jeffd
1961
Setting aside the fact that some of these are not reforms at all (selling insurance across state lines will do nothing but ensure a regulatory race to the bottom, as per credit card deregulation) and some of them are already in the bill (information system modernization) - even if we had all of these things in the bill just as you described them, I would bet a lot of money that the bill would still not get a single Republican vote.
Won’t work at all in the present structure. The ideal way for an insurance company to operate is to find a geographical area and establish a dominating presence there, at which point it can control prices. Out-of-state insurance providers probably won’t be price-competitive with in-state insurance providers because they won’t have any established networks of doctors to bring in.
Not a problem the government can solve, unless it set up some kind of national health registry, and even then I think you’ll find a lot of doctors will just hire a new assistant to handle translating their charts to public records. I know other software developers who have had to work with doctors - they are bad, bad people to try and develop software for. They like to do things the way they do them. A national health registry WOULD be beneficial for a number of reasons, however, and I think that the benefits outweigh any potential privacy concerns.
Not really. In MA there is no Community Rating and Guaranteed Issue mandates for private health care companies.
While it does provide subsidized state-run health care to individuals near and above the poverty line, it doesn’t have nearly as many sweeping industry changes as the HCR act.
MA’s bill is no shining beacon of success, either. While increasing the number of insured individuals by taxing citizens, naughty industries, and corporations, it does nothing to rein in costs. It’s expense is projected to double in 5 years.
I will grant you that there is some amount of IS modernization in one of the Dem bills, I would just argue it could go further. After all, there are pockets of health providers and insurers that are quite modernized, but have no incentive to share information with their competitors, even upon customer request.
Health insurance is already quite regulated, but if an insurer is doing wrong by the consumer, said consumer will now have the ability to “vote with their feet.” After all, there will be hundreds to choose from instead of a handful per metro area.
The concept of any type of insurance is about
risk pools. The larger the pool, the more likelihood to have a large portion of healthy individuals paying in and a smaller amount of sick individuals getting paid out.
Let’s just say if you have 50 risk pools (states) with 1000 people in each of them, and one person gets very sick in each pool, everyone’s cost rises dramatically. This happens often with small employers that have one sick person price the whole company out of the market. Now, consider one risk pool with 50,000 people in it. 50 people getting sick won’t much effect premiums for the rest of the pool.
Apparently this forum doesn’t like my curly quotes. I’ll try to stick to normal ones.
I was speaking more generally that there are benefits to having money, so people with more money will necessary have more “benefits” than people who have less money. That doesn’t mean that the two groups have unequal access to healthcare (or whatever); it’s just the reality that goods and services cost money.
Right, that’s the sum of all Republican opposition to the bill: “We don’t like it.”
No, they have made cuts and changes in order to appease some Democrats. They have not picked up any Republican votes from these changes, which indicates that the changes were not made as a deal with Republicans.
So what you’re saying is, Republicans are against the healthcare bill because of:
- Hatred of the poor, or other races;
- Selfishness;
- Stupidity and a herd mentality;
- The idea that conservatism puts poor people “in their place” and makes them easier to control
Is that about right?
jeffd
1968
Most individuals get health insurance via their employer. Removing barriers on interstate insuring will not allow them any more choice in insurer than they have today. They only have the choice that their employer’s HR department offers them.
For the individual health insurance market, in theory interstate competition would allow an individual to have more choice. In reality the structural defects in this market have nothing to do with the number of insurers competing in it. However it also guarantees that all insurers will base themselves out of the state with the lowest amount of regulation, which probably undoes any theoretical gains from increased competition. See: US Credit Card industry.
jeffd
1969
Republicans in Congress are against the healthcare bill because they’ve identified total obstruction of the Democratic agenda as their path back to power.
As far as the broader conservative movement goes - your characterizations are crude, but mostly accurate. There’s a lot of political science data (ONOS DAT) out there that indicates that individual policy preferences are almost entirely informed by a few basic factors (social/economic status and welfare, partisan identification, tribalism).
