Saturday, October 18, 2008

Government Run Health Insurance: More Hope than Reality

In 1993, President Clinton tried to pass a single payer government run healthcare system, derisively labeled “HillaryCare” as Hillary became the first First Lady to take on such a public role. This system was to move the United States to a system like the U.K. where the government owns all the hospitals and clinics, and employs all of the doctors. Because of the failure of HillaryCare and the truly abhorrent stories that come out of Canada and the U.K., Democrats have now switched to pushing government run health insurance. Barack Obama is pushing his own version on the campaign trail.

The question then becomes, did these arrangements cost as little as promised where they have been tried in the United States.

Romney Care

Mitt Romney, former governor of Massachusetts and Republican Presidential Primary Candidate helped craft a universal health care plan for that state. Included in that plan was a subsidized health care insurance program called Commonwealth Care. It was designed to offer competitive insurance for those currently without insurance and incomes below 300% of the federal poverty line. (For a family of 4 that would be $63,600 a year.)

The insurance program was supposed to be relatively inexpensive. Like Obama’s plan there is a fine for not signing up for insurance. The theory went that if they could pool all the uninsured, including a large number of young people who use very little medical services, the premiums wouldn’t have to be very high. This is the essence of Barack Obama’s plan as well.

Did the plan stay in budget? Not by a long shot. According to Massachusetts Governor Patrick’s new 2009 budget, how big will this next year’s budgeted amount and increase have to be?

“$869 million for Commonwealth Care, an 84 percent increase over the fiscal year 2008 General Appropriations Act”

Furthermore, according to an article from the Boston Globe:

“...the state expects to spend substantially more for insurance subsidies than the $869 million Governor Deval Patrick proposed in his 2009 budget just two months ago, because of increasing enrollment and higher payments to insurers. In private briefings, she has told coalition members that the cost could be $100 million more, according to several who were present.”

If you do the math, that’s a 105% increase in costs for the program in a single year.

Keiki Care

In 2007, Hawaii created a free insurance program called Keiki (Child) Care. Like the SCHIP expansion championed by the Democrats and vetoed by President Bush in the same year, children who’s parent(s) made too much to qualify for Medicaid could get free basic health insurance.

The Washington Times quoted the President after vetoing the SCHIP expansion:

"If this bill were enacted, one out of every three children moving onto government coverage would be moving from private coverage."

When Hawaii passed a very similar program, what happened? According to the Associated Press:

“State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didn't need it.”

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

So, President Bush was wrong. It was not going to be just 1 out 3 children dropping out of private coverage to get the free government insurance, it was more than 1 out of 2.

What did Hawaii do once they figured out that the insurance plan was going to cost far more than estimated? They ended it, after a mere 7 months. How refreshingly responsible.

Obama’s Plan

What will Obama’s plan cost? Whatever you hear them quote, it could easily be double. Will people drop their private health care coverage to get on the government dole? By the millions. Can we really believe that Obama and his fellow skeptics of the free market could so blindly underestimate the costs of their plans? Everyone together: YES, WE CAN!


K said...

This was a very interesting article. It's true that insurance is very confusing and stressful.

Brian Shelley said...

As an Actuary, I find that insurance is only complicated in industry where the government meddles. Life insurance, easy. Health insurance, uggh.