Posts tagged ‘public option’

Stealth Public Option

I have not read the relevant text of the law, so this may be an exaggeration, but it sure would not surprise me:

Remember when Obama and congressional Democrats made a big show of dropping the public option government insurance program that was supposedly going to give private insurers competition and drive rates down? The truth is the public option is alive and well, residing in Section 1334, pages 97-100, of the new health care law. That section gives the U.S. Office of Personnel Management "” which presently manages the federal civil service "” new responsibilities: establishing and running two entirely new government health insurance programs to compete directly with private insurance companies in every state with coverage for people outside of government.Quoting the new law, former OPM director Donald Devine notes that it makes the OPM boss a health care czar, with power to set ""˜profit margin premiums and other such terms and conditions of coverage as are in the interest of enrollees in such plans.' That's open-ended. You can do anything." Dan Blair, another former OPM director, calls the new program "nothing but a placeholder for the public option." Indeed, the OPM head is also given the authority to "appoint as many employees" as needed to run the program, and to spend "such sums as may be necessary" to establish and administer it.

The Murder Weapon Is Covered With His Wife's Fingerprints -- We Better Arrest the Butler

I am a bit late to this but from Arnold Kling:

The further into this crisis we go, the greater the share of subprime loans and mortgage losses are turning out to be located at Freddie and Fannie. Even one year ago, if you had asked me, I would have told you to expect at least 2/3 of the losses to be at companies like Citi and Bear, with less than 1/3 at Freddie and Fannie. It now looks quite different. Conservatively, 3/4 of taxpayers losses will be at Freddie and Fannie. Perhaps as much as 90 percent of taxpayer losses will be there.

Given the large role of Freddie and Fannie, it makes sense for politicians to create as large a diversion as possible. Hence, the brouhaha over bonuses at bailed-out banks.

Incidentally, the debate over the "public option" in health reform also can be viewed as an exercise in symbolic politics and diversion. The point is to divert attention away from the bankruptcy of Medicare.

Yeah, But....

From the AZ Republic, on the yet-again-revived public option:

Health-care legislation heading for the Senate floor will give millions of Americans the option of purchasing government-run insurance coverage, Majority Leader Harry Reid announced Monday, although he stopped short of claiming the 60 votes needed to pass a plan steeped in controversy.  Reid, D-Nev., said individual states would have the choice of opting out of the program. Details of how it would work were still sketchy, but states would get a year after the 2013 phase-in of the new health-care plan to decide whether to participate.

And federal taxes for citizens of opt-out states will be reduced, right?  No way.  This opt-out is a joke.  Its a bit like saying that every individual has the right to opt out of public education in favor of a private school.  Sure they do -- they don't have to attend the public school, but they have to pay for it anyway in their taxes.

Update: Sorry, the AZ Republic has made it almost freaking impossible to excerpt from their online articles without bringing over a load of cr*p code.

Totally Inconsistent

Two excerpts from Obama's speech:

That's why under my plan, individuals will be required to carry basic health insurance "“ just as most states require you to carry auto insurance.

Oh, jeez, I sure wish that were true.  Auto insurance covers only catastrophic damages, such as totaling your car or incurring serious liability by hurting someone.   It does not cover regular repairs, preventative maintenance, etc.  Also, state-mandated auto insurance has a range of coverage caps -- if you want a higher cap, you can pay for it.  No one expects their company to pay their auto insurance, and if a company were to provide it it would be considered a taxable benefit.  Compared to our current health insurance system, auto insurance-like health insurance would be a brilliant improvement.  Despite his making this analogy, this is absolutely NOT what he is suggesting.  Also from his speech:

Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies

Update: OK, here is another good pairing, from the same source -- first, he says that a public option will not be subsidized:

They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.

But then he makes this comparison:

It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

See?  The public option will not be subsidized and will work just like public universities which are highly subsidized.

By the way, it is almost impossible for government NOT to subsidize such an entity, in part because of the way government accounting differs from private accounting.  Government accounting is on a cash basis, so large up front investments show as a first year loss with no future expense implications.  In operation, it means capital spending is pretty much free.  And numerous charges that private firms take on, such as liability insurance, are not charged for on government books.   I compete with the government a lot, and have investigated this dynamic in depth.  Even why my costs are lower, the government, because of the way it accounts for things, often thinks its costs are much lower than mine and they under-price us.

The $187,500 Government Hit on My Business

I have suspected that this was coming, but I guess I have just buried my head in the sand, knowing that I would be taking a complete screwing and not wishing to contemplate it.

Sens. Edward Kennedy, D-Mass., and Chris Dodd, D-Conn., say their plan would preserve employer-sponsored insurance coverage and create an affordable public option for those who need it....

The bill includes a "pay or play" provision that would require employers to provide adequate coverage for their workers or subsidize a system that will.

"Pay or play" would require companies to pay the government $750 per full-time worker per year ($375 for part-timers) if they don't offer health coverage, or if they offer "qualified" coverage but pay less than 60% of workers' premiums. Small businesses that employ fewer than 25 workers would be exempt.   (Via Q&O)

I run a recreation business with about 500 part-time, seasonal employees.  Most of them work for the equivilent of about 1/4 of a year, or about 500 hours.  Almost all are over 70, and already on Medicare and Social Security, so we have no health plan  (no way to get a reasonable plan anyway for a bunch of 70 year olds).

Adding up the numbers, this turns into $187,500 bill I would have to pay to the government for not providing health care to people who already mostly have health care.  I will pay 1/2 the full time rate despite my employees working far less than 1/2 of the year.

One thing you can be sure of -- this may be the final death of my current human resources model.  We typically hire more people, working fewer than 40 hours, because retired folks don't generally want to (or can't) work a full week.   That's been OK, because 4 people working 10 hours a week has always cost me the same as 1 person working 40 hours.   But if I am getting charged $375 per worker whether she/he works 1 hour or 1000, you can bet I am going to hire fewer workers for longer hours.  There are probably a myriad of other implicaitons for my business model,  I just have not yet thought it through.

Don't We Already Know the Answer to this Question

Greg Mankiw writes about a Paul Krugman article on "the public option," a plan in Congress to provide a federal health insurance plan to compete with private plans and "keep them honest"**

It seems to me that [Krugman] leaves out the answer to the key question: Would the public plan have access to taxpayer funds unavailable to private plans?

If the answer is yes, then the public plan would not offer honest competition to private plans. The taxpayer subsidies would tilt the playing field in favor of the public plan. In this case, the whole idea of a public option seems to be a disingenuous route toward a single-payer system, which many on the left favor but recognize is a political nonstarter.

If the answer is no, then the public plan would need to stand on its own financially and, in essence, would be a private nonprofit plan. But then what's the point? If advocates of a public plan want to start a nonprofit company offering health insurance on better terms than existing insurance companies, nothing is stopping them from doing so right now. There is free entry into the market for health insurance. If a public plan without taxpayer support would succeed, so would a nonprofit insurance company. The fundamental viability of the enterprise does not depend on whether the employees are called "nonprofit administrators" or "civil servants."  (via Q&O)

But I think we already know the answer to this question.   If Obama and the Democratic Congress is willing to pour a hundred billion dollars or more down the Chrysler and GM rat holes, they certainly are going to pony up far more to support a program so near and dear to their heart for so many years.

There is simply not some magic, easy to access pool of savings in health care available to government managers that will reduce costs 30% or pay for increases in benefits.  If there were, Medicare should have already captured them.

** This is always hilarious to see, as if health insurers make some kind of inordinate profits.  As shown before, the typical after-tax profit at health care companies and insurers is something like 3-4% of revenues.