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Mitt-Care crashing?
Posted by: McQ on Tuesday, January 08, 2008

BizzyBlog has a fairly extensive look at the status of the Massachusetts Health Care plan.
After one year, Commonwealth Care (aka RomneyCare) in Massachusetts is imploding even earlier than I predicted, due to “spiraling costs.” Punitive fines of $912 - $1,824 are to be imposed on those who would rather not participate in the so-called “grand experiment.”
He also cites Cato:
The cost of the program has exploded; it’s running $150 million above the original projection for this year alone.

Nor has the reform succeeded in holding down other costs. Insurance premiums in the state are expected to rise 10 to 12 percent next year - double the national average. While many factors surely contribute to that jump, one reason is that the new bureaucracy that the legislation created - called “the Connector” - has been adding new regulations and mandates.
Do you remember that classic moment during last Saturday night's debate, when Fred Thompson questioned Mitt Romeny about actually admitting he favored mandates?

Well here are the results.
 
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Two questions.

Did Mitt really have any choice about implimenting universal healthcare in Mass?

Is the failure really the problem of execution or inherent in any universal healthcare plan?

Whether Romney had any choice or not, I’m not familiar with Mass politics to know if he could stop the legislature from implimenting it.

But as for its failure. It was predestined no matter how Romney help pick to impliment it. I mean isn’t that the usual socialist argument? "It will work this time because now we have better people (or plan)."
 
Written By: jpm100
URL: http://
Not that I’ve got any definitive answers for you, jp, but your first question did prompt me to dredge up this old April 2006 article from the WaPo, wherein it is stated, "Gov. Mitt Romney (R) supports the proposal." And there’s a picture of him at a podium saying, bizarrely, to my mind, "We insist that everybody who drives a car has insurance, [a]nd cars are a lot less expensive than people."

Maybe he should have added, "But not like they’re gonna be."

As to his control over the implementation of the plan, his ability to make adjustments with his line-item veto is mentioned on page 2.

There’s also some interesting speculation about the impact of his involvement with the plan on the presidential run he was at that time just considering:
"It might help him to say, ’Look, I have a solution for health insurance,’ " said Julian E. Zelizer, a professor of history at Boston University.
Then again, it might not.
 
Written By: Linda Morgan
URL: http://
JPM: What happens to prices when demand rises?

In Massachusetts, you’re looking at mandated demand, all along the entire pipeline of "production" (if we should actually call it that), to include not only all the genuine medical components, but also the bureaucracy seeing to all of it.

Figure it out.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Romney didn’t just support it, it was partially his idea. The end result was a combination of his plan and others.

No one should be forced to buy auto insurance either; what an inane rationale.

 
Written By: Grimshaw
URL: http://
As Billy Beck noted we shouldn’t be surprised at the problems that the Massachusetts plan is having. I continue to see no way to cope with the problems with our healthcare system as long as the cartel controlling remains. The natural evolutionary path for a national version of the Massachusetts plan is fiat pricing. That won’t work, either. As one of my econ profs put it we don’t know how to create prosperity but we have a pretty good idea how to create scarcity.
 
Written By: Dave Schuler
URL: http://www.theglitteringeye.com
Ummm... That’s my point Billy.

Universal Healthcare is destine to failure.

Should we bother looking at the specific of how it failed? It has to break somewhere.

The question is, did Romney have a choice not to impliment Universal Care?

If I told you to build a structure on the sandy riverbed and gave you no choice but to build it there, who’s fault is it if it sinks? I can point to the specifics of your footing design that sunk into the sand first. Does that make it your fault?
 
Written By: jpm100
URL: http://
"The question is, did Romney have a choice not to impliment Universal Care?"
Well, your initial post also included the question whether "the failure really the problem of execution or inherent in any universal healthcare plan?"

