Obamacare

Obama, Standing Athwart Health Insurance Rate Increases, Threatens to Yell "Stop!"

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As the White House prepares to roll out health care reform version 1.1, President Obama is once again following the Bay State's lead on health care. Last week, Massachusetts Governor Deval Patrick announced that, in order to combat the state's rising and unsustainable health care costs, he would push for authority to review—and perhaps reject—health insurance premium hikes. Today, according to the New York Times, the president will propose giving the federal government "new power to block excessive rate increases by health insurance companies," on the apparent theory that if the president simply demands that prices don't go up, they won't.  

Given last week's brouhaha over health insurance rate increases in California, it's certainly timely. And given the widespread public frustration with insurers, it's probably politically savvy, too. It's also hard to oppose: Who could be against blocking excessive rate increases? After all, they are, by definition, excessive (or, depending on who's talking, unreasonable).

But the problem, of course, is that what constitutes excessive or unreasonable isn't easy to define. I was at a conference with a number of lawyers this weekend, and one of them joked about how great words like "reasonable" were for the profession. (How many lawyers does it take to define what "unreasonable" means? Well, how many do you have?)  The idea is to create some legal wiggle room, but you tend to end up with absurdly circular definitions like Arizona's, which defined excessive insurance rate hikes as those that "are likely to produce an underwriting profit that is unreasonably high." It's excessive if it's unreasonable! Unreasonable if it's excessive! Feel free to ride this definitional merry-go-round until you puke. 

Fun as that sounds, let's go ahead and answer some key cable-news questions in advance: Is Obama's proposed rate-review commission a death panel? Nope! But it could result in insurance companies denying coverage more than they would otherwise in order to meet premium requirements. Is it a government takeover of the country's health care system? Not exactly. But it gives the federal government a lot more authority over health insurers. So what is it then? If you guessed "a form of price controls," you're today's lucky winner. And, just like when Bill Clinton proposed them, medical price controls are a deeply problematic idea.

The other thing rate-reviews do is provide a way to shift blame for care cuts onto the mean old insurance industry: As Cato's Michael Cannon writes:

Artificially limiting premium growth allows the government to curtail spending while leaving the dirty work of withholding medical care to private insurers: "Premium caps, which Massachusetts governor Deval Patrick is currently threatening to impose, force private insurers to manage care more tightly — i.e., to deny coverage for more services."  No doubt the Obama administration would lay the blame for coverage denials on private insurers and claim that such denials demonstrate the need for a so-called "public option."

Meanwhile, the effect of words like "unreasonable" and "excessive" is to give regulators the power to step in when they feel like it and set rules as they see fit. In theory, looser definitions give them the freedom to be more, uh, reasonable with the application of rules, but in practice, looser rules tend to make regulators even more powerful by opening up even more opportunities to step in and force changes. Somehow, though, I don't suppose we'll be seeing legislation designed to prevent "unreasonable" bureaucratic power grabs any time soon.

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  1. in order to combat the state’s rising and unsustainable health care costs, he would push for authority to review?and perhaps reject?health insurance premium hikes.

    Will he also build an impenetrable wall around the state to prevent those evil capitalists from voting with their alligator-shod, meticulously be-spatted feet?

    1. Obama is quickly taking over everything in these United States of AMERICA. Lets not forget who and what we are! A FREE country!!! Lets keep it that way before Obama and his ideas of BIG Government eats us up and spits us out. We are quickly becoming a third world country. This government wants to tell you when and what medical care you need. They want the government to own everything and controll everything you do. If we don’t stand up and STOP all of this no one in this country will have a job or a home that you own. Stop and think, most business that Government runs, like our post offices are loosing money like crazy. The systems owned and run by private sector like UPS and Fed-Ex run smoothly and make a profit. They provide jobs that feed families and make a profit. What a consept!

  2. It’s excessive if it’s unreasonable! Unreasonable if it’s excessive! Feel free to ride this definitional merry-go-round until you puke retire (early).

    in practice, looser rules tend to make regulators even more powerful by opening up even more opportunities to step in and force changes.

    They also increase regulatory risk aversion in the regulated industry. You want to stay outside the zone that the regulators occupy; if that zone is ill-defined, its boundaries are assumed to be broad.

