September 8, 2009

Making It $0.04, Then: Health Care Part II

Filed under: Politics — PolitiCalypso @ 5:44 pm

My previous blog about health care reform and Generation Y did not touch on one specific detail about the prospect of a mandates-only insurance law like the state of Massachusetts has. This follow-up will address that 800-pound gorilla and a bit more.

Let’s take the hypothetical that Congress passes, and the President signs, a bill that requires American adults to purchase a private insurance policy but does not provide a public plan. Let us suppose that noncompliance is punished with a fine that is automatically taken out of one’s taxes, as is done in MA. In that state, you must provide proof of insurance for the entire tax year or, barring extreme poverty, you will get fined for it.

Generations Y and Millennial, which contain the largest number of uninsured, will get hit the hardest by such a law. The bill that proposes this, the “Baucus bill,” would cap the out-of-pocket cost of premiums at 13% of a person’s yearly income. A year’s full-time work at the minimum wage (probably the most common wage for this age group) comes to $14,790 before taxes; you can skim off about 20 percent of that in various taxes, of which perhaps half will be recovered by the following year. (The rest is Social Security and Medicare. Yes, Virginia, there is socialized medicine in America already, but only if you’re older than 65.) I am not sure whether the 13% figure applies to gross income or income after taxes. If it is gross income, that’s $1922.70 a year for insurance premiums, or $160 a month. For net income, it is $1538.16 a year, or $128.18 a month.

This may not sound so bad until you realize that this leaves a single person making minimum wage with either $9909 a year or $10294 a year, and this must cover housing, food, transportation (including auto insurance in most cases), utilities, and perhaps other necessities such as child care. It also must cover all medical bills that this “insurance” is not covering because of deductibles and co-pays.

The only plans that run for less than $128 a month are plans that are not intended to be long-term. They are meant for people who are between jobs and need creditable coverage to avoid getting blasted with a pre-existing conditions clause when they get a job again. They often have expiration dates of a year after issuance. The kind of a plan a minimum-wage worker would afford gets them a ridiculously high deductible (up to $5000) and a horrible co-pay. This sort of policy is worthless. It’s extortion, quite frankly—forcing money out of a person to avoid a punishment, but not offering anything tangible to show for it. People with these policies pay twice; they pay for their premiums and then they pay for the cost of medical care, because the insurance doesn’t cover a bit of it unless they get catastrophically ill.

I defy anyone, anyone in the world other than Ebenezer Scrooge, to suggest that this is a reasonable thing to do to someone making minimum wage. In many cities, it is tantamount to condemning a person to living in a shelter. It encourages people to make very poor decisions in order to have enough household cash to stay out of cardboard boxes: Find a roommate, any roommate, cohabit and therefore risk an unplanned pregnancy, get married when they have no business doing so, etc. Some people will find ways of committing suicide (and decrease the surplus population?) rather than continue with what they believe is a never-ending downward spiral. Forcing vulnerable people into making bad decisions is not good policy.

However, even the most diehard Scrooges of the world surely will not have a word to say about the other horrible aspect of this hypothetical mandates-only insurance law. I am talking about deficit explosions. This is the 800-pound gorilla, the aspect of bad reform bills that I did not touch on in the previous blog. Deficits are popular to talk about these days, and it says something about the insurance industry’s stranglehold on our political system that deficits suddenly don’t get discussed when bills come up that could reap them a mountain of profit.

That 13 percent in the Baucus bill is not a cap on the market cost of a policy. It is a cap on the buyer’s out-of-pocket costs toward buying that policy. You cannot force people to pay money that they don’t have; debtor’s prisons are against the law and I think there might well be blood in the streets if we actually started sending people to jail for nonpayment of “fines” for not being insured. The government, you see, helps out. It makes up the difference by offering subsidies to poor people. There is no proposal to cap the absolute cost of policies, and there is no proposal to cap executive payrolls. Basically, there’s no means to control runaway health insurance costs. This bill, a national version of the failed Massachusetts system, would simply shift the bulk of the expense to the government.

You think the deficit is bad now? Wait till the government has locked itself into paying whatever insurance companies demand. This is what has happened in Massachusetts. I used to live there; the system that they have there has only exploded premium costs, with the state government paying the price for it. Much of the money is paying for garbage—the lousy junk (or more accurately, bunk) insurance policies that are all that’s affordable to private individuals without group coverage. The purpose of business is to make money. That’s neither evil nor good in itself, but it should be taken into account. Government policy telling a particular industry “Charge what you like and we’ll foot the bill” is blatantly stupid.

Sure enough, the most expensive Congressional bills, as scored by the Congressional Budget Office, are those that attempt such a thing. The least expensive are those that have a sturdy cost control mechanism, namely a government-administered insurance option.

