Monday, October 24, 2005

A Twofer...

Apparently, the human brain comprises some 100 billion cells (neurons).
I believe that I lost at least 250 million of those recently: I had the privilege of sitting through a “webinar” to become certified to sell the new Medicare Part D drug plan. Only a gummint-approved panel could come up with such a complicated, poorly designed, inconvenient, and altogether bothersome “benefit.” Actually, the fact that one must become “certified” to sell what should be a simple drug plan should be a tip-off that it’s anything but.
I also read Prof Quadagno’s response to my review of her book. I do appreciate that she has taken the time to offer her rebuttal.
She raises some interesting points, most notably that there may be value in an increased role for the government in the arena of health care coverage. Professor Quadagno believes that the "only reason the situation doesn’t look worse is that the government is picking up the slack." She has it exactly backwards: government cost-shifting is one of the most egregious components of the increasing cost of healthcare. And instead of answering my challenge as to where the issue of “fairness” may be found in our constitution, she proposes that the insurance industry should be even more regulated (i.e. restricted), and that government intervention is necessary to solve the (fake) problem of “46 million uninsured.
She couldn’t be more wrong, and the new Medicare “drug program” brilliantly and irrefutably demonstrates why:
Let us suppose that, for the sake of argument, the nation’s seniors were all consuming vast quantities of prescription medication and that, as a class, seniors represented the poorest of our society. Such an argument would go “Gosh, now Grandma has to choose between buying food or her med’s. Why can’t the government do something?” And so the government convenes a special panel (because that’s what government does) which is comprised of everyone affected by the “problem” except a representative sample of seniors, insurance agents who deal with the public every day, or doctors who actually see patients; in short, anyone and everyone who could bring meaningful information and experience. Such folks would not be invited to participate, while special interest groups and government bureaucrats (but I repeat myself) decide that Dr Goldberg’s model would be the ideal place to start.
And so emerges Medicare Part D (for Debacle), a multi- multi-billion dollar program to (allegedly) enable seniors to afford their med’s. It looks something like this:
Let’s start by making this a completely voluntary plan, so that Grandma and Grandpa can feel comfortable knowing that they are free to choose whether or not they wish to participate. Then we’ll slap a 1% per month penalty on ‘em if they decide not to play along, and want to join up later. Such a deal!
Then, for those that do “choose” to enroll, we’ll impose a new $250 deductible for medications, to supplement the current $912 Part A and $110 Medicare Part B deductibles. Hmmm, that’s a total of almost $1300 in deductibles right out of the chute.
Okay, so Grandma meets her $250 deductible, and all her med’s are covered now, right? Well, not so fast: actually, Medicare Part D will pay up to 75% of the next $3,000 of (covered) med’s, or a total of $2,250. Of course, that means another $750 out of (Grandma’s) pocket, but that’s not so hateful, right? So, what’s next?
How about: Grandma gets to pay 100% for her med’s until she’s out of pocket another $2,850. Ouch.
Oh, but surely she’s done now, right?
Nope, she then gets to pay 5% of all her med’s until the end of the year, at which point the whole process starts anew. That’s right: an extra premium over and above the “regular” ones for A and B, a new $250 deductible, plus $750, plus $2,850, plus 5% of the rest after that. Yikes!
Now, if you’re still following, then it’s not complicated enough for government-think, so let’s muddy the waters a bit more:
Each year, there are only certain times when Grandma (or Grandpa, for that matter) will be allowed to switch plans. “Switch plans?” you ask. Yup, because everything we’ve been talking about so far describes what the government has decided is the appropriate product for insurance carriers to sell. Kind of like Henry Ford and his famous (although probably apocryphal) comments regarding color choices for the Model T. These are plans that must be approved for sale by the same folks who designed the “product.” And you can only buy into a plan at certain proscribed times. Don’t like the plan you bought? Tough, because you can only opt out or switch plans at specific times, as well.
So there you have it: a perfect example of how government restriction of the insurance market place impacts how its citizens are allowed to purchase only “government designed and approved” products. No real free market here, folks, just move along. Of course, it’s left to the imagination as to whether or not this represents the solution to any identifiable problem. And it most certainly represents what happens when we put government in charge of even a small piece of the health care pie. Imagine what it would do with the 15% of the economy the whole pie represents.
I appreciate that Prof Quadagno probably truly believes that such onerous government control would make things “fair,” but she still hasn’t addressed how “fair” is even relevant. And programs such as Medicare Part D demonstrate that “fair” isn’t even a good idea.
For more information on the new Medicare Part D plan, or for any other Medicare issues, contact your state’s Department of Insurance or
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