  3. Open wide. Obama’s coming.

  4. I’m fine with giving the President this authority, provided that in trade the government gives me the authority to reject any tax increases I feel are unreasonable or excessive.

  5. Can we all agree that it is both unreasonable and excessive when lawyers bill for $675/hr. and up?

    1. If it was unreasonable and excessive, no one would pay it. It’s not like other lawyers are hard to find.

    2. I’d like to see some congressman (a non-lawyer, naturally) propose a bill
      1) setting maximum lawyer’s fees per hour;
      2) limiting the percentage of any judgment a lawyer could collect to 15% of the overall settlement;
      3) including a consumer’s “bill of rights”, including the right to free legal advice for the poor.

      Watching the heads explode would be hilarious.

      1. I just want a law preventing lawyers or plaintiffs collecting punitive damages. We dont need to cap them, we just need to remove any incentive to seek them beyond punishment.

        1. Where would they end up?

      2. Baked Penguin,

        Glad to see you are fine with wage and price controls. I would happily support a 15% lawyer fee cap if the law were changed to include lawyer fees in negligence cases. Further, pretty much every lawyer around would like to see better funding of legal services for the poor. Pro bono is part of most lawyers work loads (I did 300 hours last year myself). I will happily pitch in time if the funding is there for the other necessary elements of helping the poor receive effective legal serices.

    3. The unreasonable and excessive part comes in when legislators make the use of a lawyer wholly and completely necessary by means of complicating the federal and state codes to the point where noone can understand them.

      Yes, my english teacher would have failed me for that runon sentence.

    4. no we can’t

  6. I’m sure glad Obama is so smart and market savvy. Otherwise, this whole exercise would have all the makings of “Whip Inflation Now”.

    1. Hey! That WIN plan worked! We don’t have 70’s style inflation today! In other news, planting arugula keeps elephants out of your garden.

  7. “You CONSENTED, bitch!”

  8. It’s funny to see Obama reaching back to Nixon for ideas.

    1. Exactly! Maybe he can take us off that damn gold standard too…er, wait.

  9. Caption: “Can I shove the whole thing down my throat? Yes. . .I. .. can!”

    1. “Yes, it’s just a wild coincidence that the look on your face is exactly the same when passing this bill or a kidney stone.”

    2. By the way, there is a Platinum Hits dual edition of Oblivion and Bioshock out, both games for $20.

      1. Interesting. I’ve got (and completed) the Oblivion expansion.

        Now playing Dragon Age: Origins.

        1. Using a blood mage character, try using your character’s blood wound spell, Wynne’s earthquake, Shale’s rock barrage, and Morrigan’s blizzard at the same time. Pretty much makes the final battle trivial.

      2. Hard to find more entertainment value than that, outside of throwing rocks.

      3. Still playing Fallout 3: Broken Steel and getting a ton of shit from the wife. “Is that all you’re going to do today?”

        :::sheepishly::: Yes?

        1. Yeah. I just got that diatribe this morning.

      4. Motherfucker, I paid $30.

        1. I bought Galactic Civilizations II for $30, then bought the add-ons for a $30 package “deal”, only to see all three on sale for $20 about three months later.

          1. Yeah, so what. I bought Galactic Civilizations I, and then IBM let OS/2 die of neglect…

            1. You didn’t see that coming? I remember making fun of my company because we were using OS/2 (in the late 90’s). My boss, who was there at the time, was one of the people who was heavily involved in that decision. (Unbeknownst to me, I don’t enjoy getting fired).

              He also was involved in buying the main production software for the company, which has been a ~$2 billion albatross for the company to this point, but that’s another story.

      5. Sounds like I need to spend more time blogging about video games here at H&R.

        1. Of course you should, numbnuts. I expect an answer by the end of the week whether I should buy Mass Effect 2.

          1. 2nd hand: My employee, who has impeccable video game taste, says it’s better than Dragon Age.

            I finished Bioshock 2 this morning. Very good. The ending was very satisfying. Personally, I thought the game was too short (and I’m not one of those assholes who thins games are always too short) but is was a very satisfying experience. And firing rockets out of a spear gun is awesome.

            1. That’s why you’re missing out if you don’t play the multiplayer. There is a lot of fun to be had there, and a whole different side to the game.

