Saturday, January 16, 2010

The New York Times supports the Senate's excise tax on health care:

From their editorial: (which I strongly suspect was written with the input from Paul Krugman)
[As a result of the tax] Most likely, insurers will drop their premiums just below the threshold. They could do that by setting higher deductibles and co-payments, managing access to care more tightly, or reducing benefits.
Yup, that's probably what will happen. A rationing of health care.
WHY IT’S GOOD A vast majority of economists agree that the tax would be a valuable cost-control feature. In our largely fee-for-service system, doctors have an economic incentive to provide more services. With insurance covering most of the bill, neither patients nor doctors worry much about costs. Requiring workers to pay more out of pocket would force them and their doctors to think a lot more carefully about whether an expensive test or treatment is really necessary.
Talk about a simplistic view of the situation. There will be people who have chronic and serious problems that don't hinge on deciding whether or not to undergo a fancy treatment. Existing treatment regimes (not new or exotic remedies) can be pretty expensive. Even so, the change in coverage caused by the Senate bill will cause these people to not get treated, or pay out of their own pocket. Also, what's with patients making the call as to what treatment should be followed? Are they now supposed to be as informed as doctors? Patients telling doctors not to run test A, but go ahead with test B? The Times thinks so.
POTENTIAL HARM There is some risk — nobody knows how large — that higher deductibles and co-payments would discourage some people, especially the chronically ill, from seeking medical care that they need. Congress can avoid this tragic outcome by setting up a monitoring system to detect any emergence of harm and making a midcourse correction to protect the health of any groups that suffer adverse consequences.
Pathetic. Truly pathetic. "nobody knows" - but let's do it anyway. How many people will die, be permanently crippled, or go bankrupt before a "monitoring system" raises the alarm? This shows how totally experimental the excise tax is. Where are the studies of it being tried anywhere else? The excise tax is being pushed because real price reductions have been ignored while the legislation was being crafted. And talk about a potential political disaster! If it turns out that we see the "tragic outcome" the Times fears, you can bet the Democrats will be hung out to dry.

And what about the "chronically ill" that the Times now admits exist? Earlier in the editorial, these people were supposed to be feeling the hurt from less coverage, higher co-pays, or higher deductibles. And they are supposed to figure out what services not to get as a result. But they are "chronically ill", so what do you think will happen?

The New York Times also admits that workers that are older, are sicker, or those in high-risk occupations, are going to lose big with the excise tax. But the Times is still gung-ho for implementing it. An unproven, likely-to-fail approach to lowering the price of health care.


It looks like the people of Massachusetts will be making the decision for the rest of us. It's a big responsibility. I'd rather they decide than the "bought and paid-for" congress. And if I had to pick a citizenry to represent me, the Bay State would be on my short list.

By Anonymous Rockie the Dog, at 1/16/2010 7:08 AM  

That sharp pain you are feeling in your back is the tip of the Obama knife slipping between your ribs.

Can't say you weren't warned.

By Anonymous Anonymous, at 1/16/2010 8:51 AM  

Sam Zell, I mean, The LA Times, is on the same page:

Many of these policies currently impose no or minimal co-pays and deductibles, which has the unhelpful effect of insulating policyholders too completely from the cost of care. The result is that consumers make needless trips to the doctor, and healthcare providers spend excessively on diagnoses and treatments. The Cadillac tax would discourage this type of coverage, injecting more market discipline into the healthcare industry.

Yes, like so many Americans, I often visit my doctor for frivolous reasons, because getting poked and prodded is almost as much fun as hanging around in waiting rooms. Not to mention the lovely, open-back gown I get to wear.

Obviously, the way to fix the system is to make it more difficult for me to obtain treatment. Make doctor visits expensive enough, and I'll have to wait until it's Emergency Room time before seeking medical help. Progress!

By Anonymous eb, at 1/16/2010 11:30 AM  

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