Busting the Medicare Myths – Presentation

I gave a presentation today to the Michigan Intergenerational Network at Madonna University on the economic prospects of Medicare (U.S.). Thanks to the Madonna Univ. Gerontology Department for support and assistance.

For a downloadable and viewable copy of the presentation, see:  https://jimluke.com/course-resources/presentations/busting-myths-about-medicare/.

Easy Way to Fix Obamacare and Cut Deficit

The easy way to fix Obama’s healthcare bill/law and at the same time cut the federal deficit.  Just sayin’…

by Jonathan Zasloff

One can debate the political pros and cons of President Obama’s proposed budget: Jonathan Chait does an excellent job here debating with — himself!  But in fact there is a quite simple way to reduce federal spending by $47 billion a year as a conservative estimate: that old public health care option.

Such things, however, cannot be discussed in polite company, so let’s just reduce Pell Grants, maternal and child health, and food safety inspections instead.  Whew!  Glad we dodged that bullet.

 

Healthcare Act – Unintended Consequences

So far I’ve largely stayed away from commenting on the lawsuits and Republican/Tea Party attempts to repeal the Affordable Care Act of 2010 that everyone refers to as Obamacare (odd choice of name since it doesn’t set up any government-operated healthcare facilities – it’s mostly about insurance, not care delivery). It seems that there are three sources of opposition to the healthcare reform act. There are those who are opposed to the “mandate”, the requirement that individuals buy healthcare insurance or suffer financial penalties for failing to do so. This is basis it appears of the opposition that has become several lawsuits trying to stop the act. Then second, there are those, primarily many Congressional and Senate Republicans who are simply opposed because Obama proposed it, despite the fact that the program as passed is essentially the same thing that Republican Mitt Romney created in Massachusetts. Finally there are those who opposed to any attempts to find affordable ways in which less privileged Americans can obtain healthcare – they prefer an everyman-for-himself world.  Best as I can tell, these are the folks calling it “socialism” despite the fact the program is best thing to ever happen to privately-owned insurance companies.

This post is relevant to the first opposers, the ones who claim to want affordable insurance to be available for all but oppose the “mandate” on some sort of liberty and constitutional grounds. Now a caveat first.  I am no great fan of the bill as passed. It is far, far from what I would have preferred.  My preference would have been for Medicare eligibility for all,not just seniors – a single payor system with private delivery of care. But, I think those who oppose the mandate, may find, should they win their lawsuits, that they run into that bane of economic policy proposals in the real world: unintended consequences. It seems to me there’s two likely types of unintended consequences that these people will find unpleasant.  First is that should the mandate fail, then the only way to achieve affordable health insurance for even just a majority of Americans is to go to a public-option or single-payor system. The reason is because the healthcare insurance market does not and cannot work successfully without the broad-based coverage that only a mandate, public option, or single-payor can provide. Healthcare insurance, with private insurance companies leading the way, is prone to serious adverse selection problems. Insurance companies only want to insure people who have no claims and only people who need healthcare want to buy coverage until the unexpected happens. It’s the dynamic that caused the nation to have this debate and why every developed nation has some sort of public-option, mandate, or single-payor. The Incidental Economist explains more here and  gives examples of the Massachusetts experience here. So if opponents succeed and get the mandate repealed, they may very well find  that healthcare affordability is more popular than they perceive and the nation may be forced to their even-less liked options: single-payor or public option.  Oops, unintended consequence.

Another possible unintended consequence has to do with a variety of other  laws that most of the mandate-opponent conservatives favor.  Constitutional law scholar Laurence Tribe observes that should the Supreme Court strike down the mandate as unconstitutional, the logic they would have to use would reverse and/or jeopardize a wide range of other federal laws that the court and conservatives have upheld. Such as the ability of the Federal government to “regulate” or prohibit the growing and use of marijuana in one’s own backyard for your own consumption. Through some tortured logic, the same Supreme Court justices that would have rule against the mandate held that growing something for your own use that your state doesn’t prohibit still constitutes “interstate commerce”.  Hmm.  So it the mandate goes, it might create a whole meaning for “medical marijuana”.

Ok, so apparently 14 or more state Attorneys General, including my state’s AG, Mike Cox, have filed lawsuits to try to stop the recently enacted Healthcare Reform Act.  These AG’s claim to acting in the interests of their citizens to “protect” them against waste, fraud, and so-called unconstitutional mandates by the federal government.  Apparently in their desire to save taxpayers’ money, these same AG’s didn’t do their homework.

Paul J. O’Rourke at OpenSalon notes that the AG’s claim that:

“The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty, that all citizens and legal residents have qualifying health care coverage,” the lawsuit states.

He then proceeds to give the AG’s a history lesson.  It seems our founding fathers, people I presume knew something about the constitution (and the Fed Gov’s power has only gotten wider since) enacted a mandate on private persons for a healthcare insurance scheme back before 1800:

The history lesson

In July, 1798, Congress passed, and President John Adams signed into law “An Act for the Relief of Sick and Disabled Seamen,” authorizing the creation of a marine hospital service, and mandating privately employed sailors to purchase healthcare insurance.

This legislation also created America’s first payroll tax, as a ship’s owner was required to deduct 20 cents from each sailor’s monthly pay and forward those receipts to the service, which in turn provided injured sailors hospital care. Failure to pay or account properly was discouraged by requiring a law violating owner or ship’s captain to pay a 100 dollar fine.

This historical fact demolishes claims of “unprecedented” and “The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty…”

Perhaps these somewhat incompetent attorneys general might wish to amend their lawsuits to conform to the 1798 precedent, and demand that the mandate and fines be linked to implementing a federal single payer healthcare insurance plan.

With conservatives on the Supreme Court that think corporations have been oppressed and denied the ability to “speak”, it’s always possible that strange things happen.  But, frankly, I don’t see how these suits are anything but state Attorneys General wasting taxpayer money in order to promote their own political careers.

BTW: in case you don’t believe O’Rourke, try checking out WikiSource and read the law for yourself.

Healthcare Reform in 2 sentences

Excerpting from Brad Delong:

we have moved from having by far the worst health care financing system in the OECD to a health care financing system that is merely bad by the standards of the OECD…

…People will wake up one morning and realise that the healthcare bill hasn’t brought socialism to America. And … realise we have not magically solved all our healthcare problems. People should calm down a little. There has been a tendency to exaggerate recently.