              1. Bah. If I wanted to interact with other people, I wouldn’t be playing a video game.

                (The real answer, of course, is that I really would only want to play with people I know, and they don’t play at the same time I do. As for playing with strangers… well, I already have a staggeringly vast mental library of ways to call someone gay.)

                1. I will give it this – Bioshock lobbies are not nearly as misanthropic as Halo and COD lobbies. Not even close.

                  I’m not gonna try and sell you. It is awesome and fun, blinding someone with bees and then blasting them with a nail gun (and a bunch of other plasmid and weapon combos).

                  1. I’m not against the concept of multiplayer, but I’ll be glad when multiplayer is sold as an expansion rather than taking up valuable space on the disc itself.

                    Did you play Dante’s Inferno (or a demo yet)? Wow. Total God of War ripoff. It even has the same damn button map.

                    On the plus side: Lot’s o’ boobies.

                    1. I lack the emotional maturity and impulse control for multiplayer.

                      Lots of broken controllers in my past.

                    2. Haven’t played DI, although I might grab a friend’s copy before he trades it in. I read the mostly less than stellar reviews, and they all talk about how EA tried (and failed) to make a competitor to God of War. Too many of EA’s games turn out to be derivatives of other innovative, successful franchises, so I don’t doubt the criticism.

                      The new God of War comes out in April (I think), and I am looking forward to that. The first two games in the series were both amazing, and they pushed the PS2 to its limits. I’m glad they allowed this generation to mature this far before releasing a new God of War. I’m sure they put the technology to work, and expect a really incredible game (yet again).

          2. From what I’ve read, you should.

            I too am working on Fallout 3 & Bioshock II.

          3. Peter, for the record, I have full faith that your nuts have a full range of feeling and are not numb as Warty suggests.

            1. Bullshit. We’ll settle this in the rap-off tomorrow night. And if you lose, I’m gonna bulldoze the shit out of your teen community center.

              1. You think long and hard if you want to go through this. You seem to forget that I am The Shogun of Harlem.

              2. Warty, I think you should iron SF’s shit. Just a suggestion.

          4. Mass Effect 2 – pretty good.

            In sharp contrast to Dragon Age, they really streamlined/dumbed down the inventory, armor, and levelling options – its more of a shooter than an RPG. And I am getting tired of scanning planets for resources to research my upgrades, and would like a more open-world feel.

            But those are pretty minor quibbles: the gameplay, story, voice acting, and graphics are quite good. I give it two thumbs up.

        2. Try replacing the Friday Funnies with a weekly game breakdown. Even the non-gamers will appreciate it.

          1. Or make the Friday Funnies screen caps for games with libertiod captions.

            I can haz Libertreeburger?

        3. If you really want to increase your page hit count, do weekly threads on video games and homebrewing / specialty beer.

          1. Don’t forget the pizza wars.

      6. I just finished BioShock 2 this weekend. Great game, although I’m not sure it was worth $60.

    3. “AND I….

      WILL ALWAYS LOVE YOU(ooooOOooOOoOO)”

    4. “Obama’s left hand: cheering himself on, or keeping the next car in the train ready for action?”

  10. Today, President Richard Milhouse Nixama announced his plans for price controls. In his statement, President Nixama said:

    ‘There are some teabagging extremists who say that price controls are wrong. They think that the days of our country’s greatness are behind us and that Americans just don’t have what it takes to regulate prices. Now, let me make one thing perfectly clear – we are all Keynsians now, and America is a great country – great enough to whip this inflation.’

    President Nixama then held up both arms to make two “V” signs with his fingers.

    1. And shouted “I am not a crook!”.

    2. ‘There are some teabagging extremists who say that price controls are wrong. They think that the days of our country’s greatness are behind us and that Americans just don’t have what it takes to regulate prices. Now, let me make one thing perfectly clear – we are all Keynsians now, and America is a great country – great enough to whip this inflation.’

      Nixon had price controls on health care.

      Why did the Democratic-led Congress abandon that?

    3. Then the President joined the “V”s he had made with his fingers in order to make a “W.”

      “Same as the old boss, suckers,” he cackled.

    4. Price control, bitches! Arrrrooooooooo!

  11. It’s Seventies Nostalgia Day!

  12. The headline reminds me of the song, “Blood on the Coal” from A Mighty Wind:

    Now an Irishman named Murphy said,
    “I’ll stop that iron horse!”
    As he stood athwart its passage,
    And it crushed him dead, of course.