That’s "the question" that I answered.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Quick note here, this is a very complex discussion - but in terms of rising costs. There are certain things in our society where ’price control’ or ’lack of profit’ control is appropriate. Consider H2O - the average human needs it every two days at a minimum (we’re addicted...) if those controlling water could raise it’s price uncontrolled to where others couldn’t afford it in combination with anything else we would have a true water crisis - consider the Flash Gordon story line where Ming’s control is based on control of clean water... Thus the water industry doesn’t provide unlimited profits that might otherwise be available from the market.

Similarlly there was a time in this country where the Healthcare market wasn’t a ’for profit’ market. Not that individuals couldn’t get rich (doctors) and not that you couldn’t run a for profit service, but the base service wasn’t focused on profit, this was IMHO when our heathcare peaked. Individual doctors were well compenstated individuals could do well but hospitals weren’t focused on creating profits, we didn’t have advertisements which when you follow the money are paid for with healthcare dollars (how would you feel watchin commercials to tell you to buy your water from your water company knowing that they could only service those people that were on your system and there wasn’t another system available... for most of us hospitals are based on location - it’s "great" that the hospitals 20-100 miles away advertise to me, but I’ll still wind up at the one 4 miles from my house.)

Even if you want universal health care step A is limiting profits again - so let’s just take a step back from de-regulation, eliminate profit as a organization motivation, and this will help limit the growing cost of healthcare. There are alot of other things to consider but before putting everyone’s insurance and what choices are available under government control, let’s start by just controlling profits and unnecessary costs (ads) in the base healthcare markets.

(BTW - having healthcare for profit is like having basic police for profit - most of us would recognize the universal demand for civil law enforcement prevents it being a ’for profit’ endeavor. However, there are still for profit security and related services and similarlly there will still be high quality for profit medical and healthcare services.)
 
Written By: BIllS
URL: http://bills-opinions.blogspot.com
Bill S -
BTW - having healthcare for profit is like having basic police for profit - most of us would recognize the universal demand for civil law enforcement prevents it being a ’for profit’ endeavor. However, there are still for profit security and related services and similarlly there will still be high quality for profit medical and healthcare services.
The universal demand for food does not prevent it from being a for-profit endeavor. Explain this stubborn fact.
 
Written By: Bryan Pick
URL: http://www.qando.net
Sure, it is a supply vs. demand equation. The claim of course is that there isn’t enough food in our system - but reality shows based on the amount of food disposed in the US that we actually have a supply of food which exceeds demand. An attempt to profit at food must be balanced by the fact that there is more then enough to go around. Note not all of it is quality, but if grocery store A bumps up it’s prices because it sells out of everything everyone goes to grocery store B.... On the other hand watch what happens during a natural disaster, when suddenly things like food (I’m including bottled water here), gas and other essentials are suddenly in greater demand then availability - we have price gouging laws... ie. laws that limit profit during those times when food isn’t in ready supply. Not to mention that keep in mind food can be skipped for weeks as opposed to water which is measured more in days...

Water on the other hand is a truly limited resource - one which has started wars.
Healthcare - when you deal with the sick and aging is another case where demand exceeds supply.
 
Written By: BIllS
URL: http://bills-opinions.blogspot.com
Similarlly there was a time in this country where the Healthcare market wasn’t a ’for profit’ market.
When was this time and where can I read about it?

None of the historians I have seen seem to be aware of this medical Eden.
Sure, it is a supply vs. demand equation. The claim of course is that there isn’t enough food in our system - but reality shows based on the amount of food disposed in the US that we actually have a supply of food which exceeds demand.


Precisely because food is done FOR PROFIT!!! Take away the money that farmers get for food and see what happens to your surplus.
On the other hand watch what happens during a natural disaster, when suddenly things like food (I’m including bottled water here), gas and other essentials are suddenly in greater demand then availability - we have price gouging laws... ie. laws that limit profit during those times when food isn’t in ready supply.
I’m sorry, but what in the hell are you prattling on about? What serves in the role of a natural disaster in your analogy?
 
Written By: Terry
URL: http://
"this was IMHO when our heathcare peaked."

