WSJ: RomneyCare's Failures in MA Not 'Widely Known'; I Wonder Why?

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An editorial in yesterday's Wall Street Journal bemoaned the fact that the state-run health system in Massachusetts is failing, and that its implosion isn't common knowledge.

Formally known as CommonwealthCare, the Massachusetts scheme has the political name of "RomneyCare," in "honor" of the Bay State governor and former presidential candidate who championed its passage in 2006.

The Journal understands that the Bay State Blowup is one of the media's least-covered stories because exposure of CommonwealthCare's true results would make all too clear the awaiting disasters found in the various versions of ObamaCare Congress is considering for the entire country.

The Journal editorial yesterday primarily addressed what I'll call the "free rider" problem (link to outside blog post added by me; bolds are mine):

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In a rational world, the prognosis for ObamaCare would wait on the evidence in Massachusetts, given that the commonwealth's 2006 program closely resembles what Democrats are trying to do in Washington. If the results were widely known, it might be dead on arrival.

The Massachusetts law, which was championed by former GOP Governor Mitt Romney, imposed an individual mandate, requiring nearly all residents to buy health insurance or else pay a penalty. (The exceptions are those who qualify for the state's public program.) This was supposed to cover everybody and save money too. We've written before about how costs have exploded, but it also turns out that consumers have other ideas.

Well, the returns are rolling in, and a useful case study comes from the community-based health plan Harvard-Pilgrim. CEO Charlie Baker reports that his company has seen an "astonishing" uptick in people buying coverage for a few months at a time, running up high medical bills, and then dumping the policy after treatment is completed and paid for. Harvard-Pilgrim estimates that between April 2008 and March 2009, about 40% of its new enrollees stayed with it for fewer than five months and on average incurred about $2,400 per person in monthly medical expenses. That's about 600% higher than Harvard-Pilgrim would have otherwise expected.

The individual mandate penalty for not having coverage is only about $900, so people seem to be gaming the Massachusetts system. "This is a problem," Mr. Baker writes on his blog, in the understatement of the year. "It is raising the prices paid by individuals and small businesses who are doing the right thing by purchasing twelve months of health insurance, and it's turning the whole notion of shared responsibility on its ear."

Mr. Baker is right, though he underestimates the extent to which it is rational for people to do this, considering the government-mandated incentives. To one degree or another all insurance pools require the younger and healthier to subsidize the older and sicker, though part of the risk-sharing bargain is the hedge against unanticipated or future health problems -- i.e., true insurance. The combination of guaranteed issue and community rating actively encourages parts of the healthier population to forgo coverage and thus blow up voluntary risk pools. No doubt our politicians will conclude that the solution is to raise the penalty for going uninsured, though it would be easier and more rational to let insurance markets function without mandates.

But the statist politicians who dominate the Massachusetts legislature didn't want "easier" and "more rational"; they wanted "more controlled" and, with Ted Kennedy cheering them on (see picture above), "more national." The failure to recognize this ultimate objective, and to thus get co-opted into concocting a scheme that he naively thought would be enough to appease the statists, is Mitt Romney's most obvious economic policy failure as Bay State governor.

As to the media, almost nothing of what is going wrong in Massachusetts gets reported outside of New England. Even when problems do get noticed, newspapers like the Boston Globe persist in describing CommonwealthCare aka RomneyCare as a "grand experiment" and "trailblazing." Rationing is already occurring; yet a Globe reporter recently described the 12% cost cuts necessary to stay within budget as mere "trimming."

If the failures of state-run health care in Massachusetts were more widely known, the clear and imminent failure of what might become ObamaCare would be drop-dead obvious. That would seem to explain the statist solutions uber alles establishment media's disinterest.

Cross-posted at BizzyBlog.com.

—Tom Blumer is president of a training and development company in Mason, Ohio, and is a contributing editor to NewsBusters


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Thanks for putting this one out there, Tom. For the life of me,

I fail to understand why Governor Romney keeps bringing up this grand 'accomplishment' of his term!

Anyone with half a brain would know that our 90+% Democrat legislature would be fighting over themselves to get to be first to sign such a liberal (i.e., LOSING) policy. After all, we are right there next in line to 'spend spend spend - who cares where the money is going to come from' California! I wonder when Deval Patrick, our current governor, will begin issuing I.O.U.'s following the Governator's example!