The main benefit of a public plan would be that NO money going to it would be funneled into the 8-figure salaries and bonuses that have actually driven the cost of health insurance premiums sky-high. It could pay for people’s health care rather than the yacht of some corporate bureaucrat. It is a complete myth that malpractice lawsuits, overuse of medical services, and/or a reckless iPhone-loving generation voluntarily going uninsured are what have caused costs to go up. All of these things undoubtedly happen on case-by-case bases, but the real culprit, pure and simple, is executive greed, just as it was for Wall Street.

A private-only reform plan could work, theoretically. Other countries have done it. However, the countries that have pulled it off have regulated their private sectors to the hilt. There are strong cost control mechanisms and in many cases, take-home pay is capped. I don’t think such a system would be the best fit for the United States of America. We are about choices in the marketplace. A government plan is just another choice. If it provides a better product than the private sector, well, that’s the marketplace at work. They would either improve themselves or take the consequences.

I do believe in economic freedom, provided that basic safety of labor, consumers, and the environment has been accounted for. Earlier in the year when people were screaming for Congress to cap executive pay, I was against the idea; I favored a punitive tax on firms that had abused the bailout money. I am against the government placing a cap on the pay of any private sector individual, including those most hated. All legitimate businesses get government assistance, whether in the form of tax benefits or in the much loathed bailouts. In many situations, government contracts jobs out to private businesses, paying them with taxpayer money. Saying “X business should have its salaries capped because it gets money from the government” is a slippery slope, and what the people calling for it actually wanted was a cap on “bad” businesses encoded into U.S. law. This is a bad idea. I am all for highly progressive taxes on the wealthy, but I am unequivocally against dictating a maximum limit for a person’s gross income.

So, a mandates-only bill will drive people who are barely treading water further into financial disintegration, most of whom are the young generation and are already saddled with mountains of debt and a truly atrocious economic situation. It will force them to create more credit card debt as they pile basic living expenses onto their cards out of sheer necessity. (Do you hear the voice of personal experience in this?) It will drive governments into a sea of red ink as they foot the bill for the remainder of whatever outrageously priced bunk insurance policy that the private sector, when guaranteed a captive customer base, will force on people. This is not theoretical, though the theoretical financial estimates of such a proposal back it up too. This has actually happened in the state, Massachusetts, where it has been tried.

There’s a call these days that “some reform is better than none at all.” I most vociferously disagree. There are ways of making the status quo worse, and the Congressional bill out there that does not have a public option definitely does that. It may be bad for the Democratic Party to fail to pass a bill, but the long-term fiscal health of the United States of America takes precedent over the health of a political party.

September 6, 2009

My $0.02 on Health Care: Beware the Sleeping Giant

Filed under: Politics — PolitiCalypso @ 12:55 am

I’ve avoided saying anything on this blog about the health care debate, not because I don’t have an opinion, but because it seemed to vary on a daily basis about which way the debate was going, and anything I said would be obsolete very quickly unless I updated the blog each day as well (which I don’t have the requisite commitment to blogging to do).  This is likely to be my sole comment on it, and it is to serve as a warning to certain people in politics.

If you pass a health care reform bill that mandates all adult Americans to purchase insurance policies without providing a Medicare-like public option, beware.  Beware the sleeping giant.

I speak of Generation Y, the group of people born in the 1980s.  This is my generation.  It is the generation that, arguably, delivered Barack Obama the White House.  It is also the generation with the most people who are “voluntarily uninsured.”  (The “young invincibles,” as the sneering corporate media dubs us, a phrase that is extremely offensive to those of us in our 20s who do have serious pre-existing conditions, such as yours truly, and already have accepted that our bodies are on a time limit because we get proof of it at every doctor’s visit.)

Yes, of the voluntarily uninsured, a majority of them are young people who (for whatever reason) don’t think they need health insurance yet.  This is true.  This means that my generation has become a convenient scapegoat for those forces who think that the problem is that things cost too much for the insurance industry.  We (I say “we” to refer to Generation Y as a whole, since I am obviously not part of the “we” who can voluntarily forgo health insurance) are blamed for the rise in premiums, since we aren’t there to share the costs with everyone else.  The fact that the health insurance industry has raked in record profits lately seems to have escaped the minds of these people, but there you have it.  A mandate from the government to buy insurance would hit my generation the hardest.

And let me tell you, the Democratic Party will not like the result.  In all the calculations by the White House and the Blue Dog members (not least of which appear to be calculations about how much money they will lose from the industry in donations if they support real reform), the effect of waking up the sleeping giant of Generation Y and its successor, the Millennials, seems to have been lost.