  13. If only Nixon knew that the first black President would be so much like him, maybe he wouldn’t have supported the abortion of biracial babies.

    Then again, supporting the abortion of biracial babies is just another area on which Obama agrees with Nixon.

  14. No doubt the Obama administration would lay the blame for coverage denials on private insurers and claim that such denials demonstrate the need for a so-called “public option.”

    I fail to see the problem here.

    1. Nothing. As has been shown time and time again, price controls always work.

      1. Nothing. As has been shown time and time again, price controls always work.

        It depends on what the purpose is.

        If the purpose of a free market was to guarantee huge profits for corporations like Montgomery Ward, Smith-Corona, and General Motors, then the free market has failed miserably.

      2. He’s right, you know!

  15. Nixon? I thought he grabbed this idea from Chavez.

    Too bad he doesn’t apply it to tax rate increases.

  16. Caption: “Music and passion were always in fashion at the Co-pa…”

    1. Hey! I used that last week! Get your own Barry Manilow song to mock the Pres!

      1. Who’s ironing my shit now?

        Ha-ha-ha-ha-ha!

  17. We need a five year plan. They worked great on tractor and beet production.

    1. A 5 year plan that, unlike tax cuts, never expires.

  18. THANK YOU SUDERMAN!!!

    That’s the pic I’m gonna use for my Zombama shirts! It needs the alt-text “BRAINS!”

  19. “This is the face Michelle makes when I shove my “microphone” in her face.”

  20. President simply demands that prices don’t go up, they won’t.

    Price controls, what could go wrong?

  21. In political terms, we know have a suicidal lunatic as President. I think Obama doesn’t care if he leaves office the most hated President in history. He just wants to get what he wants. He has reached the point of being a danger to the Republic.

  22. the President will propose giving the federal government “new power to block excessive rate increases by health insurance companies”

    Sorry, but I’ll say it again:

    “Nuevo dollar.”

  23. Obamacare is so bad and would be such a disaster for the country, I wonder if the Republicans wouldn’t be wise to make a deal with say 10 really vulnerable House Dems. The deal would be vote against Obamacare and run unopposed in 2010. Yeah, they would still have lunatic left to deal with in a possible primary challenge, but the lunatic left isn’t likely to be much of a force in the districts I am talking about. I would rather give up control of the House which a much larger minority in 2010 and kill Obamacare than have Obamacare and win both houses in 2010. Stopping this is that important.

  24. “President simply demands that prices don’t go up, they won’t.”

    And for his next trick, Obama will wage war on health care service hoarders and speculators.

    1. I have always said that the health care end game will eventually involve the militarization of health care and the drafting of health care professionals.

      Demographics don’t lie.

      1. Does this hurt?

        How about this?!

      2. That is one logical conclusion. Unless you draft people, you can’t force doctors and nurses to work for less pay. Ultimately, I think we just end up with the few docs and nurses who are either totally altruistic or more likely too stupid to do anything else.

        1. You think doctors should be paid $40,000 a year, you’ll wind up with a doctor who’s worth $40,000 a year. Ask anyone who has extensive experience with the military health care system about some of their experiences with doctors.

      3. Didn’t Belgium do that in the early 1960’s?

  25. …if the President simply demands that prices don’t go up, they won’t.”

    Well if they do it anyway, then they’re obviously racists.

  26. Somehow, though, I don’t suppose we’ll be seeing legislation designed to prevent “unreasonable” bureaucratic power grabs any time soon.

    We used to have a Constitution for that. Anyone know what happened to it? I could swear it was around here somewhere.

    1. I ate’d that shit with my shiny metal teeth. LOL

      Jess
      http://www.online-anonymity.vze.com

  27. Has anyone thought of how bad this thing could end? Suppose Obama gets Obamacare by reconciliation. After the Massachusetts election that will be the equivalent of giving the entire country red and blue a giant middle finger. The country then revolts and it is a bloodbath of historic proportions for the Democrats in November. The Republicans no in control of both houses along with a few now chastened Democrats repeal the major elements of Obamacare in early 2011. Obama then vetos the repeal. Can you imagine that? The country will go into revolt.