As far as I can see, yes. I HAVE asked you to provide whatever Republican changes/alternatives which may have been proposed. You haven’t, so far.
No, they have made cuts and changes in order to appease some Democrats.
I said “conservatives.” Not “republicans.”
They have not picked up any Republican votes from these changes, which indicates that the changes were not made as a deal with Republicans.
Again, what changes have the Republicans requested? Do you have any evidence that the Republicans have made any good faith efforts to be involved in the process?
But it would allow the employer to have more choices about which insurer to offer. And as insurers will be competing for those dollars, that will drive costs down.
User Sharpe gave a pretty comprehensive set of objections to the Republican reform proposals.
jeffd
1974
Sure, that’s the Ec101 version of things. As I’ve pointed out to you before, Ec101 is introductory economics, the subject goes way beyond that. The situation is more complex than MORE COMPETITION GOOD!
In reality, the price of health insurance to employers is mostly driven by two things:
- Size of the employer. Collective bargaining works! Also you get a better risk pool, which brings down costs.
- Cost of healthcare. As healthcare gets more expensive, health insurance gets more expensive.
Remember that the overall profitability of the insurance industry is actually quite low (something like 6% for the entire industry). Earlier in this thread I broke out the numbers for individual segments of the industry. As I recall the overall profitability of insurance companies catering to large employers (large defined as something like 5k+ employees) was pretty small, like 3-4%. It gets better for insurers catering to small employers, but not much better.
The point? There’s only so much savings you can squeeze out of these guys via increased competition. I’ll grant that there may be some, but it’s not much. I’m not aware of any studies that show there’s serious gains to be made here.
On the other hand - opening insurance up to interstate competition creates some concrete costs. I’ve mentioned it twice now, and both times you’ve avoided addressing it so I’d like to hear your thoughts about the inevitability of a regulatory race to the bottom analagous to the one that occurred when the credit card industry was deregulated. What’s going to stop someone (say North Dakota, this time) from totally deregulating its insurance industry, followed by every insurer moving to North Dakota. If you think insurance companies are assholes now with recission and whatnot, just wait until they’re totally deregulated!
Or they believe that the general public does not support the healthcare bill as currently written, and any suggestions that have made for improving or amending the bill have been rejected by the Democratic leadership. And by the way, since the Democrats have 60 votes, I’m not sure where Republican obstruction even comes into play.
Man, and here I thought we had already passed the heyday of Republican trolls on Qt3. First brettcmd, now this Bates kid.
It’s like having your very own Republican talking points generator built into your website! Only in this case, it’s trolls on a forum.
jeffd
1977
GAME TIME!
I’ve labeled the claims Andy has made in his post.
One of them is an outright falsehood. Andy is either lying or totally misinformed.
Two are misleading, either deliberately or because he’s poorly informed.
One of them is actually true, without any obvious attempt to misinform.
Can anyone tell me which one is which?
BONUS QUESTION FOR ANDY: For the one that’s outright false - are you lying deliberately? Or do you just not understand what you’re talking about?
Quoting this just to point out that while the Republitards argue in bad faith, at least the Demoncrats’ supporters have this funny thing called reason.
(Unless Sharpe isn’t actually a Democrat, but I presume he is.)
Um, no…only 59. I’m guessing you haven’t turned on a TV, read a newspaper, or opened an Internet browser in the last two weeks?
Oh, and trying to dismiss the obstructionism charge is even more hilarious on the day that one Republican Senator put a hold on EVERY Obama appointee.
jeffd
1980
Yeah. For some reason I give Andy slack though. brettmcd is obviously a troll, there is no attempt at good faith participation on his part. OTOH Andy reminds me of me, circa 10 years ago - he’s read a book on introductory economics, or maybe took a single course on it and thinks he’s got it ALL FIGURED OUT and if only we’d apply introductory economic principles we’d see that IT ALL JUST MAKES SENSE!
