Rock The Youth Vote

I attended the Hillary event in Hampton, New Hampshire last night and one of Hillary's introductory speakers may have provided a new insight into Obama's ability to rock the young.

The speaker (Maggie Hassan) was extolling the virtue of Hillary's health care plan, specifically her mandate that everyone must buy insurance or face the (as yet unspecified) consequences.  And why is the mandate, which is missing from Obama's plan, so important?  Because otherwise, she explained, healthy people, most likely healthy young people, would prefer not to buy insurance; if they don't participate, the cost rises for everyone else.

Hmm - put another way (OK, almost exactly the same way), young healthy people need to be forced to buy health insurance in order to subsidize the old, obese, and infirm.  No Hillary staffer gave Ms. Hassan the bum's rush but one might have wondered just why a young person in the audience would find that message appealing.

Now, I am not claiming that Hillary's mandates are uppermost in the minds of Obama's supporters.  But as Ms. Clinton reviews her policy laundry list, she has an anti-youth position on the biggest issue in her party.

ERRATA:  We looked at mandates in some old posts - 1, 2, 3.

Comments

[Sara]

Oh please, go into any emergency room in this country and tell me what you see. You will see young people, children with the sniffles, or a broken arm, or some other non-threatening ailment. They are there because their young parents have no health insurance and they know that that won't be turned away at an emergency room.

Older people either have health insurance or they will have coverage with Medicare. They aren't draining the system, except in terms of Social Security's Medicare, which everyone who works pays for and eventually receives. It is the young who drive up the costs. And out here in California, those young people are almost all illegals to boot.

[Sara]

And I should have added, lots of young people don't have health insurance available. Both my kids work full time. My d-i-l has been with the same job for 8 years. My daughter works 75 hours a week. Neither have the option of insurance thru their jobs. Try buying private, non-group insurance. I tried when I lost my own insurance and I just could not afford close to $500 a month. I pay dearly for that loss as I've suffered through this broken back business.

Find a way to offer a group rate that works nationally for all the waitresses, cooks, service people, secretaries in small businesses, etc. who cannot get health insurance thru their jobs. Give us a way to buy into a group system that provides the economies of scale that those who get group insurance through large corporations get now.

Find a way for those of us who gave up good paying jobs with full benefits to provide at home care for our elderly to continue coverage while we are saving the government hundreds of thousands of dollars they would have paid to nursing homes and off-site caretakers. We are already taking a huge hit with the loss of income, the loss of benefits and the loss of quarters counted toward our own retirement.

[Jake]

Sara... I'm fifty years old in good health and have been paying for my own insurance for twelve years. It started out at $112 per month and, over the years it has risen to $185 (with a $2000 deductible). The zero deductible option is around $245, less than half your estimate.

That said, I don't have cable tv or a cell phone. Do you?

[Pofarmer]

It is the young who drive up the costs. And out here in California, those young people are almost all illegals to boot.

You could have left out the young part, and you would have nailed it.

[JM Hanes]

TM:

Isn't the notion of "insurance" really turned on its head when it comes to healthcare? The traditional insurance equation rested on probabilities. A lot of people pay for insurance against one disaster or another. The insurer makes his money either because the percentage of disasters which actually occur is relatively low, or because the insurer has had time to grow its investments by the time the payout takes place.

What we're really talking about is covering healthcare costs, not hedging bets. When, for example, an overwhelming majority of adults over 40 are on permanent (i.e. continuous) medication for an illness or condition of some kind, doesn't that change the model completely -- even when you factor in deductibles?

It seems to me that healthcare costs as a whole would inevitably be driven up when so many people are getting so much more healthcare, both routine (medications) and diagnostic, in addition to catastrophic coverage. Insurers have got to make the money to pay for all that somewhere. New emphasis on preventative care seems to be part of the changing equation, (an attempt to minimize the catastrophic debits?) but I'm not sure how it can offset the simple, growing volume of care being delivered.

Sara:

There's certainly a lot of anecdotal evidence of the kind you're describing. Have you seen any stats on the actual dimensions of the free rider problem? I suspect it may be more significant rhetorically than it is in fact, when it comes to the sheer scale of healthcare as a whole, but I could easily be completely wrong

[clarice]

It wouldn't turn it on its head if it were catastrophic health care (and states allowed insurers to sell that just like they sell homeowners insurance which doesn't cover routine maintenance and collision insurance which doesn't cover oil changes.)People would simply cover their own diagnostic treatments and medicine.