    1. On Obamacare alone, I’d say no. If you throw in a genuine desire, willingness, and above average possibility of success to convert 401ks and IRAs like the Gingrich story spoke about, then I’d agree with you.

  28. No no no no no no – these aren’t just price controls.

    They’re price controls coupled with service provider mandates.

    In other words, Obama has finally decided to put forward the Steel Unification Plan.

    Can someone please comb through all 1000 pages of Atlas Shrugged and find for me something that’s still a caricature or hyperbole?

    They have finally defeated even Rand’s capacity for not depicting her enemies in accordance with the principle of intellectual charity.

    Obama: “I propose that the insurance companies be forced to operate at a loss.”

    Insurance Companies: “How are we supposed to do that?”

    Obama: “Oh, you’ll do something.”

    No. Longer. Metaphor.

    1. It used to be that I would look at a proposal like this and think, “OK, what do they *really* want?” Obviously they are starting out high to negotiate their way down to where they actually want to be. Either that, or to put out such a dishonestly-titled poisoned bill that the opposition will have to fight and make them look like the chumps when it doesn’t pass.

      Now, I’m not so sure any longer.

    2. ‘Can someone please comb through all 1000 pages of Atlas Shrugged and find for me something that’s still a caricature or hyperbole?’

      The part where people have consequence-free sex outside of marriage – without leading to pregnancy, disease, or even jealousy over competing lovers?

      1. among competing lovers

        1. The jealousy thing I give you, but the disease thing is a bit off.

          The pool of partners is extremely small.

          Lillian Rearden is really the only opening for a disease vector.

          And for all we know Dagny had lots of abortions and they just weren’t covered in the text. They wouldn’t have contributed to the advancement of the plot.

          1. The book leaves out some of Dagne Taggart’s sexual experiences.

            Like her ill-advised fling with the evil bureaucrat Lesly Limp. Fortunately, she was at no risk of catching an STD from *him.*

            Or her one-night stand with Wesley Mouch – she can’t believe she was so drunk she fell for his line, ‘my regulations aren’t the only things that are long, baby.’ When she woke up the next morning, she left after leaving a 300-page note on his dresser explaining why it would be incorrect to have such a cross-ideological relationship.

            Or her lesbian experience with the crusading, philosophically-correct, chain smoking novelist Ann Antikant, whom Dagny describes as ‘the greatest, and sexiest, philosopher in the history of the universe.’ But Dagny ends the relationship after realizing that Ann is just too good for her.

            1. OK, Maxie, you made me LOL there.

      2. Actually, there was jealousy. They just overcame it.

      3. You know Max this may shock you, but plenty of people have indeed had consequence free sex outside of marriage. I can personally attest to this fact, it was great. You should give it a try…

        1. There seems to be a small, though admittedly significant, % of the population which has had some bad consequences from sex outside of marriage, but for most of the nation it has been engaged in not only without horrorstories but it’s added to the quality of their lives.

          1. I’m afraid I don’t see it as my duty to abstain from sex outside marriage just because a small portion of society can’t seem to do that without scerwing up their lives. Most people can do it without that happening….

          2. ‘added to the quality of their lives.’

            That phrase should be on a banner at the next meeting of Adult Children of Divorce. Or the local welfare office.

          3. So rugrats on welfare are a feature, not a bug?

        2. The consequences will be in the afterlife, fornicator.

        3. it was great

          Then it wasnt consequence free, was it?

          1. Yeah, ya got me there, but I assumed Max wasn’t thinking of any “good consequences.”

        4. Where are you?

        5. plenty of people have indeed had consequence free sex outside of marriage. I can personally attest to this fact, it was great.

          What was his name?

          1. Sage, he may name some of the boys on this site.;-)

            1. No wonder Sage likes to iron.

        6. “Not having been caught yet” =/= “consequence free”

          You might want to have a divorce attorney on retainer if not speed dial, MNG.

          1. “Outside of marriage” is not a synonym of “adulterous”.

            All your premarital sex was outside of marriage, too.

  29. Has the tax penalty for not having insurance gone away?

  30. Service provider mandates: meaning you have to pay for the maternal care of some broad because she has been knocked up for the gazillionth time because welfare benefits entices her to have more babies.

    1. Service provider mandates: meaning you have to pay for the std care of some guy and his kids because he has been knocking up women for the gazillionth time because his dick/brain entices him to have more sex.

