Nationalized Heathcare Already Tried.......& FAILED.
- March 24, 2010 21:04:10
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The prospect of a nationalized healthcare system as proposed has created a furor of debate. The proponents claim that it will reduce costs, improve care, and cover everyone. Opponents stress that costs will climb, quality will degrade and liberty in the form of personal choice will vanish. Still others in the middle believe that the truth will be somewhere in between. The argument is made that the experiences of other countries are not applicable to the American situation. Such prognostication is unnecessary; the reality of an American system has been proven – not once but several times.
The states of Tennessee, Hawaii, Oregon, Massachusetts, California, Kentucky, Maine and Wisconsin have tried universal healthcare systems with varying degrees of success. Many more states have tried or are currently operating schemes designed to address the needs of children only. In ALL cases, the programs have cost more than predicted. Some programs have delivered less care and the quality has declined. In a couple of notable cases, the programs have been terminated.
Tennessee - TennCare
The state of Tennessee first tried TennCare in 1994 as a single payer system that was designed to use the anticipated savings from Medicaid to provide coverage to children and the uninsured. The costs and enrolled numbers swelled to the point that Tennessee’s governor made a very unpopular proposal to institute a state income tax to bridge the shortfall. The program nearly bankrupted the state and reduced quality.
The state of Tennessee first tried TennCare in 1994 as a single payer system that was designed to use the anticipated savings from Medicaid to provide coverage to children and the uninsured. The costs and enrolled numbers swelled to the point that Tennessee’s governor made a very unpopular proposal to institute a state income tax to bridge the shortfall. The program nearly bankrupted the state and reduced quality.
A reduced form of the program is now in place along with the companion TennCover. The state had to slash the roles and coverage to avoid a complete economic collapse of the state government.
Hawaii – Keiki Care
Hawaii tried the similar Keiki Care program for children in 2007. The intent was to cover children of parents who did not receive coverage through their employers. The cost was low enough that employed parents realized that they could drop employer provided coverage and put their children on Keiki Care and save a substantial sum. Hawaii’s governor, Laura Lingle, terminated the program after a mere 7 months.
Proponents of a nationalized healthcare system argue for mandating everyone must partake in a socialized system, so that the costs will be shared equally. But Hawaii’s example has shown that the costs will skyrocket when healthcare is “free” as people are more inclined to use the system for even the smallest of incidents. As people look to cost shift to the state and to “get their money’s worth” with more frequent usage of the system, the taxpayers will see the costs increase exponentially and the wait times will drag out considerably.
Oregon – Oregon Health Plan
In an effort to prevent an overload of Oregon’s state healthcare program, the state has limited the number of people eligible for coverage to 24,000. The acceptance is granted through a lottery system. One must wait to obtain benefits through the system that the taxpayers fund. The Oregon Health Plan was designed in the 1980’s to reduce the uninsured from 18% of the state population. The current recession has had the opposite effect of increasing the number of uninsured as the state seeks to limit the number of enrollees.
Massachusetts – Commonwealth Care of Massachusetts
The program that has generated the greatest amount of study is the Commonwealth Care of Massachusetts. This program has been hailed as the model for the nation to follow, but the experience of the state is the better barometer of how well a national plan will work and the impact that it will have on families. For those making as little as $30,000 per year and facing a health issue, the costs of premiums and deductibles rises to as much as one third of one’s income. The state’s spending on this program has doubled from the projected $630 million in 2007 to an estimated over $1.3 billion in 2009.
Insurers report that the cost of premiums must rise by 10% per year in Massachusetts in order to cover the cost of the increased usage of the medical care system and the additional uninsured that are enrolled in the program. This is after the admission that the state program is constructed to allow the poorest to be exempt from the program resulting in nearly 20% of Massachusetts poorest still lacking insurance coverage.
California – Medi-Cal
California is experiencing the unenviable position of having to extend coverage to illegal immigrants that compose a significant percentage of the state’s population. As this group pays nothing into the system and constitutes the group with the highest usage of the medical care system, they are draining California’s resources at an unprecedented rate. Medi-Cal, the state program for the poor, is mired in over $1 billion in debt this year and no end in sight. Attempts at reform in California’s legislature have failed.
Kentucky – Kentucky Kare
An older, but no less applicable study is that of Kentucky. In 1994 the state implemented a reform program that by 1997 had driven 45 insurers out of the state’s market and had the unintended consequences of higher rates, less coverage, increased pricing of services and a shortage of doctors as they left the state for a less restrictive market. Kentucky Kare led to a series of gaffes including leaks of patient records.
Maine – DirigoChoice
Despite repeated attempts to reform the healthcare system in Maine, the state seems to degrade the system with each reform. DirigoChoice, the current incarnation of state insurance, is derisively referred to not as a healthcare experiment but as a deathcare experiment. Like Oregon, DirigoChoice has a wait list for enrollment and has, like Hawaii, had the unintended result of encouraging people to drop their private care to enroll in the state program.
Wisconsin – BadgerCare and BadgerCare Plus
Wisconsin’s BadgerCare and BadgerCare Plus enrollment were suspended in October of 2009 due to reaching the limit of allowable enrollment. Without additional funding, these programs would quickly spiral into debt. The majority of states have programs to assist their poor and uninsured. These programs, in conjunction with the federal programs provide a safety net that negates the need of ObamaCare.
http://www.jsonline.com/news/wisconsin/63529162.html
http://www.jsonline.com/news/wisconsin/63529162.html
Summary
Although these programs vary in their designs, they collectively contain all of the components of the proposed national programs. With history as our guide, we can see the predictable results of the ObamaCare programs without implementation. We are facing increased cost, lower quality, extensive waits, rationing of care, denial of service, economic collapse due to strained government budgets, massive tax hikes, practitioner shortages, decrease in life expectancy, increase in mortality rates, lower productivity, stifling in innovation, and most importantly, an unprecedented loss of liberty.
