Healthcare RSS feed for this section
mike-stenhouse-avatar

Important Questions for Rhode Island In A Reshaped Healthcare Landscape

If the final federal healthcare law that eventually emerges from Washington, D.C. is similar to the version that passed the House of Representatives in early May of 2017, Rhode Island lawmakers will find themselves in the middle of largely reshaped federal and state healthcare landscape. Soon they may be faced with multiple important questions; and they will also realize that they will be newly empowered to make state-specific decisions for the people of Rhode Island.

justin-katz-avatar-smiling

No Health Policy Is Perfect, but Remember Both Sides

Mary Katharine Ham makes a critical point as we all debate (make that, “debate”) health care policy:

Arguing about this as if beneficiaries of ACA don’t exist isn’t right. Arguing about it as if people like me don’t is also not right. ACA was never the panacea it was sold as and it remains distinctly un-utopian in its results. Lazy characterizations of things you like as perfect—and of people you oppose as big fans of people dying—are not particularly helpful to actual people.

So if you’re weaving a utopian or dystopian scenario for Facebook, remember reality is almost always less extreme and more nuanced than you’re asserting, and you probably know a real human on both sides of every imperfect adjustment to our Frankenstein system.

That’s the level at which policy debates ought to be conducted, and it would be true to say that both sides have people who reach that level and people who decidedly do not.  It’s vertigo-inducing to watch the speed at which we go from a mainstream with no major concerns about the wholly partisan, parliamentarily manipulated, nature of ObamaCare to, for example, a Democrat Congressman’s proclaiming that overhauling health care shouldn’t be done in a partisan way.  (It’s like that childhood friend who would keep breaking the rules of a game and then saying that they would apply from that point forward.)

To get to that point, one must ignore the past, and in the case of ObamaCare, it means ignoring people who have been harmed, not to mention the long-term harm to our health care system and economy.  Somehow, we have to see the self-interested partisan talking points and get to the question of which direction policy should actually go.

justin-katz-avatar-smiling

Disconnect Between Health Care Rhetoric and Reality

So it seems that Rhode Island and national Democrats have decided that the outrage machine must remain dialed up to 11.  Rhode Island Congressman David Cicilline has proclaimed that Congress would kill “tens of thousands of Americans” if it passed the Republican health care bill.  (Put aside evidence that ObamaCare’s already tallying the deaths.)  Democrat governor of Rhode Island Gina (everybody calls me “gov”) Raimondo insists that the bill would strip families of health care coverage.

Meanwhile, as WPRI’s Ted Nesi reports, Care New England hospitals are losing money and struggling under ObamaCare:

The $26-million operating loss for the winter quarter, Beardsworth said, “further tells the story we have been very candid about – decreases in patient volume, a worsening payer mix, changing health care needs of the population, and extremely restrictive reimbursement caps in place through the state health insurance commissioner’s office.”

The payer mix refers to what share of hospital bills are paid for by different commercial and government insurers. In Care New England’s case, more of its revenue is coming from Medicaid, the state-federal insurance program for low-income people, and Neighborhood Health Plan; it says both pay less than Blue Cross & Blue Shield. The hospital group’s management attribute the shift to the Obama health law, which President Trump is now seeking to overhaul.

And not to be outdone, insurers around the country are beginning to be more vehement in warning that ObamaCare may have entered the much-warned-about “death spiral.”

Of course, many have suspected that a death spiral leading to full government control of health care was the underlying plan of ObamaCare all along.  So those now squawking are trying to score political points (and out-of-state donations, no doubt) while preventing Republicans from doing just e-pitiful-nough to keep American health care from fainting fully into the arms of the government vampire.