My generation put these Democrats and this President into power.  I have to admit that I was never on board with hope and change; I was always skeptical and cynical about that rhetoric.  But many of my generation actually did believe it.  More importantly, they believed in it. They saw candidate Obama as a person who was in touch with them and could actually represent them. I can say with near certainty that forcing this generation to send their money to the bloodsucking private insurance industry, in exchange for junk policies (which is all that will be offered at the rates that Generation Y can actually afford—keep reading), will drive these new voters into cynical apathy or possibly even into the arms of the Republican Party.

The AFL-CIO recently completed a report on the economic state of young workers.  Their findings were that my generation (and to an extent, Generation X) can barely afford their bills, if at all; that a third of us still live with parents because of necessity; that if we lost our sources of income, a huge majority of us would have no more than a month’s worth of living expenses saved up; and that we have the worst health benefits, sick/vacation packages, and retirement benefits of any age group.

THIS is the generation that the Democrats in Congress and apparently, the President, would force to enrich the health insurance industry.  Generation Y cannot afford it. However much CNN and its ilk may want to pretend that my age cohort has a large number of uninsured because we would rather pay out for iPods, the truth is that we don’t have it because a great many of us have crappy jobs (if any) with crappy wages and worse, no benefits.  I am exceedingly grateful to be in the portion of my generation that does have at least mediocre health insurance that covers my pre-existing conditions and a deductible that wouldn’t require me to tap into the cash line of my credit card to pay.

If we get a mandates-only health insurance bill out of Washington, where is the money going to come from to pay for the premiums, I ask?  Government subsidies?  Try getting government subsidies as a young person unless you are a single parent or living in a box.  I’ve tried.  The proposed subsidy program in one of the many health care bills, the one that does not have a public option, is about at this level.

Will it be like in Massachusetts, where you must provide proof of insurance to the state tax commission come tax day, and if you cannot provide it for all 12 months, you get a fine automatically taken out of your rebate?  That’ll go over well.  What if such a law would mean that a tax rebate became a tax liability, a liability that one could not pay?  Are we going to put people in jail for failure to send money to a private industry?  The Republican town hall disruptors scream about “fascism,” but if that’s not actual fascism, I don’t know what is.  If this is what we end up getting, you can toss me a tea bag and count me as one of them.  I strongly suspect I will not be the only liberal-turned-”teabagger” if this is what passes.

Incidentally, the cost of insurance premiums in Massachusetts has shot through the roof since “Romneycare” was enacted.  So much for mandates alone being an effective way to lower costs.

If the Democrats pass Romneycare-turned-national, they will lose Generation Y and the Millennials.

Obama’s going to make a statement on Wednesday about his vision for health care reform.  About time.  I hope he’s taken to heart the lesson that there are few real leaders in Washington, DC, and that Congress is used to 8 years of being threatened and intimidated by a consummate bully of a President to the extent that they have apparently forgotten how to lead.

A mandates-only bill is what I am against.  What I am for is a little harder to articulate.

I am in favor of a public health care option that is administered like Medicare—something that every American would be eligible for but that was not mandated and did not have automatic enrollment.

Call be a libertarian, but I am not in favor of “universal coverage” in the sense that 100% of the population would have “insurance” (whether public or private).  I think that if you are an adult, you have comprehensive and affordable options available to you, and you don’t want coverage, that should be your right—as should paying your own medical bills.  I am in favor of making good insurance affordable to everyone who wants it, and to all children regardless of what their parents want.

I am against caps on malpractice settlements.  What’s your eyesight worth to you?  What about your limbs?  What about the life of a loved one?  You see the problem with this.

I am in favor of passing a law allowing people to sue their health insurance providers.

I am in favor of having a strong federal committee to regulate the private insurance industry, but I am concerned about it becoming corrupted whenever a President or a Congress came in that didn’t want the insurance industry regulated.  Any means of making this committee robust rather than subject to the partisan whims of the time, I would be in favor of.

I am in favor of decoupling health insurance from employment.  If employers want to offer a group policy, that’s fine, but I do not support automatic enrollment of employees.

And with the exception of my tort reform opinion, I don’t see what’s so controversial about any of this.  But then, I’m not taking in thousands of dollars in campaign contributions.

April 15, 2009

Valuing All Americans’ Work

Filed under: Other,Politics — PolitiCalypso @ 11:06 pm

Another tax day is over, and hopefully, your returns are safely in the mail, faxed, or e-filed to the IRS. Whether you got a refund or had to pay them this year, the odds are that you at least looked at the worksheet for the Earned Income Credit.

Whether you could take it, however, depends on your age. As strange as that sounds, this is not one of the bizarre, obscure credits that only tax lawyers and IRS employees even know about, let alone use. Indeed, age discrimination is written into one of the most common, mainstream tax credits in our code. Specifically, people under age 25 who have no children cannot take the credit that every other American under retirement age can take. (Read more…)

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