There are other implications that we have not explored in our national discussion of the potential effects of socialized medicine. As government grows and assumes more power, it accelerates the restrictions on our choices in every facet of our lives. To control the outlays and costs, at some point we can expect that government will begin to curtail our activities as too dangerous and contributory to higher healthcare expenditures.
Will we begin to see our leisure pursuits limited as too dangerous? Will hunting, skiing, scuba diving, martial arts study, sky diving, football, archery, racing, boxing, canoeing and kayaking be deemed too risky and therefore expensive? Will we find ourselves restricted from attending movies and sporting events that excite us too much or from eating foods that are too rich or fattening due to a heart condition? How far will the politicians and bureaucrats take doing “what is best for us” despite our desire to lead our own adult lives?
Socialized healthcare may prove to be the slipperiest of the slippery slopes.
Top Opinion
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gr8punkin March 24, 2010 21:30:45
+9The great thing for the progressives is this is a single payer plan, it's simply public option in sheep's clothing. Rather than paying taxes to have the government tell you what your health plan is, we are paying an insurance company who will have the government tell them what to tell us our plan is. That is the way that thing was sold to the socialists who wouldn't sign on without a strong public option, it was explained that we didn't need one because they would just do the same thing while making it look like it was still private insurance. Finally when this ponzi scheme fails they can try and declare the "private" industry of health care dead, and proceed with the open socialization of even more of our economy.
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It will happen this way, mandates will drive up private ins. costs. Obama to the rescue, he will do what he does blame the ins co. and push his redistribution ideas.
Weak people need to blame, need to create demons. He does a lot of that.
"Any national program based on the troubled Massachusetts and derailed California plans will have to address another major, perhaps insurmountable, problem central to the market-based model, in which insurance companies run the show: how to cover everyone when insurers can turn away those who are sick and likely to file claims--a standard profit-making practice of insurance companies known by the Orwellian euphemism "risk selection." Massachusetts didn't have to deal with this question, because since 1997 it has required insurers to take all comers, even those with serious health conditions. In the political horse-trading over the California bill, most of the state's insurers had agreed to offer "guaranteed issue" policies, that is, ones available to everyone even if he or she is in bad health. But they still insisted on conditions like limiting policyholders' ability to switch to more comprehensive plans in the individual market. Even so, Blue Shield vice president Tom Epstein told me: "The [universal] mandate would have to be well enforced to make this work. It would have to be effective for us to support elimination of medical underwriting." Translation: everyone must be in the pool to spread the risk among the sick and healthy, or insurance compan...
"Any national program based on the troubled Massachusetts and derailed California plans will have to address another major, perhaps insurmountable, problem central to the market-based model, in which insurance companies run the show: how to cover everyone when insurers can turn away those who are sick and likely to file claims--a standard profit-making practice of insurance companies known by the Orwellian euphemism "risk selection." Massachusetts didn't have to deal with this question, because since 1997 it has required insurers to take all comers, even those with serious health conditions. In the political horse-trading over the California bill, most of the state's insurers had agreed to offer "guaranteed issue" policies, that is, ones available to everyone even if he or she is in bad health. But they still insisted on conditions like limiting policyholders' ability to switch to more comprehensive plans in the individual market. Even so, Blue Shield vice president Tom Epstein told me: "The [universal] mandate would have to be well enforced to make this work. It would have to be effective for us to support elimination of medical underwriting." Translation: everyone must be in the pool to spread the risk among the sick and healthy, or insurance companies won't go along. Indeed, this has been at the core of the mandate versus no-mandate argument between Clinton and Obama, and why Clinton has pushed hard for a punitive mandate to cover everyone. She knows this is the only way to get insurance companies to give up risk selection.
In California, Blue Cross did not go along. According to one insider who insisted on anonymity because of his sensitive position in the industry, "They said privately they will spend whatever it takes" to defeat any law that limited the company's ability to select risk. "Blue Cross is the best at risk selection," he said. "They would take a big hit to their profits." Throughout last year, Blue Cross, whose parent corporation is WellPoint, the largest health insurer in the country, geared up for the battle. It created the Coalition for Responsible Health Care Reform, with a $2 million investment aimed at organizing employers, insurance agents and individuals to sign on to the company's efforts to make sure it controls the substance of reform. One of the ads it ran to sway public opinion said: "Unintended consequences do happen. Other states have tried healthcare reforms like 'guaranteed issue' that sounded good. They now have the highest premiums in the country while California has the lowest." (One reason it has the lowest is that Blue Cross and others are selling cheap policies with skimpy benefits, shoving a lot of costs onto policyholders.) "
The issue being that insurance companies will try to avoid paying claims at all costs (literally, this is where their profits lie). They are okay with the risks if everyone is involved, but usually only the sick seek coverage. Given the option they will deny claims wherever they can and move to states that are less restrictive to them. ALL of these issues are addressed by the health reform bill as most Americans will join the insurance pools, "denial of service" will be regulated, and being a federal mandate, there will be no states in which they can dodge responsibility. They certainly won't be moving their corporations to Canada, Mexico, or Europe either...
Pretty soon, the only ones with coverage will be minorities and illegals......paid for by middle class working folks.
Your conclusions are correct. The simple fact is that absent competition, price goes up and quality goes down. Monopolies always behave like lazy utilities, because there is no incentive to excel. And government monopolies are especially bad, because they restrict your freedoms to reduce their risk.
Stu