[Sara]

Jake, I would dearly love to know where you are finding private insurance, not supplemented thru an employer, for that price. I can't even find a company that wants to write individual policies. The BC/BS figures go up over $1000.

When I left the job market to care for my Mom, I was able to keep my coverage for 3 years thru Cobra. Even there my costs went up from approx. $160 mo. to $295 mo. To continue past that would have been $485 mo. so yes less than the rounded off figure of $500 but close enough for discussion.

[jimmyk]

The reason "insurance" has morphed into comprehensive health plans is primarily the tax system: Much of it is tax deductible, so whatever can get stuffed into the plans rather than paid out of pocket is tax-advantaged. But it's probably not politically acceptable to make health insurance come out of after-tax dollars. Beyond that, there's an argument for insurers subsidizing preventive routine care like checkups and innoculations.

As for the age/subsidy issue, an easy partial solution would be to have premiums be age-based. Of course there are healthy older people and unhealthy young people, but no doubt average spending goes up with age. This is how life insurance is priced, after all. And if people don't like the idea of rising premiums, as with life insurance they could buy fixed premium plans, that start higher but don't rise over time.

Needless to say, this is probably what would happen if the government kept its hands out of it, beyond making some kind of (private) insurance mandatory. I won't hold my breath for that.

[Sara]

And for the record, my measly $1235 mo. income would qualify me for Calif. Medicaid coverage, but I will not take welfare for my own care for any reason short of being near death. That's my own pride, I guess, but I refuse to live off the public dole. So Sue's snide remark in the other thread, notwithstanding, I do not and will never advocate for government paid healthcare. All I would like to see is some company form a group designation that all uninsured not covered by an employer offered insurance could buy into for the economies of scale. If those same people don't want to buy into it, then tough luck to them, but there are millions who would love to have the option that their employers don't offer. Myself and 3 people in my family being 4.

[Sue]

So Sue's snide remark in the other thread, notwithstanding,

The snide remarks started with you Sara. As they usually do and then you bow up like a show dog when someone questions you. You are complaining on the one hand that republicans are cheering for Obama and on the other hand wanting some kind of government intervention to have affordable healthcare. If that isn't the democratic party's platform, I don't know what is. If the government doesn't provide the "change" you are talking about, it won't get "changed". The market, the one republicans used to depend on, apparently don't find the need to provide you cheap insurance. That leaves the government.

[clarice]

Well, Sara, I have no idea about the California private health insurance market though I see several online services which claim to be able to help people find private insurance thru comparison shopping. I expect if you took out catastrophic insurance with a reasonably high deductible you might be able to save some money. But I have no idea.
It's also possible, I suppose for you to check with Kaiser Permanente which is all over California to see if they offer a plan your family would find affordable. (I know people here who were in a similar spot and find a plan offered by a local hospital was the best for the money.) Finally, perhaps you could turn your small blog into a business in which your family would play some role and qualify for a lower group rate. Sunny Day might offer some suggestions on that having set up a financially successful blog of her own.

[Sara]

Jimmyk, I'm not sure you are right, you may be, but I don't see it. Yes, older people have more catastrophic events, but they are covered thru Medicare and Part B supplementation plans. I spent far more time at doctors and hospitals with young children than I have since they are on their own.

I have no problem with deductibles being tied to age to a certain extent. But as a for instance, a preventive drug like Actonel, that prevents and reverses osteoporosis, a number one problem for the older adult, costs $8 mo. with insurance, it costs about $115 mo. to buy outright. How many fixed income seniors can afford $115 mo. for a preventive drug if they are already needing other medications that may be life saving? Yet, osteoporosis is a huge and expensive problem that can be controlled with a simple pill taken once a month.

I worry about people like my d-i-l, who works so hard, about 12 hours a day 6 days a week, yet has no health coverage on her job. She discovered 3 breast lumps at Christmas and we are waiting now for the results of tests as to whether they are cancer. What she will do if it turns out the worst case scenario, I just don't know. For her, it will be a death sentence. She is only forty and in the 15 years I've known her, has never had anything more threatening than a bad cold.

[Sara]

Bullsh!t Sue. How many times do I have to say it -- no government healthcare. Are you reading impaired.

[Sara]

It is you Sue, who keeps equating a private group plan for the uninsured as government care.

