Should IN Opt Out?
I blogged last week about how Indiana lawmakers are taking a wait and see approach to whether the state will opt out of the public option component being discussed in the national health care reform debate.
I understand the need to be cautious, but it’s my hope that Indiana will opt out of the public option because it really isn’t necessary.
Indiana already has several programs to insure the uninsured. Healthy Indiana insures adults 18-24. Hoosier Healthwise insures low-income families, pregnant woman and children. And there’s always Medicaid.
Instead forcing Indiana to participate in a national health care, the federal government should give the state more flexibility and more cash to expand its current programs. There are 25,000 people on the waiting list to join Healthy Indiana and state officials want to shorten that list by the end of the year.
With Hoosier Healthwise it’s estimated that 59% of the children who are eligible aren’t enrolled in the program. That’s something that can be fixed by more outreach and marketing.
Anyone who still isn’t covered, but can’t qualify for any of the other programs should be given a voucher to purchase private insurance.
It’s estimated 560,000 Hoosiers do not have insurance.
November 2nd, 2009 at 10:16 am
As currently structured, I don't know if it will work, but I see the primary value of a public option as providing meaningful competition to private insurers, thereby keeping premiums down.
For my part, anyway, insuring the uninsured is a secondary concern. The primary concern should be squeezing the waste out of the system we have. Other countries manage to get better health care results for about 1/2 the price. About $700 billion of our health care expenditures each year doesn't add any value to our health.
November 2nd, 2009 at 10:45 am
Does anyone actually believe that the states will be allowed to 'opt out' without suffering the wrath of Barry, Harry, and Nan?
Does anyone remember what happened to states that decided to 'opt out' of the 55 mph national speed limit when it was being pushed?
November 2nd, 2009 at 10:54 am
Rico -
Considering I haven't been to a state where the speed limit is 55 mph. I would have to say not much happened to them. Or at least enough to make them change their speed limit
November 2nd, 2009 at 10:57 am
I hope the opt-out does work because all of the Republican governors will opt out, and when possible all of the people will move from those states and to ones that haven't opted out, leaving the Republican states as shells of their former selves.
That is highly unlikely immediately, but over a generation you will likely see a much higher population in the states that offer it, a decrease in states that don't, and probably quite a bit of backlash in the opt-out states (as a more immediate effect). Republicans need to be careful, all of the polls show that they don't have the support and numbers to survive much grandstanding on this. Their loyal base will back them, but all indications are that that is only 20% of the population.
So, bring it on!
November 2nd, 2009 at 11:06 am
Can we opt out of the taxes too? I'm guessing not.
Yes, that's a plan I can get on board for, “please sign me up for the costs, but I'd like to opt out on the benefits, if that's ok?”
Harry Reid and his ilk must think we're really stupid to have even come up with this plan.
November 2nd, 2009 at 11:07 am
I don't understand how the “opt out” feature would work, considering federal tax dollars will be paying for the insurance coverage. Would Indiana residents pay the same amount in taxes as residents of other states, but still lose the benefit of insurance? If so, opting out (obviously) sounds like a terrible idea.
November 2nd, 2009 at 11:24 am
My first thought is OPTing out would be great, especially if we can “opt out” of the increased tax burden that might be imposed as well.
My 2 Cents (Above) makes a great point about how people will redistribute themselves to live based on where the economic environment is one they desire. Ambitious people interested in business, commerce, economic growth, employing people and who aren't appreciative of being penalized for the massive risks they take to do so will move to low-tax, free market areas. People who want a nanny state, with high taxes, lots of government benefits and don't mind the extra drag on the economy will move to appropriate places for them.
While “My 2″ makes the case that it would decimate “Republican states” … let us look at examples of high-tax, lots of government benefits, liberally run areas…
Los Angeles (California is barely hanging on as a whole)
New York (They're talking about a soda pop tax. seriously?)
Chicago
Detroit
Those top three cities are losing population, especially the productive class, faster than any others.
According to the information from the census bureau and a national real estate group:
“Of the 25 largest cities in the country, 18 lost population from 2000 to 2004. The combination of outrageous housing prices and exorbitant taxation have led to this situation.”
