosed and treated, and don't get to extremis.

1) Your assumption that 'insured people....get diagnosed...' is just that--an assumption. They may--or they may be more likely to do so--but not necessarily.

2) ALL people go to "in extremis" at one point in time or another. The logical response is "so what?"

It is proven that National Health systems (e.g, England and Canada) will preference the young and/or healthier in treatments--meaning that YOU would be last-in-line.

I am hardly as cold-hearted as that response sounds--but in fact, you have treatment available, yes?

And treatment is just as assiduous and urgent as it is for private-insured.

Karen Marie said...

I am private-insured (secondary to Medicare, since I've been totally disabled for more than two years....) One of the advantages to being a public servant in this city is, that if one serves at least 15 "pensionable" years, the city keeps the retiree in the city's insurance pool.

I wouldn't be here if I would have had to wait the two years before Medicare started uncovered. (Too poor to pay, too "wealthy" to qualify for T-19)

And I know that there are some people out there who are of the belief that disabled people have a duty to die...... even those of us who are still very much alive.