In a state with no political pull within the national Republican Party (i.e., the party in power), it seems politicians’ time would be better spent trying to figure out how to handle any changes that come along than jumping on this week’s excuse for stoking a “resistance.”

justin-katz-avatar-smiling

Congressional Health Care Bill and the Purpose of Government

Look, I get it.  It doesn’t do anybody any good (except maybe politicians) to caricature the opposition, and I understand that Big Government types believe, at some level, in the mission of government, and on that level, an equivalence between funding and policy goals is justified.  But reading news from up north, I can’t help but think a critical line of perspective has been crossed:

The health care bill that Congressional Republicans plan to bring to the House floor for a vote Thursday afternoon would result in “a massive loss of critical funds” for Massachusetts, Gov. Charlie Baker said. …

The potential loss of federal revenues, a major source of funds for the state budget, could compound budget problems associated with tax collections that for many months now have come in well short of the projections that Baker and legislative leaders have used to plan state spending.

Somewhere in this process of elected officials’ making statements and journalists’ reporting them, shouldn’t somebody have the role of putting front and center the key question, here, which is whether a particular policy is better for the people of the United States of America?  If ObamaCare crashes of its own weight, wouldn’t that be bad, too?  If so, wouldn’t that be worse than a state-level budget crunch?

(Yes, look, I get it… a health-industry collapse would just mean more money and power for the federal and state governments.  I’m being rhetorical, here.)

justin-katz-avatar-smiling

Why Knowledge Is Important (Pre-Existing Conditions)

Josh Blackman highlights one of those political truisms that still surprises when one sees evidence.

First, he cites a 2009 Kaiser Family survey finding that support flips for an ObamaCare provision that makes it difficult “for insurance companies to drop your coverage when you get sick or water it down when you need it the most” when people are informed that it would increase their own premiums.  Next, he cites the same phenomenon in a more recent Cato/YouGov survey, concerning the “community rating” provision that forbids adjusting premiums based on medical history.

This is why it makes a difference how surveys are worded and, even more, what points news stories present.  It makes progressive policies look much, much more attractive if there’s never any cost associated with the feel-good legislation.  Every story should contain a micro-lesson on basic economics.

Making this tendency more tragic, in this case, is that these small populations of exceptions could be addressed in ways that are much more fair and much better economically and with regard to outcomes.

Knowledge, as they say, is power, which is why the Left spent decades corrupting institutions like the media and higher education by which Western Civilization transmits its information.

(Via Instapundit.)

justin-katz-avatar-smiling

Government Is Allowed to Change Bad Decisions (As on Medicaid)

Virgil Dickson, of Modern Healthcare, reminds us that government is allowed to rethink bad decisions, even when they relate to welfare entitlements:

Democratic lawmakers in Oregon are considering ending the state’s Medicaid expansion in an effort to address a $1.6 billion budget shortfall.

The state’s Ways and Means committee, which includes both senators and representatives, suggested cutting Medicaid expansion in an effort to curb Oregon’s $1.6 billion budget deficit.

As Kevin Mooney pointed out in this space in 2012, the Medicaid expansion was implemented in Rhode Island through administrative action and with little debate.  It was just assumed that we would and should do it.

It’s been a disaster.  In a policy brief from the RI Center for Freedom & Prosperity, we expected one in four Rhode Islanders to be on Medicaid by 2020.  Instead, we’re already nearing one in three and increasing every month.  Medicaid enrollment exploded as soon as the expansion and the health benefits exchange (HealthSource RI) came online, and it’s reaching the point that the exchange is shuffling its own paying customers onto Medicaid, undermining its own business model.

Legislators should admit that the expansion was a mistake and repeal it.

justin-katz-avatar-smiling

Does ObamaCare Kill?

Here’s an interesting finding to ponder as we wrap up the work week, from Brian Frankie in The Federalist:

We know that the same year Obamacare’s insurance expansion provisions took effect, there was a pronounced, and statistically significant, surge in U.S. adult mortality. We know the surge in mortality remains after removing drug-related deaths, and other external morbidity causes, from the statistics. That is all we know. The rest is speculation. But it is fascinating speculation.

Has Obamacare, or some of the secondary effects of Obamacare, actually caused the negative impact in U.S. adult mortality so evident in the statistics? Is the improvement in public health that was assured turned out simply to be another false Obamacare promise, like being able to keep our doctors and health plans, or reducing our health costs?