IMAGINE, if the world wide immigration environment was similar to how it was prior to World War I. Were basically you could pack and go live in another part of the world with relatively little hassle. How many people paying 15.2% (with the cap likely coming off) + (up to) 35% (going to 39%) + state taxes up to 10% + local taxes (indy = 1.62%) + property taxes + sales taxes + anything else that moves or doesn't (according to Hilary) … How many would be looking for another place to park themselves? How many of those people are the very ones that might start a business, fund the creation of one, put their money in a bank for other people to borrow or whatever else.
You have to decide. Do you want big government, a nanny state with cradle to grave care for everything under the sun, massive regulation and intrusion into every nook and cranny of our lives by government bureaucrats and the high taxes to pay for it all.
OR do you want jobs, economic prosperity, opportunity and a high standard of living.
Why not be able to pick? You go where you want to, I'll go where I want to. We'll see who ends up better off.
Now, somebody is likely to bring up some of the Scandinavian countries that rank high on how happy their highly taxed populations are. BUT, there is a different in expectations. In many of those countries a significantly larger portion of the population take a bag lunch to work everyday, drive their cars for twenty years and are less interested in “the American dream” as we would call it over here. Interestingly, a few of those countries are starting to try and drop their tax rates to spur economic activity, innovation and business creation.
In the long run, taxes don't redistribute income … they redistribute people.
November 2nd, 2009 at 11:38 am
Abdul, you mention healthy Indiana but you do not tell that there is income limits on this program. So it does not cover everyone that don't have insurance. With Medicaid income level is very hard to meet. You can not have more then $2000 in your back accounts.
So what if you make $1000 to much for either of these programs? Again if you work and try hard, you are still left out in the cold
So if you hold a low or even a medium paying job with insurance you DO NOT qualify for these programs. So what is your answer to this question? If your income is just over the level can you afford seven or eight hundred dollars a month for health insurance? NO
November 2nd, 2009 at 12:23 pm
Yep, that's on the money.
A bureaucrat's “dream” is taxing the dreams of others; immoral claims to / on the life & times of other human beings. That ain't a “love thing.”
Adding to your list of four cities:
1) LA: Metro area has lost dozens of Wishards or ER facilities, due to an oversupply of public sector “solutions.”
2) NYC: Exodus of tax base (people who actually pay for the stuff government forces them to pay for until they escape or leave) is resulting in less “revenue” to maintain the girth of local blubberment.
3) Chicago: Behind several months in its bills, looking at cuts & shorter work weeks for public employees. No buyers, no market for several suburban homes being sold for one dollar.
4) Detroit: “Socialist art,” an interpretation of a doughnut hole.
November 2nd, 2009 at 1:07 pm
If I am paying, I want the option. How else is someone like me supposed to get insurance when I decide that I want to join the consumer/non-producer class? Getting up at 5AM for work is getting to be a pain, especially when I have to constantly toss nickles, dimes, quarters, and dollars to various elites so they can rake in big bucks with their public-private partnerships.
November 2nd, 2009 at 2:19 pm
I'm not sure how old you are, Mike, but this was over twenty years ago. And states were, in fact, threatened with the loss of federal highway funding.
November 2nd, 2009 at 4:57 pm
Very likely the opt out option will be taken by some of the overly reactive R governors just as some were not going to participate in any of the stimulus programs. And anyone thinking that taxpayers in states that opt out won't be paying should get real. Whether the public option or any part of the plan is a good thing or not will have to await to observe how it ultimately works. Several actions that might be able to reduce costs such as limits on liability awards (how much of a doctor's bill, how much of a hospital's bill, how much of a precription bill, how much of an health insurance policy cost, etc… then reality check on administrative salaries and reasonable profits will be essential for investor return or govenment will be the only option.
November 2nd, 2009 at 5:47 pm
Unfortunately, forcing legislation on states via blackmail isn't exclusive to any one political party. States were going to lose a lot of highway money if they didn't “voluntarily” raise the drinking age to 21 back in the 1980s.
November 2nd, 2009 at 8:43 pm
Abdul; I'm with you on this one. I hope Indiana, and all the other red states opt-out. First, because they'd still be paying in to the system, although likely not full boat. (Do you really believe that the federal gov. will give $ to states opting out? Those that would are saying they don't want the federal gov. to help their citizens but, oh, give us $ to help our citizens.)
