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Wednesday, July 22, 2009
Jacob Sullum :: Townhall.com Columnist
Paying a Premium for Insurance
by Jacob Sullum
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Will Congress pass Obamacare by the end of the year?

This week President Obama promised "the reforms we seek" will bring greater "inefficiencies to our health care system." It was a slip of the tongue, but the Obama-inspired health care bill moving through the House of Representatives suggests the president accidentally told the truth. The bill, approved last week by two House committees, would spend much more than necessary to subsidize medical coverage for uninsured Americans while failing to deliver on Obama's commitment to control health care costs.

The Congressional Budget Office (CBO) estimates the legislation would cost $1.3 trillion during its first decade: $438 billion for Medicaid and the Children's Health Insurance Program, $53 billion in tax credits for small businesses that offer health insurance to their employees, and $773 billion in subsidies for a government-administered "insurance exchange" in which people could choose among various health plans, including a newly created "public option."

One reason the tab is so high: The bill defines its target too broadly. U.S. Census Bureau data indicate that nearly 40 percent of the 46 million U.S. residents who were uninsured at some point in 2007 had annual household incomes of $50,000 or more. Another 23 percent or so were already covered by existing government programs or could have been. Instead of focusing on the minority who can't afford insurance but are ineligible for taxpayer-funded health care, the House bill takes aim at "the uninsured" generally.

By 2018, the CBO projects, the legislation would provide insurance to 37 million Americans who currently lack it, at a cost of $234 billion. That works out to about $6,300 a person for a year of coverage, which seems pretty pricey, especially since the total cost would be higher: People participating in the insurance exchange would be expected to pay part of their premiums.

According to a December 2007 report from America's Health Insurance Plans, the average annual premium for nongroup health insurance that year was about $2,600 for individual coverage and $5,800 for family coverage. The Census Bureau reports that three-quarters of uninsured Americans live in family households, which in the general population average three people each. Taking that into account, buying insurance for 37 million people in 2007 should have the cost around $78 billion, or a little more than $2,000 each.

How much would it cost in 2018? Kaiser Family Foundation data on employer-provided health benefits (which tend to cost a lot more than policies purchased by individuals) indicate a recent premium growth rate of 5 percent a year, which would make $2,000 in 2007 about $3,400 in 2018, a little more than half what the House bill would spend to insure one person. Even if premiums double during the next decade (as they did during the last decade), simply buying insurance for 37 million people would still be about one-third cheaper than the subsidy scheme created by the House bill.

Also keep in mind that government spending, especially on health care programs, tends to be much higher than anticipated. "When Medicare was launched in 1965," note Cato Institute policy analysts Michael Tanner and Chris Edwards, "Part A was projected to cost $9 billion by 1990, but ended up costing $67 billion. When Medicaid's special hospitals subsidy was added in 1987, it was supposed to cost $100 million annually, but it already cost $11 billion by 1992."

The subsidies championed by Obama would only aggravate the problem of runaway government spending on health care. "In the legislation that has been reported," CBO Director Douglas Elmendorf told the Senate Budget Committee last week, "we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."

The bill does have a great name, though. In the spirit of the spending binge that Obama dubbed a New Era of Responsibility, it's called America's Affordable Health Choices Act.

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About The Author
Jacob Sullum is a senior editor at Reason magazine and a contributing columnist on Townhall.com.
 
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My plan would work

Gary Location: TX
Reply # 22
Date: Jul 22, 2009 - 8:32 PM EST
Jim from CA post

Please read Gary at 8:32, then come here.
==========
The news the other day said that $285 billion dollars are now being stolen from Health Care of various kinds.

And you think doctors, under my plan, could do worse. Years ago the Dr. charged what he wanted to charge, no insurance or Gov’t nut would check the bill, and we all lived until we died.

Of the names you mentioned - insurers, government health care people and doctors, all are people.

Under my system, all the people involved, the patient, the doctor, and the auditor, will be people.

Why would the people I mention commit more fraud than the people you mentioned?

The main difference is that I would not permit a doctor to have malpractice insurance, and would execute any lawyer who sued a doctor, within 30 days of the date of the suit.

If the patient thinks he needs malpractice insurance, he buys it, just like he does when he buys an airplane ticket.

If the doctor makes a mistake, so what, you are most likely there because you made a mistake. If the doctor does something wrong, that is a crime, and the Gov’t takes care of that, not a lawyer who is most likely a criminal, in any shape or form.

Properly used, a computer system can keep track of what is going on. If a computer criminal (suffering from computeritis) messes with the computer system, he will be executed within 30 days.

By the way, where I got that idea for 30 days, was in the early 1930s, someone shot at FDR and missed, but killed the Mayor of Chicago. Thirty days later he was executed, the way it should be done all the time.


Jim from CA post
Of all the proposals I have heard, that one takes the cake. Make all health care free (that will drive demand to the moon) get rid of the insurers, government health care people and give doctors a blank check. To keep them "in line" you will use auditors who will audit them to make sure they don't overcharge.

Poor Jim. It is fitting he is from California, a state that is going broke. Did he ever hear of fraud? He never has heard of doctors having fictious people in for fictious treatment for fictious ailments. Who will be checking on that? No insurers who have to pay only what the contract says; no government employees to see if a white collar crime is being committed and how are the auditors supposed to check on this? The paperwork looks in order. Yeah, that'll work.
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