Ah yes, those Golden Days of Yesteryear. Balderdash. I was there, and it weren’t that golden. Give me a ride in a ’for profit’ ambulance any day, the ones with trained paramedics and radios and drugs and oxygen and stuff that keep me alive until I reach the hospital. Those ’non profit’ ambulances of yesteryear (which oddly enough used the same Cadillac model as a hearse) didn’t have any of that stuff.


"Take away the money that farmers get for food and see what happens to your surplus."

I believe that was done in the Ukraine a few years back. Also in most other Communist countries; you know, the countries where the terrible weather is responsible for bad harvests for years and years. Take away the money that doctors get for medicine and you get what Great Britain got in the 50’s—lots of emigration. I don’t know about where you live, but here in Maryland we have oodles of doctors who not only have illegible handwriting, but frequently have incomprehensible accents.
 
Written By: timactual
URL: http://
Oh, fisking... cutting individual sentences out of context so you can try and take the argument out of context that’s so... 90’s :-)

Let’s focus on my basic point - "Basic Healthcare needs cost control as part of any form of universal/governament/socialized/private change." I stand by this statment and the elements I attempted in fewer then 300 pages to explain it. I’m going to work backwards since it’s less scrolling ...

"Take away the money that farmers get for food and see what happens to your surplus."

I believe that was done in the Ukraine a few years back. Also in most other Communist countries; you know, the countries where the terrible weather is responsible for bad harvests for years and years. Take away the money that doctors get for medicine and you get what Great Britain got in the 50’s—lots of emigration. I don’t know about where you live, but here in Maryland we have oodles of doctors who not only have illegible handwriting, but frequently have incomprehensible accents.
The overall theme seems to be that if we didn’t have to pay for food we would have a problem - no kidding, brilliant - doesn’t address anything I claimed. I claimed that because we have a good surplus of food that it isn’t possible for farmers to charge whatever they want - we have a healthy market, and yes that means profits but it doesn’t imply pricing at a sole seller’s choice. "Farmers" are still limited by their own costs - costs which are shared by other producers and resellers in the market - they can’t just raise prices because they are a single source for food - if you disagree with that claim and think that an individual farmer can hold a portion of our society hostage for their basic food needs (note I haven’t said they can’t try to charge whatever they want, just that in our society people will have a choice of whether or not to pay it) please correct me - point me to the tomato/potator whatever food producer who doesn’t have any competition. On the other hand if you water company bumps the rate 500% because ’they can’ do you have a choice? If the hospital in NY has a special on emergency room visits are you going to take advantage of it in Maryland - I don’t think so... you don’t have an open market for you basic and emergency healthcare needs.

Now the first paragraph of you response:
"this was IMHO when our heathcare peaked."

Ah yes, those Golden Days of Yesteryear. Balderdash. I was there, and it weren’t that golden. Give me a ride in a ’for profit’ ambulance any day, the ones with trained paramedics and radios and drugs and oxygen and stuff that keep me alive until I reach the hospital. Those ’non profit’ ambulances of yesteryear (which oddly enough used the same Cadillac model as a hearse) didn’t have any of that stuff.
You quoted me but again you seem to have missed my point. My point wasn’t that hospitals were more capable 20 years ago - but that we managed the costs better. However, you were kind enough to help illustrate one of the items in my favor. You wouldn’t want to ride in a given ambulance - how much are you willing to pay for me to ride in an ambulance? What about my children? Would you refuse to send said ambulance to the ghetto/projects because those people couldn’t pay? Would you turn away a bleeding man or deny a senior who has outlived their retirement oxygen and other stuff that will keep him alive? Would you try and base it on the ability to pay? I think if you really analyze those question you quickly reach a conclusion that perhaps this basic element of healthcare is something society as a whole agrees we need - as such we should pool our resources and standardize on a given level of service and limit the profits to the provider who has this service.