As with the infamous ObamaStimulus metric of jobs “saved or created,” supporters of the O will insist that we cannot possibly know what mortality rates would have been like had ObamaCare never passed.  That’s a nifty trick to never have to truly subject one’s policies to real-world assessment, but serious discussion would require finding some evidence that an even bigger surge came in low.

I’m not saying I’ve got any answers on a Friday afternoon, but I certainly find it plausible that ObamaCare actually killed thousands of people (to put it in not-at-all-inflammatory terms).  Medicaid has worse health outcomes than private health insurance, even than no coverage at all, so people ushered onto Medicaid would be expected to increase mortality rates, especially if they’d planned to buy private health insurance through an exchange and discovered their eligibility for the free version.

Whatever the cause, we should certainly get past the simplistic public debate that saving ObamaCare saves lives and trying to eliminate (or even substantially reform) it is an inhumane goal.

justin-katz-avatar-smiling

The Many Methods of Expanding Government’s Role

Although fully aware that I’m (let’s say) unique, I still think bottle deposit charges ought to outrage people.  The idea of the charges was to give consumers some incentive to recycle bottles and cans, but Susan Haigh reports for the Associated Press on how that rationale continues to transform into something else:

In Connecticut, distributors were allowed to keep the unclaimed bottle deposits to help offset the costs of running the program, but state officials decided in 2009 to use that money — about $34 million each year — to help balance the government’s budget.

Step 1: Use some public purpose as justification for the creation of a new funding stream, claiming (don’t worry) the government’s intentions are wholly dispassionate.  Step 2: Spot a big pot of money that government can contrive a justification for taking, and take it.

And now:

Connecticut, Massachusetts and Iowa are among the states where bills have been proposed to replace the bottle deposits with a tax. Supporters say the tax revenue could support recycling efforts that did not exist when the bottle redemption systems were introduced.

Thus does the government essentially open up a line of business in recycling.  What started as an incentive charge that government imposed, but from which government did not profit, is becoming an excuse for government to process money for a particular activity.

Liliana Rutler and Rosie Woods report on another line of work the government of Massachusetts is edging toward entering:

Sheriffs urged lawmakers Monday to use the legalization of marijuana as an opportunity to invest in substance abuse treatment. They are urging state lawmakers to increase the tax on pot from 10% to 15% to pay for those treatment programs.

Step 1: Legalize an illegal industry.  Step 2: Effectively turn it into a government-monopoly.  Step 3: Find new sideline businesses such as treatment for those who abuse the government-monopoly substance.

justin-katz-avatar-smiling

Consumers Can’t Handle Options They Don’t Have

Not to build a day of blog posts drawn from a source, the Wall Street Journal, to which not everybody has full access, but an essay by Amanda Frost, taking up the “no” side of the debate question, “Can consumers be smart health-care shoppers?,” gives an opening for a point that ought to be made more frequently:

When it comes to making decisions about our health care, being a “smart shopper” takes more effort than most of us are willing to put in.

Advocates for price transparency would have us believe that we, as “consumers,” should consider our health care a product to be shopped for, like a pair of shoes. But mainly we are “patients,” with varied, often time-sensitive health-care needs. There is an important distinction between presenting the information—and choices—to patients and asking consumers to make complicated decisions about their health care based on that information. …

Available evidence is not cause for optimism about how much money can be saved with more choices and publicly available prices. While large health-care payers may save some money from consumer shopping, the average person will likely see little, if any, savings.

Frost’s argument appears to be that consumers in a market with artificially constrained options — that is, in which choices are limited, obscure, and difficult to understand — don’t seem to want to clear that high hurdle, so lowering the bar is a bad idea.

Look, if shopping for health care “takes more effort than most of us are willing to put in,” then people will pay extra for options that free them from the burden.  Frost is essentially saying that those who are willing to put the effort in should not be allowed.