[Sara]

Let's break it down. Suppose you take all the waitresses in this country, there must be a huge number in that group if you consider the entire country. So just the waitresses. Most restaurants do not offer benefits to their wait staff. Suppose any company, pick one, BC, Kaiser, Scripps, you name it, offered a Waitress group that all waitresses could join in order to get the reduced insurance costs a large group affords. Then add in receptionists at all those one or two man offices, or the cooks, or secretaries, or home health care workers. By the time you are done, you have an extremely large group of potential customers, thereby reducing the overall cost for the insurance to the individual.

[Jane]

Clarice,

I really like your style.

[Pofarmer]

Where are you that insurance is that high? I can get my entire family covered with a $1,000 deductible and $5,000 max copay for between $600 and $700 a month. That's even with the same carrier my wife is currently with at work. When I worked out, I had to fight a couple employers who wanted to provide healthcare to keep the policy that I had. Now, in MO, it's state law that if you have a healtcare policy, you can take it with you. Also, there are a lot of different group policies that independent brokers can access.

Yes, parents with kids may see the doctor more, but it's usually an $80 office call for the sniffles or what have you, and not for a full blown MRI and bloodwork for an obstructed bowell.

Personally, I'm like Clarice, I'd like to see catastrophic insurance coverage, and let's price out the rest. I think you'd see the price of routine procedures drop. Let's take heart stendts. These are so common now that Dr's can do them in 15 minutes, yet, because of Ins, govt, and Dr's, the prices continue to INCREASE. That just doesn't happen in a competitive environment. Dr's complain about being "price takers" then build the biggest houses in town. Really chaps my ass.

[Pofarmer]

Sara, worst case scenario for your daughter, those that are insured will pay for her. Either that, or the payments will be prorated out over 20 or 30 years.

[JM Hanes]

Clarice:

Exactly. The politics of healthcare obliterate the real, logical, actuarial difference between buying health insurance and negotiating the cost of services.

[Sue]

Sara,

By the time you are done, you have an extremely large group of potential customers, thereby reducing the overall cost for the insurance to the individual.

What is to stop them from doing that now? Who is going to make them do it?

[clarice]

Thanks, Jane.
Sara is so adept online and has run several blogs, maybe she might consider settingup a blog to help individuals form groups for coverage.

[Dennis D]

While I am not a proponent of Universal Government Healthcare I do believe the issue of high healthcare costs needs to be addressed by the GOP. Something is wrong. Dems want to turn us into the USSR and the GOP wants to ignore the issue totally.

[Jane]

Romney hasn't ignored the issue. He's the only person who has implemented Universal Health care via the private sector, not the government. It's hard to know if it will work yet as it started January 1.. I have private health insurance and I'm telling you right now, the quotes you people have posted are bargains compared to mine. That has nothing to do with Romney's plan. There is not much of a free market for anything in this state.

[Pofarmer]

Why does every single issue need to be addressed by the Gubmint.

When did we start thinking this way? Whatever happened to personal initiative?

[Sue]

When did we start thinking this way? Whatever happened to personal initiative?

My point exactly.

[clarice]

http://www.amazon.com/New-Health-Insurance-Solution-Traditional/dp/0470040211>Sara, You might want to read this book

Apparently it's very good on individual insurance plans in California.

[jimmyk]

Why does every single issue need to be addressed by the Gubmint.

Good question. But a lot of issues are the result of Gubmint innervinshun, and that does need to be addressed. The gubmint (state and federal) has its hands all over "private" health insurance.

At the same time, there is the point we've discussed here before about why some sort of mandatory (privately provided) system might be a good idea.

[Pofarmer]

The gubmint (state and federal) has its hands all over "private" health insurance.

So kick em out of it!! I don't see how adding more, or making this or that mandatory, will reduce the cost of healthcare. It's time we started taking our lives back from the gubmint, but, sadly, it's probably too late for that.

[jimmyk]

I spent far more time at doctors and hospitals with young children than I have since they are on their own.

You are right that birth and the first year or two of life are expensive. But the fact is that health care expenditures are hugely disproportionately related to critical care and those months and weeks before death. Yes, a lot of that is under Medicare (which doesn't mean it's not a problem), but death rates pretty much rise with age starting at age 2 or 3. If you look at 25-34, 35-44, etc., it more than doubles each decade.