It is time for SOME ONE in the mainstream media to do a THOROUGH investigation into why Hawaii tried and disbanded a state-run healthcare system and why the plan in Massachusetts is NOT working at all...and hasn't since just a few months after it went into effect.

Again, I question WHY Mitt Romney brags so about 'his' pet project? The biggest clue ever to its less than glowing stature is the fact of how quickly the Tax-It-All Legislature jumped in on signing it...along with our Do-You-Know-Who-I-Am senior senator getting face time at such a joyous LIBERAL occasion!

You know darn well that Congress will exempt themselves from having to be covered by this abominable national healthcare system. Only we, the great unwashed, knuckle-dragging masses, will be subjected to silently falling in line...or else!

Charlie Baker for our next governor!!!!

One more

Don't forget Tennessee tried the same thing. I believe it lasted one year. Any comments from a NBer in Tenn. with experience in it?

Romney the RINO

I still maintain that RINO McCain had the best chance against Obama and he may actually have won if he didn't dramatize the suspending his campaign thing.

But unless a true conservative gets elected we're just going to see more of the same Obama stuff, though only watered down.

However, at this stage it could be possible that even a President Hillary would be a vast improvement.

One of the 34% who thinks George W. Bush was a great President. One of the 61% who wants to bring back the stock and pillory (yep...approval for Congress now at 39%...do you believe that!?).

Cost of insurance rises dramatically with guaranteed issue.

Tom, that is a very important piece. Imagine how many journalists/editors, who read that WSJ piece, instantly understand that they must never mention it in their coverage of this debate? 

This information ( a bit out of date ) from CA Assembly member, Mike Villines, provides a quick look at how "guaranteed issue" (no pre-existing questions or waivers of coverage) affects the cost of plans in the individual/family market: 

Family Coverage Individual Market, 2004

State   Average Premium      Cost Difference
CA             $3,972                        0
NJ            $14,403                  +$10,431
Mass        $10,126                   +$ 6,154
NY            $ 9,696                  +$ 5,724
NH            $ 5,582                  +$ 1,610
Kentucky   $ 4,453                     +$ 481

(;~> gary

Game theory at work

"so people seem to be gaming the Massachusetts system."

Well, of course they are. And they should.

  • I study game theory. That's the academic study of interactive logic, commonly known as strategy. It's the study of what logic reveals when what you do is based on what everyone else will do. Further, it's the study of what logic tells you to do when your knowledge is limited about what others will do (and the range of uncertainty in between).
  • In that sense, financing healthcare is a game. It's an artificial (i.e., man-made) system that uses strategic incentives and penalties to affect behavior. It's interactive. If you do X, we will respond with Y. It's a game.
  • The "free rider" problem has been studied extensively in game theory. It's also a fundamental issue in the study of "public goods."

Once you accept that healthcare financing is a strategy, you can't complain that individuals act strategically themselves. Or, to be blunt, if you start playing games, you can't get mad when others play games as well.

The people who devised the system expected individuals to act in a certain way. But that's because the behavior they expected from individuals maximized their own outcome. For instance, at the end of the Massachusetts healthcare game, insurers made a profit. Why should I restrain myself from "gaming the system" so that other people would make a profit at my expense? You can't demand that individuals ignore their own self-interests to maximize your self-interest. Why should an individual feel compelled to help insurers make a profit? You want to play a game? Fine. I'll play too.

It's naive and arrogant to expect everyone else to play your game, in your way, when you profit at their expense.

The great advantage of any free market system (whether it's business, healthcare, or any other category) is that the rules of the game emerge on their own. More importantly, the game doesn't succeed or fail because some "architect" wasn't clever enough to anticipate what other people should or shouldn't do. The downfall of any "planned" system is that success depends on people behaving in an expected way; but with over 300 million people in a system, you cannot anticipate every possible behavior. And so the argument for the free market is: why try? Don't bother trying to force people to act against their own interest - they won't.

 

KC

Your last paragraph struck a nerve with me.

"The downfall of any "planned" system is that success depends on people
behaving in an expected way; but with over 300 million people in a
system, you cannot anticipate every possible behavior."