But I don’t believe she’s correct.  Once people get used to the idea that they aren’t under the watchful eye (or the thumb) of their insurance companies and the government, they’ll begin figuring out pricing and talking among themselves.  The possibility of choices will make new products and more competition possible, lowering prices and improving quality.

justin-katz-avatar-smiling

Rhode Island Does (or Did) Something Right

In its design (as opposed to its objective) Stephen Moore doesn’t much like Medicaid:

You’d be hard-pressed to find a more poorly designed program in the federal budget than Medicaid, the health insurance program for low-income Americans. The costs are shared between the states and the feds, which means that the more money a state wastes under Medicaid, the bigger the check Washington writes to the state. No wonder the program costs keep spiraling out of control.

Obamacare added nearly 20 million people to the Medicaid rolls, and the left considers that a policy victory. Federal and state budgets are swelling.

Oh, to return to the days when taking people off of welfare — not putting them on the dole — was the goal.

In an unusual experience, for a conservative, Moore cites Rhode Island as an example of a different way, referring back to a block-grant program implemented in the waning days of the President Bush and Governor Carcieri days.  Gary Alexander, who ran Health and Human Services in RI back then comments in Moore’s essay:

Alexander has become the Pied Piper for Medicaid waivers. “This is such a terrific solution because in Rhode Island we reduced costs and provided better care. When the state had an incentive to save money rather than spend it, this changed everything.” He added, “State waivers are the way out of the Medicaid crisis.”

Of course, elected officials in Rhode Island moved quickly to give away the budget slack in the Medicaid expansion and other constituent buy-offs, so clearly we have to work on step 2 of the “saving money” process (i.e., not immediately spending it on something else).  But it’d be nice to be recognized more often for innovative, smart policies.

justin-katz-avatar-smiling

Lining Up to Be the Future of Vulnerability

Yes, the idea of receiving scannable implants in the body for the collection and transmission of information is terrifying of itself, but it’s the peer-pressuring described in this James Brooks AP article that’s truly unsettling:

The [Swedish startup company, Epicenter,] offers to implant its workers and startup members with microchips the size of grains of rice that function as swipe cards: to open doors, operate printers, or buy smoothies with a wave of the hand.

The injections have become so popular that workers at Epicenter hold parties for those willing to get implanted. …

The implants have become so popular that Epicenter workers stage monthly events where attendees have the option of being “chipped” for free.

Encouragement parties.  Coworkers prying into your business — almost literally under your skin — to ask “Are you chipped?”

Go ahead.  Everybody else is doing it.  Don’t worry that it can be read some distance from your body and that you’d need to cut open your skin to take it out and perhaps face the inverse peer pressure for being a troglodyte and apostate who has become “unchipped.”  You can trust that the company won’t collect any creepy information, or anything.

What else does “the future” that these chipped folks talk about hold in store?

justin-katz-avatar-smiling

The Dead End of Rhode Island’s Government Plantation Model

The entitlement mentality in this state will be palpable as the federal government rolls back the Obama Administration’s give-aways. Lynn Arditi writes about the potential cost to Rhode Island if it refuses to change its Medicaid program to reflect federal spending under the Republican health care plan:

Predicting how much it might cost the state to cover the roughly 70,000 adults in the Medicaid expansion population under the Republican plan is especially difficult, health experts say, because people move on and off the rolls. If, for example, the job market weakened and people who had left the Medicaid rolls return, the lower federal cost-sharing rate means they’d be much more expensive to re-enroll.

“While certainly we’d support the state continuing to fund the Medicaid expansion population,” [Linda] Katz [of the Economic Progress Institute (no relation)] said, “the reality is … it would be very difficult to replace with state dollars the federal dollars and keep people insured.”

Rhode Island never should have signed on to the Medicaid expansion if this was possible, and the likes of the RI Center for Freedom & Prosperity were ignored when we warned that it was most definitely possible.  What everybody can see clearly now is that insiders and bureaucrats padded their budgets at great cost and risk to others.

