The
NY Times reports that President Obama wants the government to have veto power over private health insurance company rate increases. (via
Greg Mankiw)
WASHINGTON -- President Obama will
propose on Monday giving the federal government new power to block
excessive rate increases by health insurance companies, as he rolls out
comprehensive legislation to revamp the nation's health care system,
White House officials said Sunday.
...
By focusing on the effort to tighten regulation of insurance costs, a
new element not included in either the House or Senate bills, Mr. Obama
is seizing on outrage over recent premium increases of up to 39 percent
announced by Anthem Blue Cross of California and moving to portray the
Democrats' health overhaul as a way to protect Americans from
profiteering insurers.
Ok, 39 percent is a lot. I'll give you that. So my first question would be whether there is a reason for that.
Anthem, California's largest for-profit insurer, has announced premium
increases for nearly 700,000 customers, citing the soaring costs of
medical care and the effects of a weak economy in which many younger and
healthier people are dropping insurance. But the increases, far
outpacing the rate of medical inflation, led to outrage among officials
in Sacramento and Washington.
Less disposable income leading to a worsening of the adverse selection problem? I'd like to see the numbers on that. While I'm a little skeptical, I'll admit that I don't know enough of the details. Let's go on...
The president's bill would grant the federal health and human services
secretary new authority to review, and to block, premium increases by
private insurers, potentially superseding state insurance regulators.
The bill would create a new Health Insurance Rate Authority, made up of
health industry experts that would issue an annual report setting the
parameters for reasonable rate increases based on conditions in the
market.
Hmmm...
The legislation would call on the secretary of health and human
services to work with state regulators to develop an annual review of
rate increases, and if increases are deemed "unjustified" the secretary
or the state could block the increase, order the insurer to change it,
or even issue a rebate to beneficiaries.
The new rate board would
be composed of seven members, including consumer representatives, an
insurance industry representative, a physician and other experts like
health economists and actuaries, the White House said. The board's
annual report would offer guidance to the public and states on whether
rate increases should be approved.
Seven (politically appointed) people in charge of deciding how much you'll pay for health insurance. Of course, they will be infinitely wise, incorruptible, and above political influence, right? Yeah, right.
[Senator Dianne] Feinstein said that only 25 states allowed their insurance
commissioners to regulate rates and that California was not one of them.
"For the life of me, I am not sure why not," she said. "The time has
come for the secretary of health and human services to step into this."
I'm not a huge fan of government regulation, but in our country we have come to a basic agreement that insurance should be regulated by the states. This is an imperfect system. Some states will do it well; others will not. But the same is true of roads and schools, which have also been left in their care. So half of the states have figured out how to take care of this themselves, and we need the federal government to be the nanny for the ones that don't have the courage to do it.
Now the fact that Anthem is raising their rates 39 percent suggests to me that Anthem may have caught onto the fact that California's regulatory environment is lax. If there was a stronger insurance regulator, perhaps they would be a bit less aggressive. Perhaps. I'm trying to give the benefit of the doubt here. Ms. Feinstein, I agree with you that for the life of me, I'm not sure why California hasn't done it since it looks like it might be a problem. But with all due respect, that's California's problem.
On a related note,
Leaders of the National
Governors Association meeting in Washington on Sunday expressed
frustration that they had been largely shut out of negotiations over the
future of the health care system, even though they would be responsible
for carrying out many of the changes envisioned by federal officials.
They said they wanted more of a voice in shaping those changes.
Indeed. Nervous about turning your state's regulatory power over to seven federal appointees? Come on... what could go wrong?
Mankiw calls this an example of price controls. He's right, to a point. Our system of health insurance, such as it is, really stinks. The fact that it really is 50 different statewide markets with different regulations is bad enough. Tying health care to employment is another problem. There are plenty of things that could be done to improve the system.
This isn't one of them.
Selling insurance isn't like selling apples. There are a lot of variables to consider. Suppose companies are forced to accept lower rate increases. There are dozens of ways that they could respond to reduce coverage. How is that seven member committee going to keep up with that for all the insurance companies in the U.S.? Are they going to tell them what they have to cover? What the deductibles can be? Hardly realistic, is it? I mean, that sounds like that seven member panel would be more ambitious than whatever bureaucratic apparatus would run Obama's health plan.
Actually, they would probably just publish guidelines as to what is acceptable, but how detailed could those guidelines be? If a company wanted to go outside those guidelines would they have to appeal?
The mind reels.
There is no way that this would end well.
To be continued...