Now does that mean everyone would be limited to that service - survey says - no. Since you brought up Ambulance aka emergency personal let’s look at fire fighters. We all have and use them - and they make money (profit) - however, as was illustrated in the recent California wild fires - if you have lots of money you can hire your own. Yeah some million dollar homes burned - but if you followed the fires they were supposed to burn right through Rancho Santa Fe to the coast - magically they stopped on the borders of RSF where home values tend to be in the 10-20 million range... people with homes of that value can (and do) pay $10K per month for private firefighting services - it’s expensive but they have the resources to pay and resources to protect. They still got the base service the rest of us got - but they paid to go beyond the base services - healthcare needs to follow this model better.

——- earlier comment ——
Similarlly there was a time in this country where the Healthcare market wasn’t a ’for profit’ market.

When was this time and where can I read about it?
Yeah you got me - I oversimplified my point here. quick question can you tell me of a hospital corporation which was founded prior to 1940?
1950? 1960(maybe)? sure you can find tons starting in the late 60’s (HCA 1969) and throughout the 70’s when healthcare became a true ’for profit’ endeavor, but prior to that (and no I wasn’t alive for it) hospitals weren’t run by profit focused corporations. At least in my history books, people still made money but the driving force wasn’t returns to the shareholder. I’m also not saying that the shift at the time wasn’t good for society, I tend to think it was but I’m not afraid to say that perhaps we’ve reaped the available benefits and it’s time to take a portion of the ’purely for profit’ model back a step....
Sure, it is a supply vs. demand equation. The claim of course is that there isn’t enough food in our system - but reality shows based on the amount of food disposed in the US that we actually have a supply of food which exceeds demand.
Precisely because food is done FOR PROFIT!!! Take away the money that farmers get for food and see what happens to your surplus.
On the other hand watch what happens during a natural disaster, when suddenly things like food (I’m including bottled water here), gas and other essentials are suddenly in greater demand then availability - we have price gouging laws... ie. laws that limit profit during those times when food isn’t in ready supply.
I’m sorry, but what in the hell are you prattling on about? What serves in the role of a natural disaster in your analogy?
Again never claimed food wasn’t for profit - I pointed out differences in the available supply - if you have a market which can meet the basic needs to support life then you need cost controls - in our society food is plentiful it is a basic need but we can let the market drive costs because there is a viable market. When in our society does this market fail - natural disasters. Suddenly the viable market breaks down for a period people looking to profit can do so - we call this price gouging and we as a society made it illegal because the market we depend on to set natural pricing has broken down. I was asked to explain why food didn’t need price controls and the reason is a viable market that exceeds basic requirements - when the market no longer fits that model we have designed laws to restrain it - which is what I’m saying we need to do for healthcare. Not I never said that people working in that industry can’t make any profit but that we’ve got to limit profits for basic services, define basic services etc.

If you try and take our system and just say ’everyone can get whatever they want’ then you are taking a market which can’t meet everyone’s desires and opening it to abuse and certain failure... if on the other hand you can effectively define priorities and limit the costs in those areas then you can define what people are eligable for - the cost they need to bear (through any means) and what they’ll need to cover on their own. Again they’ll still need to bear some cost for certain things but some of these items will have fixed costs.

Keep in mind that having insurance cuts your hospital bill by 50-60% before even the insurance company pays anything - why should only those with insurance get the discount - why shouldn’t those prices be constrained for everyone at the same level... this would limit profits for healtcare companies but it is the first step in controling unlimited costs for a basic service that isn’t open to market forces at the individual level.
 
Written By: BIllS
URL: http://bills-opinions.blogspot.com
btw, somehow probably because I put it in brackets my comment that "these questions are rhetorical" with regard to the ambulance services was removed (along with a couple other spelling edits) and I didn’t reread that section after adding that statement.
 
Written By: BIllS
URL: http://bills-opinions.blogspot.com
What happened to car insurance once the states mandated it? Did the costs go up?

I think you’ll find they did. Why on earth would anyone expect this to be any different?

 
Written By: Bithead
URL: http://bitsblog.florack.us

 
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