And it’s not just Medicaid.  Dan McGowan reports from Providence for WPRI:

President Donald Trump’s proposal to eliminate the $3-billion Community Development Block Grant (CDBG) program would be a “devastating” blow to Rhode Island’s capital city, Mayor Jorge Elorza said Friday.

Trump’s proposed budget would do away with the 42-year-old CDBG program, which provides local governments across the country with funding for community centers, housing programs and neighborhood improvements.

None of these programs should ever be built into state government budgets or the local economy.  They should be treated as gravy on a healthy, independent economy.  Instead, we’ve allowed our elected officials to suffocate real industry and substitute a government plantation model premised on being able to bill the federal government and local taxpayers for government services for others.

Eventually, when you turn toward an obvious dead end, you reach it.

justin-katz-avatar-smiling

CBO Points to the ObamaCare Abusive Spouse

This Wall Street Journal editorial offers some worthwhile perspective on the meaning of the Congressional Budget Office’s (CBO’s) estimates around Republicans’ initial ObamaCare repeal bill:

The CBO attributes “most” of this initial coverage plunge to “repealing the penalties associated with the individual mandate.” If people aren’t subject to government coercion to buy insurance or else pay a fine, some “would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.”

What this finding says about the value Americans attach to ObamaCare-compliant health insurance is damning. If CBO is right, some 14 million people would rather spend their money on something else, despite the subsidies.

In keeping with the general worldview of central planners, if you cease to get something through them, you’ve “lost” it.  This attitude permeates government, from charitable grants that local governments give to their preferred charities up to massive federal entitlements.  In this case, the government isn’t even just taking credit for something it’s using other people’s money to provide, but behaving as if forcing people to do something gives them that something.

As perverse as that is, it may be the perfect representation of progressive government.  It’s like an abusive spouse who rationalizes his or her pathology into the belief that commanding and berating his or her significant other is for the other person’s good.

As for the CBO, the Journal also reminds us that it’s a policy group working off a model, not a mystic order of prophets telling the future.

justin-katz-avatar-smiling

Paying for the Entitlement That Never Should Have Been Extended

This is a great idea that Rhode Island should pursue, as reported by Michelle Hackman in the Wall Street Journal:

Ms. Verma, a health policy consultant, made a name for herself as the architect of Indiana’s Medicaid expansion program under then-Gov. Mike Pence, which that state administered through a federal waiver. Ms. Verma struck a deal with  the Obama administration allowing Indiana to charge enrollees under the expansion monthly premiums.

There is no reason childless, able-bodied adults relying on a government welfare-insurance program can’t pay something to give them a stake in their coverage.  From the beginning, we’ve seen examples of people who were willing to pay for private insurance, but who discovered their eligibility for a free plan through Medicaid.

Moreover, the state of Rhode Island never should have leaped into the ObamaCare Medicaid expansion with so little thought. Some of us warned at the time that the state shouldn’t count on the federal government holding the share it would pay at 90%, particularly as part of an unpopular and entirely partisan bill.  Since the state government conducted absolutely zero public debate over whether to accept the expansion, we can only surmise that elected officials and bureaucrats in Rhode Island either didn’t care to look that far ahead or counted on their ability to do what they’re trying to do now: get political mileage out of the federal government’s predictable move and attempt to transfer the burden to state-level taxpayers.

mike-stenhouse-avatar

The “Real” News About Healthcare Reform

The Providence Journal and Rhode Island progressives are doing a disservice to the people of our state by advancing a biased and non-realistic perspective on the federal healthcare reform debate.

There are few issues that are more personal or important than planning for the care that can preserve the health of ourselves and our families. But what governmental approach best helps us accomplish this?

Currently, our state is following the federal Obamacare approach of seeking to insure more people with government-run Medicaid or with a one-size-fits-all government-mandated private insurance plan. This approach is in a death-spiral.

