11/2001: The Pulse

Published November 1, 2001

The Census Bureau released in early October a revised report on the count of uninsured for the year 2000. By using a new methodology that eliminates some of the misreporting of the past, the Census Bureau now finds the numbers of uninsured dropped fairly substantially from 1999, making the second year in a row the count has gone down.

Also in the report:

  • People covered by employment-based coverage increased from 63.5 percent of the population in 1999, to 64.1 percent in 2000.
  • The percentage of people covered by government insurance actually decreased slightly, from 24.3 percent to 24.2 percent.
  • People generally are getting wealthier. The total population with incomes below $25,000 dropped from 64.6 million in 1999 to 61.1 million in 2000. The population with incomes of $25,000 to $49,999 dropped from 77.1 million to 75.4 million. The number of people with higher incomes increased from 132.6 million to 140 million.
  • Non-insurance continues to be a particular problem for the foreign-born, the young, and Hispanics.
  • The percentage of uninsured children dropped from 12.6 in 1999 to 11.6 in 2000, but the improvement was due to the increase in employment-based coverage. The report says, “no change occurred in government health insurance coverage.” Poor children are nearly twice as likely to be uninsured as non-poor children (21.5 percent to 11.6 percent), reflecting the failure of the SCHIP program.

None of these numbers is very reliable in any event. They count on self-reporting of things that happened over a year ago, and have been plagued by exaggeration. But they do provide a frame of reference for discussing the issue.

Source: There are plenty of mainstream media reports, but to get the source material, go to: http://www.census.gov/hhes/www/hlthin00.html

FamiliesUSA: Tax Credits Won’t Help

Reflecting the fanaticism of the Left on health issues, FamiliesUSA went ahead and released its new report on tax credits the day after the terrorist attacks, September 12.

Snidely titled, “A 10-Foot Rope for a 40-Foot Hole,” the report pretends to show how a $1,000 tax credit would be of little value to the uninsured. It defines a “standard” plan as the Blue Cross Blue Shield Standard Option under FEHBP. This plan has a $250 deductible, 10 percent medical coinsurance, prescription drug coverage with no more than a 25 percent coinsurance, and an annual stop-loss of $3,000. No plan with a higher deductible or more than 20 percent coinsurance was considered, or was labeled “substandard.”

The report’s first finding was, “$1,000 plans are not always available for healthy, non-smoking, 25-year-old women.” Actually, the real news should have been that such plans are available for this price in 19 of the 25 states studied.

Of course, no one has suggested that a $1,000 tax credit would, or should, pay 100 percent of the premium for anyone.

Source: http://www.familiesusa.org

EBN on Defined Contribution

Employee Benefit News has run the second of its two-part series by Jill Elswick on defined contribution.. This installment describes five business models as laid out by the Coalition on Consumer Driven Health Care, and mentions which of the new vendors are following which models.

The models are called: Decision Support (offered by Definity Health, Lumenos, and Sageo), Benefit Design (Destiny Health and Choicelinx), Health Plan Catalog (MyHealthBank), Time-of-Need Network (HealthAllies and HealthMarket), and Advanced Selection (Vivius and the Buyers Health Action Coalition).

The news coming out of the article is that the Choicelinx product will be offered by Morgan Stanley to 10,000 employees in Arizona, Utah, and Ohio.

Source: http://www.benefitnews.com/pfv.cfm

Washington Docs Oppose Single Payer

The Washington State Medical Association has “resisted the call” to set up a single-payer system in Washington, according to an article by Peter Neurath in the Puget Sound Business Journal. The group instead has decided to support repealing state mandates, refundable tax credits, and expanding MSAs.

The emphasis on mandated benefits comes from a task force created by the association that concluded, “Today, everyone wants everything to be covered by insurance. As a result, insurance products are laden with a host of mandated providers and mandated coverages.” Past president of the association, Dr. Nancy Auer, said, “What is the value to society when in 2000 Regence Blue Shield paid out more for massage therapy than for oncology services?”

Source: http://seattle.bcentral.com/seattle/stories/2001/10/01/newscolumn4.html

CU Hates MSAs, Loves SCHIP

From the “Come Again?” Department: Consumers Reports proudly announces how its parent organization, Consumers’ Union, is protecting consumers by fighting against medical savings accounts and tax credits, and fighting for expanding government programs like SCHIP and Medicaid.

Source: http://www.consumerreports.org/

From the Canadian Press on MSAs

Speaking of MSAs, we’ve been saving up some articles from our friends to the North. As much as Consumers’ Union would like to have a Canadian-type system here in the States, Canada seems to be running away from it as fast as it can. These articles may be difficult to link to, so I’ll just give the regular citations:

  • The Ottawa Citizen reports that the Senate Social Affairs Committee, chaired by Liberal Part member Michael Kirby, has released a 138-page report on the health of Canadians. On health care financing, its suggestions include: installing MSAs, charging premiums, and requiring the government system to pay for private-sector services under certain circumstances.
    Source: “Dr. Kirby’s Cure: The Ottawa Citizen, September 21, 2001
  • But according to the Canada Newswire, the Canadian Union of Public Employees (CUPE) isn’t buying it. They say Senator Kirby has a hidden agenda, and the report would result in a “two-tiered” health care system.
    Source: “Kirby Report Offers More Than Issues and Options: Senate Committee Pushes Privatization,” Canada Newswire, September 17, 2001
  • Writing in the Edmonton Sun, Mike Jenkinson “commends” health minister Gary Mar for “thinking outside the box a bit,” by considering MSAs, user fees, and making health coverage a taxable benefit. The article claims there are problems with all these ideas, but “still, Mar is on the right track in thinking the patient should be more directly involved.” The paper would prefer to privatize the whole system and let people pay premiums, instead of taxes, for their health coverage.
    Source: “Good Idea, Gary,” The Edmonton Sun, September 20, 2001
  • The Vancouver Sun ran an article about “a (British Columbia) health economist who has spent the last year studying the health care systems in various countries” and concluded Canada should try out the “user-pay concepts employed by Singapore.” Economist Cynthia Ramsay looked at the systems of eight countries and concluded Singapore has the lowest mortality rates and the lowest costs of all of them. Ramsay is described as “a big supporter of the medical savings accounts” used in Singapore.
    Source: “Singapore Has Health Lessons for Canada,” by Pamela Fayerman, Vancouver Sun, August 25, 2001
  • The Calgary Herald comments that, while many Canadians would like to see a greater role for the private sector in health care, they also want more direct federal involvement. Counter to that trend is outgoing Calgary health chairman Jim Dinning, who would prefer to experiment on a local basis, rather than inflicting any particular idea on all 30 million Canadians.
    Source: “Try Something New: The Role of Ottawa Must be to Promote, Not Hinder, Health Care Alternatives,” The Calgary Herald, July 16, 2001

Greg Scandlen is senior fellow in health policy at the National Center for Policy Analysis in Dallas, Texas. To sign up for his free weekly e-newsletter, Scandlen’s Health Policy Comments, log on to www.ncpa.org/sub/. Scandlen can be contacted by email at [email protected].