Anytime any "planned" system runs up against the unanticipated then the "rules" are changed exponentially to handle the unanticipated behaviors until the "plan" becomes a complex byzantine "organism" with a life and a support system (bureaucracy) of its own. Just take a look at our Federal income tax system as an example. This boondoggle from hell is going to be an economic disaster and regulatory nightmare of the first order. The road to hell is always paved with good intentions. But you know the liberals "mean well" and of course it's for "the children".

"Somehow, I told you so, just doesn't quite say it." Will Smith in 'I, Robot.'

Agreed

These days, I'm a programmer. I create computer systems, which means that we (the client and I) always start off with assumptions about how things get done. Inevitably, we stumble across round pegs when we have only square holes. Or as Hamlet said, "there are more things in heaven and earth, Horatio, than are dreamt of in your philosophy." There are limits of what we can anticipate. So it's a betrayal of experience to establish unshakeable expectations. Instead, it makes more sense to start with minimal expectations (some are necessary), but to be ready to adjust as circumstances arise.

The movie Patton had a great line: "fixed fortifications are monuments to the stupidity of man." The same is true of systems.

With 60 dimocrats in the

With 60 dimocrats in the Senate, ObamaCare will pass in some form or another.  This is especially true given what the House was willing to do to get Crap and Tax passed. 

But, let's recap what the government has and is doing to make this happen.  The government decries the rise of health care costs in our country.  They use this as a bludgeon to get this passed.  But, what are those costs and who is paying for them?

Here is an accounting of those costs:  If you are a taxpayer and private insurance payer whether directly or through your employer you are paying three time for health care.  You are paying for the indigent that walk into your local hospital emergency rooms to get free care, you are paying for ridiculously low balled care provided by various government programs, and you are paying for your own coverage. 

In the first instance, besides our own citizens, there are 20 million illegal aliens that pay little or nothing into the system in any way.  Hospitals make up the difference by billing you at a higher rate just to stay in business.

Then, there are programs such as medicare that pay .15 and .20 cents on the dollar of billed costs.  You pay the rest in the form of higher taxes at the county, state and federal level for ever expanding programs.  In addition, you pay more in premiums every year to make up for the governments low balled payments. 

Next, there are your premiums.  Here, the state where you live has imposed huge mandates for all kinds of ancillary treatments that must be a part of your policy whether you like it or not. 

What is outrageous is the government has created the inevitable increase in your premiums with the above and then turns around and decries it because it is running out of control.

Here is a prescription that will stop the insanity:  Tell the illegal aliens that if they want health care they must either pay for it or go back to the countries that they came from and get it there. 

Tell our government that if it wants to cover an ever larger group of Americans with their "free" government health care programs that they must pay the going rate for services rendered. 

And, tell the states that they must proscribe mandates on our private health care policies.  If people want mental health services, for example, as part of their health care policies then they must pay for it in addition to their normal health care policies. 

If all the above were done, the high cost of health care would stop.  The constantly increasing policy costs were move into the rage of inflation - that is 2-3% increase a year.

 

jdh - you make TOO MUCH sense, therefore your suggestions

would NEVER be accepted in Washington DC! 

The Number One requirement for serving in public office is you must leave all COMMON SENSE at the door - NONE is permitted to taint the hallowed Halls of Congress!! 

I know our founding fathers must be getting tired of spinning in their graves, so we must continue to try to get our message across to those WHO KNOW IT ALL!

This comment comes from a proud Tea Party attendee, otherwise designated by Homeland Security as a Right Wing Radical Extremist!     It is no dishonor to be in a minority in the cause of liberty and virtue ~ Sam Adams

Fixing a problem

So I purchase mandatory federal coverage.  At such time they do not perform, we cancel.

If I have to wait 2 weeks for an urgent appointment, I say deal is not performing.  They threaten me, I sue for non performance.  If docs get slow pay from the government, or if they get after the fact rejections on claims, the doc suspends services. 

 

In the benefits industry there is an expression called "adverse selection".  One of my HR/Benefits manager friends says his company has applications for jobs that really only want the insurance.  One hire had a 17,000 dollar month pharmacy bill.  Year in and year out.  They would never quit. 

That's the worst I've heard ....

.... but there are a lot of stories out there lie that.