And second, because in a few more years the people will see how the Republicans “helped” them out on this one and will then vote accordingly.
A backlog of 25,000 shows how good Indiana's system is working. And next year when there is a backlog of 30,000 it will means the system is working even better.
The reality is that the republicans missed the boat on this issue and the democrats will “own” it. Kinda like Social Security. I love it.
I don't get the voucher thing. Another giveaway to big biz, inc. Corporate welfare already accounts for about 4 of every 5 welfare dollars spent today, and if we have to give out welfare the wealthy should get the most, not poor people.
Why exactly is it that someone has to make (not earn) a buck off of a person's medical maladies? Is the cost of health insiurance so low that we can afford to pay an extra 20-30% for it to be private rather than public? Or did I miss something and health insurance providers actually do add some “value?”
To be certain, I am looking at this thru liberal-colored glasses wherein people are more important than profits. After all, the more money one has the happier one is. This also applies to the uber-rich, as an additional $10 mil. to one worth $500 mil. will allow them to do things they couldn't afford to otherwise.
November 3rd, 2009 at 5:18 am
Again, you have to be “in” to opt out. The bill as currently proposed would give states an option to opt out after a number of years in the program. It does not give the states the option not to participate from the onset. If it is successful then no state is going to opt out….if it is not successful then every state should opt out. I personally believe that it will be successful but only time will tell.
November 3rd, 2009 at 7:38 am
Sean nails it. With (presently) 2000 pgs at their disposal, inapplicable to Congress, suppossedly to be paid for by cuts, reform and efficiencies that should have already taken, written in sufficient “regulatoryese” to cloak nearly anything, – I'd be shocked if opting out will be a real option.
You have a chance, NOW. Maybe only NOW. Keep calling or writing your Congressmen, talk shows, and urge voting NO to this health care “reform”. Further expansion of entitlements with money we don't have is not resolution we can pass on to our children.
November 4th, 2009 at 4:07 am
I don't honestly know if a public option is the best route. But here's what I do know:
In Indiana, one company has 44.5% of the market. Its next-closest competitor has 11%.
There are 19 states where one company has over 50% of the market.
There are 6 states, including three of our largest, where one company has over two-thirds of the market.
Look: it's expensive to establish and operate a private insurance company. They're not starting up left-and-right…there probably won't be any new ones anytime soon. So, what we now have, is probably all we're going to get from the private sector.
And what we now have, is rife with inconsistency, anti-trust protection and state-to-state (borderline) corrupt practices.
As we dawdle discussing all our options, our international competitive situation worsens, for many reasons….but one of the most succinct is the cost of health care. Our international competitor nations have nationalized health care, so their “private” sectors don't have to worry about it. They pay taxes, but…somehow, their companies come over here and sell products cheaper and, too often, better.
I don't have all the answers. But what we're doing isn't working, and the private sector, left unchecked, in this category at least, has failed us miserably. State insurance regulatory systems are a patchwork that allow insurance companies to dodge effective oversight.
November 4th, 2009 at 10:07 am
I don't honestly know if a public option is the best route. But here's what I do know:
In Indiana, one company has 44.5% of the market. Its next-closest competitor has 11%.
There are 19 states where one company has over 50% of the market.
There are 6 states, including three of our largest, where one company has over two-thirds of the market.
Look: it's expensive to establish and operate a private insurance company. They're not starting up left-and-right…there probably won't be any new ones anytime soon. So, what we now have, is probably all we're going to get from the private sector.
And what we now have, is rife with inconsistency, anti-trust protection and state-to-state (borderline) corrupt practices.
As we dawdle discussing all our options, our international competitive situation worsens, for many reasons….but one of the most succinct is the cost of health care. Our international competitor nations have nationalized health care, so their “private” sectors don't have to worry about it. They pay taxes, but…somehow, their companies come over here and sell products cheaper and, too often, better.
I don't have all the answers. But what we're doing isn't working, and the private sector, left unchecked, in this category at least, has failed us miserably. State insurance regulatory systems are a patchwork that allow insurance companies to dodge effective oversight.