In the Wall Street Journal Peter Suderman recounts the experience the several states have had with healthcare reform and their track record hasn’t been particularly good:
Like participants in a national science fair, state governments have tested variants on most of the major components of the health-care reform plans currently being considered in Congress. The results have been dramatically increased premiums in the individual market, spiraling public health-care costs, and reduced access to care. In other words: The reforms have failed.
One by one he goes through the varied experiences of New York where guaranteed issue and community rating, i.e. requirements for private insurance to cover people with pre-existing conditions and to do cover everybody in the same geographic area at roughly the same rate, have been imposed, Washington state which conducted a similar experiment, Maine, and Tennessee. None of the experiments have succeeded in controlling costs.
I notice that Mr. Suderman doesn’t detail the experience in Hawaii, where the employer mandate has been tried. Despite the extravagant claims of the benefits of Hawaii’s system, Hawaii has not succeeded in controlling the increase in healthcare costs, has roughly the same number of physicians per thousand population as on the mainland, and has a rate of people without healthcare insurance roughly equivalent to those Midwestern and Northeastern states. See here, here, and here.
An obvious retort to the problems the states have experienced with the same healthcare reforms being proposed for the nation is that things would be different on a national level. In the absence of a fully nationalized healthcare system along the lines of BNH, able to impose cost controls by fiat, I see no reason this should be the case.
As I’ve been arguing for some time it’s going to require more radical changes than anything that’s in the bills making their way through the Congress to achieve the reforms that we really need.
Like you I don’t see why this has to be the case either. I would say it is imperative of those wanting to push health care reform that we are currently seeing in Congress to provide evidence that the above is true. Of course there is absolutely no evidence being provided, which leads me to wonder…is there evidence supporting the claim.
And if we look internationally, I’ve only found two cases where costs have been successfully controlled: Singapore, the Netherlands. Both are small countries with (relative to the U.S.) homogenous populations. Could this be a factor? France which has a more diverse and larger popultation is having cost issues not unlike the U.S. is experiencing, although not in the same magnitude.
But hey, we’ll just declare it a right and money will fall from the skies.
That’s what I’ve been saying. I think it affects the ability to deny treatment.
BTW, Steve, can you make the show? If so, email me. I can’t reach my addressbook or I’d’ve emailed you?
No, the new time is just horrible for me being in the middle of my day. Wish I could….
I can think of a couple reasons. For example, the state is a local political entity in what is otherwise more or less an open market – if they end up having to increase taxes or the like to cover UHC, then the more mobile businesses simply move next door to the nearest state without those expenses. That’s not quite the case with federal level efforts at provision.
How? On a side-note, if you’re opposed to government intervention in the health insurance market, Singapore is not your type of country. It’s basically government-provided universal catastrophic insurance coupled with mandatory contributions to an HSA equivalent, combined with cost and price controls on the supply side.