The Oregon Medicaid Study

Why it should change our thinking about health insurance and health care:

A bunch of people sarcastically asked whether I was planning to drop my health insurance. The answer is no, because my employer pays for it. But if the question is “Has this caused you to revise downward your estimate of the value of health insurance?” the answer has to obviously be yes. Anyone who answers differently is looking deep into their intestinal loops, not the Oregon study. You don’t have to revise the estimate to zero, or even a low number. But if you’d asked folks before the results dropped what we’d expect to see if insurance made people a lot healthier, they’d have said “statistically significant improvement on basic markers for the most common chronic diseases. The fact that we didn’t see that means that we should now say that health insurance, or at least Medicaid, probably doesn’t make as big a difference in health as we thought.

Certainly, this bolsters my belief that health insurance should provide financial protection from catastrophic events, not wrap-around first-dollar coverage. Those who used to read me on The Atlantic may recall that the McArdle Plan for Healthcare involved the government picking up the tab for any medical expenses above 15-20% of income: simple, progressive, and aimed at the actual problem we know health insurance can fix. Unfortunaely, Obamacare made that sort of coverage functionally illegal.

And that was the kind of coverage I’ve always purchased for myself. That is, true health insurance, not what the moron Sibelius thinks is health insurance. And they want to make it impossible for me to get it.

Gun control isn’t about guns — it’s about control. And health care isn’t about health — it’s about control. The thing is never about the thing.

16 thoughts on “The Oregon Medicaid Study”

  1. My company’s fiscal year starts in June so we’re in the process of benefit enrollment. I attended a briefing last week. One of the new fees brought on by ObamaCare is a $63 per covered person (not just employees but dependents) fee to renew our insurance. For my company, that cost is about $150,000 just to renew insurance. It gains us nothing. Our premiums are going up 10%.

    By 2018, we’re going to get hit by the “Cadilac” tax because our coverage is pretty good. That Cadilac tax will be an additional 40% of the premiums over and above whatever the rates increase before then. We’re not going to pay it. Instead, they’re researching our options and will probably go with a catestrophic coverage (hospitalization) plan plus health savings account. That kind of insurance makes a lot of sense but for people with longterm health conditions, they’ll likely get stuck with higher medical bills. Oh, and they just raised the amount of your AGI from 7.5% to 10% before you can deduct medical expenses from your taxes. It just gets better and better.

    But we all knew it would, didn’t we? Obama lied out his ass promising it would cost less and if we liked our plan, we’d get to keep it. We knew he was lying. Anyone with a functioning brain knew he was lying. But then, the rules won’t apply to him and his family, so why should he care?

    1. will probably go with a catestrophic coverage (hospitalization) plan plus health savings account

      So Obamacare might result in slower health care spending growth at your company? Isn’t that a good thing?

      the rules won’t apply to him and his family

      How so?

      1. Obama said that if we liked our coverage, we’d get to keep it. Only the lying son of a bitch didn’t say that we’d be charged an additional 40% tax to keep it. He said it would cost less. He was lying out his ass about that, too.

        1. an additional 40% tax

          Just to clarify, that’s a 40% tax on the amount by which a “Cadillac” plan’s cost exceeds a price threshold (not on the entire premium). Those thresholds are currently $10.2k for a single employee, $27.5k for a family (not including vision or dental). So the tax on a $28.5k family plan would be $400, raising its overall cost by 1.5%, and making it a $28.9k plan.

          What are the premiums on your company’s plan?

          Employer-paid insurance premiums are tax-deductible, i.e. subsidized by 35% (the corporate tax rate). So the 40% tax essentially cancels that subsidy past the threshold. If you want more insurance than the threshold, you can still buy it, you just don’t get a tax break on it. [Note: the plan that McCain proposed as an alternative eliminated the tax break for employer-paid premiums entirely; it was 35% tax that starts at the first dollar.]

          And the tax doesn’t kick in until 2018, when employers will have had 8 years to plan for it.

          Still waiting to hear how Obamacare doesn’t apply to Obama and his family.

          1. And what does that 40% tax do but make things more expensive when Obama said things would get cheaper? What’s the justification for this additional tax?

            For the next fiscal year, I’ll be paying over $200 a month for just myself and my wife, a 10% increase over this year. That $150,000 our company is having to pay just to renew our health insurance could’ve created jobs but instead goes to the bureaucracy.

            Obama and most government officials will be exempt from the restrictions of ObamaCare. That’s the way they work in DC, especially when Democrats run things. The rules don’t apply to them.

          2. What’s the justification for this additional tax?

            Two things: paying for Obamacare spending (e.g. subsidies so low-income families can afford insurance), and de-subsidizing high-end insurance plans to restrain health care cost growth.

            a 10% increase over this year

            My insurance went up by 40% this year. That isn’t Obamacare (I was seeing >10% hikes before 2010), it’s rising health care spending — the very thing the tax (which won’t kick in until 2018) is meant to address.

            Obama and most government officials will be exempt from the restrictions of ObamaCare

            No, they will be required to get insurance that meets Obamacare requirements, just like everyone else. Nothing much will change for them, just as nothing much will change for most people, because their insurance is provided by their employer.

          3. I’ll be paying over $200 a month

            I assume that’s just your share, and that your employer is paying most of the cost? Otherwise that’d be a very cheap plan, way below the “Cadillac” plan cutoff (which is over $2k/mo for a family).

            That $150,000 our company is having to pay just to renew our health insurance could’ve created jobs but instead goes to the bureaucracy.

            It’s going to create jobs at the insurance company, hospital, drug company, clinic, medical device manufacturer, etc.

          4. It’s going to create jobs at the insurance company, hospital, drug company, clinic, medical device manufacturer, etc.

            Aaaaaannndd…out comes the broken window fallacy.

          5. Nope. Nobody is arguing that people should get sicker in order to boost health sector employment. But Larry’s insurer is raising premiums, presumably because it’s sending more money to health care providers, who in turn are employing more people. Larry’s employer’s expense is someone else’s income.

          1. Did I say “inaccurate?” I did not. I did say “dishonest.” An honest man would read “your health insurance gets cheaper” to mean…pretty much anything but forcing someone off their existing coverage, which ObamAA+ said we could keep if we liked.

            Not that you don’t know that, but of course you’d never admit it.

          2. You accused me of dishonest spin (the most dishonest spin yet, in fact). What did I write that was dishonest?

  2. A point to keep in mind when debating health care:
    Sanitation, clean water, and first aid taught in boy scouts cover most of the practical life extension seen since ancient times. Antibiotics and vaccines, crackerjack trauma surgeons, and basic workplace safety cover much of the remainder.

    We are seeing more and more spent on a slope of diminishing returns, treating ailments that a century ago were rare because most people didn’t live long enough to see them.

  3. This has nothing to do with health care and everything to do with government control. We’re losing (even if we get rid of ObamaCare.)

  4. “A bunch of people sarcastically asked whether I was planning to drop my health insurance. The answer is no, because my employer pays for it.”

    Remember when Megan posted as Jane Galt? Those days sure are gone.

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