Continue reading at Rhode Island Center for Freedom and Prosperity.

justin-katz-avatar-smiling

Approval of the Cognoscente Versus Approval of the People

It seems to me that politicians (particularly those on the right) should take data points like this, from Austin Yack on NRO, as justification for further experimentation going against the common wisdom of their Washington–New York social set:

The Republican-majority Congress also polled well. Americans trust Republicans to legislate on issues pertaining to the economy, jobs, immigration, energy, and health care — and, astonishingly, these responses were recorded during the days in which the Congressional Budget Office found that 24 million people will be uninsured by 2026 under the Republican-majority Congress’s health-care plan. Forty-six percent of registered voters approved of the health-care plan; 35 percent disapproved, and 19 percent had no opinion.

Perhaps people are learning that the news media hypes stories from a point of view benefiting a particular political party, not the country, and perhaps people understand that when a country (like a person) has let itself go, getting back on track involves some discomfort.

justin-katz-avatar-smiling

The Poster Hairdresser for How Government Interferes with Civil Society

Rhode Islanders may have noticed that Providence Democrat Representative Anastasia Williams has submitted legislation to allow people to braid hair for pay without requiring a license.  This is actually a subject that the RI Center for Freedom & Prosperity has raised in the past (although I can’t find a link, just now) and is consistent with both our long-running insistence that the state government is strangling our economy with regulations and our more-recent emphasis on shifting policy in favor of helping Rhode Island families and facilitating non-government civil society.

Via Instapundit, however, comes an entry by Eric Boehm of Reason, who may very well have spotted the poster child for the government’s overreach in directing our lives and preventing us from serving one another as human beings:

The Arizona State Board of Cosmetology is investigating Juan Carlos Montesdeoca after receiving complaints that he was cutting hair without a license, Tucson News Now reported Monday. According to the complaint, which Montesdeoca shared with the TV station, the board received an anonymous complaint alleging that Montesdeoca was “requesting local businesses and local stylists to help out with free haircuts (unlicensed individuals) to the homeless.”

This morning, the Tiverton Budget Committee (of which I’m a member) toured the town’s Senior Center, and the new director related some of the anecdotes that she’s heard about the 100-year-old building.  Back when it was a school, apparently doctors would open weekend clinics for various procedures, including the removal of tonsils.

Now, given advancements in knowledge, we can surely agree on a role for government in requiring sanitary conditions and licensed professionals to perform such surgeries.  At the same time, we should be able to agree that rules against hair braiding and charity trims don’t really protect anybody but established practitioners who are able to charge more money the less competition they have.

justin-katz-avatar-smiling

Anybody Buying the UHIP Spin?

Come on, now. This is like lie-detector 101:

“There was pressure [to launch UHIP despite its not being ready], no doubt about it,” Raimondo told reporters. “High ranking members of the General Assembly said, ‘Deliver this now.'” …

[Department of Human Services Director Eric] Beane, called to testify about his month-long probe of UHIP, tempered his answer, saying employees he spoke with at DHS and the Executive Office of Health and Human Services talked about pressure from former House Finance Committee Chairman Raymond Gallison and former Rep. Eileen Naughton, who chaired the finance subcommittee on health and human services.

So, the governor tried to deflect some blame, and the administration realized it was starting a political fight, so a flunky ostensibly testifying with a neutral assessment of what went wrong implied (indirectly, notice) that the blame should fall on two legislators whom a governor would hardly take seriously as directing the administration’s actions and who, conveniently, are no longer in office (one because he was jammed up with criminal investigations).

This is cover-up land. The governor can’t be trusted.  As I suggested in my “Last Impressions” podcast this week, it appears that Raimondo has invested in the tagline that she’s the “governor who gets things done,” and sliding down the UHIP wormhole had to be a major concern.

justin-katz-avatar-smiling

A New Winner for Most Pro-Government-Spin Headline in the Providence Journal?

I’ve been meaning to nominate the headline that the Providence Journal used in its print edition for this article (from the Associated Press):

‘Obamacare’ sees high enrollment

To be fair, the Projo headline writer was taking his or her cue from and amplifying the spin of AP writers, Ricardo Alonso-zaldivar and Kevin S. Vineys who try to slip in the real story in the third paragraph:

Although initial enrollment is about 4 percent lower than last year, the sizable number of sign-ups illustrates the risk Republicans face as they begin moving to dismantle the Affordable Care Act and put in its place a yet-to-be-defined conservative approach.