    2. Jerry & Broad – you both need to talk to MNG. He said he’s got “consequence free sex outside of marriage” all figured out. So he could COUNSEL these people.

      He’ll fix it for us!

  31. “…on the apparent theory that if the President simply demands that prices don’t go up, they won’t.”

    If only King Cnut had spent more time on healthcare and less time at the seaside we would have had affordable health care a thousand years ago.

  32. “Artificially limiting premium growth allows the government to curtail spending while leaving the dirty work of withholding medical care to private insurers” The point is moot because the insurance companies are already withholding care. The only thing accurate in the Cannon statement is “the need for a so-called ‘public option.'”

    1. The point is moot because the insurance companies are already withholding care.

      So even more withholding = better?

      1. Insurers are limiting care by weeding out non-profitable clients and legislating premium hikes will have little consequence.

    2. Because we all know that government would NEVER withhold care!

      1. It’s not that the government wouldn’t withold care, it’s that the decision of when to withhold care would tend to be determined by the number of swing votes in Ohio it could win or lose.

        1. +1 (but good luck getting a “progressive” to understand this; whenever I mention it I get the “lalalala I can’t hear you”)

  33. Well you know this shit isn’t going to happen. There isn’t going to be a health care bill *without* price caps, much less with them. It’s just populist rhetoric.

  34. It’s also hard to oppose: Who could be against blocking excessive rate increases?

    Anyone who understands basic economics and understands that price controls turn out badly?

    Wow, that was easy.

  35. You must mean version 0.9.1. They haven’t actually shipped anything.

  36. Is it a government takeover of the country’s health care system? Not exactly.

    Make no mistake though: that’s the ultimate end game our little communist dictators have in mind. The ultimate plan is to back-door in a single payer system by eventually putting the insurance companies out of business, even if it takes them a while.

  37. The point is moot because the insurance companies are already withholding care.

    Insurance companies don’t provide care, and cannot withhold care.

    All they can do is decline to pay for it.

    There’s a difference, you know.

    1. Don’t make them think, R C. They’ll get all riled up before naptime.

    2. Then let’s play semantics: Physicians don’t withhold care, their hands do. You know damn well that insurance companies make decisions based on profit and not care. Your “cannot withhold care” insurance companies pull physicians in this game with year-end bonuses and incentives for less treatment.

  38. Everyone loves to jump on the insurance companies and their “unreasonable” rate increases but the truth is that premiums are already regulated by the states. If costs go up then the insurance company is allowed to raise their premiums. Insurance companies have profit margins around 5-10% which is no where near the excessive profit margins you might find in the pharmaceutical industry. If you want to see health insurance premiums go down you need to control the ever increasing medical costs. Medical costs are rising due to payments to doctors, hospitals, drug companies and medical equipment makers. It just so happens that those industries have some of the strongest lobbys in DC. Hmmm…
    http://www.altruance.com/2010/…..-for-less/

  39. This is a quite good article,yes it is right that there has been a tremendous increase in health insurance rates followed by low quality service by insurance providers.All have also came across lot many people who were very confused regarding their insurance providers as they were not getting the claims on the right time and of full benefits as per the policy.
    But still there are very good insurance providers who stand by you even in toughest conditions and one among them is the site as follows

    http://www.long-term-care-insu…..index.html
    Just go on this site and feel the difference.
    Thanks

  40. You people are bat-shit crazy.

  41. Great article,
    It is very important for everyone to have health insurance.If you don’t have insurance and you have to go to hospital, you’ll have to pay over $20,000.That happened to a friend of mine.I know a site that offer the cheapest possible price for health insurance, free quotes and a lot of benefits.

    http://www.NationalHealthInsurance.info

  42. forget Obama buy Wizard of Oz books

  43. With many new announcement about the wizard of oz movies in the news, you might want to consider starting to obtain wizard of oz books

  44. Great post, informative.

    While I was looking for the cheapest price health insurance, a friend of mine told me that there is a site, where people can compair prices from many different insurance companies.All of these companies offer free quotes.

    With this site you will save a lot of time searching for the lowest price, because you will get offers from the top rated health insurance companies.

    All you have to do is to complete the form and you will receive free quotes.

    http://BestHealthInsuranceNow.info

    Hope that helps.

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