My broader point was just that insurance companies can sort all this out. That's what they are good at. They do it all the time and in creative ways with life insurance.

[clarice]

I understand that WalMart now has clinics that provide a lot of basic care for a flat fee of I think $69 a pop--vaccinations, throat swabs, etc. They also provide prescriptions of a lot of popular drugs for a song. A lot of innovation is coming.

[Sylvia]

How about Wal-Mart run nationally available catastrophic health insurance for individuals (who aren't WalMart employees)? They lowered the prices for everything else...

[cathyf]

Suppose any company, pick one, BC, Kaiser, Scripps, you name it, offered a Waitress group that all waitresses could join in order to get the reduced insurance costs a large group affords.

Suppose any company, pick one, Blackwater, MPRI, Steele, you name it, offered a Waitress group that all waitresses could join in order to get the reduced defense costs a large group affords. If they didn't want to join the group, then they could just wait to see if their town got invaded, and then just pay for their defense costs then out of pocket.

[BarbaraS]

One of the reasons that health insurance is so high is because the government has already interfered too much with the insurance companies. One of the ways was congress made a law that insurance companies had to accept people with pre-existing conditions. They aren't actually covered for these conditins until after 255 days but they are covered after that. And if people have had other insurance during the previous quarter to applying then pre-existing conditions don't count. Who is goint to pay for that? The answer is all of the other policy holders. Insurance have to make a profit or go out of business. That is just a fact of life.

The government has mismanaged medicare so badly that costs are out of sight and there is a lot of graft and corruption. I don't want them to handle private insurance also. That is the road to socialism which is the dems' goal.

[steveaz]

Since healthcare is a consumer-product, and the state of one's health is usually a subjective sample of one's feelings at any given time (ie. "I don't feel well."), it is not hard to imagine that, just like any other producer of consumer goods, the health-care industry will benefit from the inculcation of myriad new consumers of its product.

The result is the industry, and particularly unionized care-givers, have an interest in lending subastance to millions of subjective, fleeting diseases.

I'm noticing that CNN, the BBC, and MSNBC, all purveyors of the Global Warming meme, regularly report on new "super-bugs," or they hype diseases, like SARS and Asian Bird Flu These regular reports seem designed to create hysteria among our citizens about epidemics and pathogens with an eye to scaring us all into the Socialized model of health care.

Anyone notice the parallels with the Left's contrived Global Warming hysteria? Same modus operandi, same destination!

[kim]

It seems certain that a certain somone's interest in public policy is less interested in improving the well being of hoi polloi than in honing the edge of power by stropping it on the reins of public consciousness.
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[MarkD]

New York has made it impossible to buy high deductible coverage for catastrophic care. I can't buy insurance, except in the state. Providers have to cover a lot of routine things, including even the immunizations and physical for my daughter to attend college.

As noted, this is not insurance. This is a bundled mess of Healthcare services I have to take or leave. I've got coverage, through both my wife's job and my own. I've also got a Healthcare reimbursement account where I get to guess how much I might spend next year then lose the unspent money. You couldn't sell me this mess, but the government can force it on me.

I was doing fine until they decided to help.

[steveaz]

Kim,
Put another way, for Socialism to get a toe hold in any segment of our economy, two things are required.

1. The Government must take over the means of production. Hence the drive to regulate, certify and unionize health-care providers. (BTW: this puts self-medicators in the same league as home-schoolers in the Left's eyes. Both defy easy collectivization.)

2. The consumer of the product must not be exposed to the real costs of the product, lest he begin to question the real value of the service.

Once these two objectives are achieved, all the market-driven epistemilogical data that define the industry's efficiency, such as cost of production and profit-loss ratio, are lost, and a rational critique of the industry becomes impossible.

The outcome is a Euro-socialist's wet-dream: all "glory" with no accountability.

[Pofarmer]

You folks that think being a member of a "group" is some magic pill, need to think again. My wife is a member of a group. The coverage actually costs MORE than if we had the policy on our own. Why? Probably because there are too many of an advanced age in the group. Why do we stay with this? Well, because if we lost what her job kicks in, we'd be behind, but not by much. I reprice stuff about once every couple years. They just jacked the rate on the group policy again, so it's time to make a call to the independent insurance agent for another quote. The real kicker? It's pricing coverage through the SAME COMPANY. That's right, I can get an independant policy through the same company cheaper(if you include what they employer says they pay) than what the group rate is. It all depends on the group.