You can’t get from a 4% drop in enrollment to a headline proclaiming “high enrollment” without being something more like propagandists than journalists.  If I were an objective journalist working for one of these organizations, I’d be furious with my coworkers for undermining our publication’s credibility.

justin-katz-avatar-smiling

The Creeping Grim Reaper of Euthanasia

Just in case you’re thinking the grim reaper of euthanasia won’t be a creeping killer, here’s a Catholic News Agency article to consider:

An Oregon bill on advanced medical directive rules could allow patients who suffer from dementia or mental illness to be starved or dehydrated, opponents warned.

These are patients who are awake, can chew and swallow and want to eat, even though in some cases they may need help in delivering food to their mouths,” Gayle Atteberry of Oregon Right to Life said Jan. 31. “Current safeguards in Oregon’s law protect these patients from this type of cruelty. This bill take away these safeguards.”

Whether proponents see euthanasia as compassion or as a scheme to slough off some excess population, it has no boundaries once one cedes the argument over the sacred value of human life.

justin-katz-avatar-smiling

Freestanding ER Bill Shows How Price Has Been Disconnected from Service

The lesson of Susan Campbell’s WPRI story about one woman’s surprise bill from a “freestanding ER” business from which she received service may not be quite what’s intended:

“They gave me oxygen, they did chest X-rays, an EKG, and blood work,” [Elizabeth] Darling said.When she got to the ER, however, Darling overlooked a sign at the front desk, warning patients that Medicare and Medicaid are not accepted at the facility. She was billed more than $1,600.“I never would have stayed there,” Darling said. “I would have walked out that door, had I known.”

This may look bad — and we’ve been trained to see the word “gouging” between the lines of such stories — but it goes with my broader analysis: We’ve completely disconnected price from service.

Given her insistence that she would have gone elsewhere if she’d known her price of service, this woman could obviously have made it to another service provider that would have saved the system money.  Instead, within a system that ensures that the decision-making consumers don’t usually care about the price of services, she chose a high-cost option.

A great many people would do the same thing, because the way the government has manipulated our health care system, people not only don’t associate direct payments with services, we don’t even have a concept of what those services actually cost to provide.  It’s a system designed for waste.

healthsource-enrollmentlossbysource-2016-featured

Transfer to Medicaid “Main Driver” of HealthSource Decline

Rhode Island’s Affordable Care Act (“ObamaCare”) health benefits exchange lost 5,027 members (18.6%) as of the December 31 deadline for open enrollment.  Officials largely blame the withdrawal of UnitedHealthcare’s plans:

HealthSource RI said in a statement that the “main driver” of the enrollment decline was the departure from the market of UnitedHealthcare, which HealthSource RI estimated insured roughly 1,400 exchange customers in 2016.

One source of lost customers was more significant, however: Medicaid.  A HealthSource spokesperson tells the Current that “about 1500 individuals who had [qualified health plan] coverage at the start of Open Enrollment have since been determined eligible and enrolled in Medicaid.”  A request for the number of Medicaid recipients who went the other way — losing the taxpayer-funded welfare benefit and signing up for a paid (if taxpayer subsidized) plan — had received no reply as of this writing.

healthsource-enrollmentlossbysource-2016

Since the beginning of HealthSource RI and the related Unified Health Infrastructure Project (UHIP), the RI Center for Freedom & Prosperity has warned that the system was designed to draw Rhode Islanders toward welfare benefits and dependence on government.  From the beginning, new Medicaid enrollment has far exceeded the numbers of Rhode Islanders who have used the exchange to purchase insurance.

These decisions and results have been a significant part of Rhode Island’s drop to 48th in the country on the Center’s Jobs & Opportunity Index (JOI) and to 39th on the index’s Freedom Factor, which is the ratio of jobs and employment to reliance on welfare programs.

Quantcast