Policy Papers
Policy Brief #19: Hawaii's Lesson in the Perils of Universal Health Insurance
by Carrie L. Lukas
March 23, 2009
Executive Summary
President Obama intends to greatly expand government's involvement in the provision of health insurance, moving toward the goal of "universal" health insurance coverage. He included $634 billion over ten years in his budget for healthcare reform, which his staff has characterized as a "down payment" for a more expensive reform package. President Obama will find a willing partner in the cause of expanding government's role in our healthcare system in the Democrat majority Congress. Both Speaker Nancy Pelosii and Majority Leader Harry Reidii have expressed support for universal insurance.
Yet the American people should be concerned about the march toward greater government provision of health insurance. While President Obama pledged during the campaign that nothing will change for those satisfied with their current health insurance, that will be a difficult promise to keep. Everyone will be affected by such massive changes to our healthcare system.
State forays into providing "universal" health insurance provide a helpful preview into what the public can expect from similar federal efforts. For example, the state of Hawaii recently created a program to provide free health insurance coverage for children. Lawmakers intended that this program help the uninsured population, but they found that an estimated 85 percent of those who enrolled had insurance previously. Recognizing the program's inefficiency and concerned about its costs, lawmakers terminated the initiative just seven months after its launch.
Federal lawmakers can learn an important lesson from Hawaii's experience: expanding government health insurance programs will crowd out private insurance by encouraging many who are currently covered by private insurance to switch to the government program. This will affect all Americans, both through the high costs of the new program and the strain placed on the private marketplace.
There are better ways for policymakers to make health insurance more affordable and accessible for all Americans: by ending the bias in the tax code for employer-provided health insurance, providing refundable tax credits for the purchase of health insurance, and eliminating regulations that require individuals to purchase policies from providers in their state. More competition and individual control of health insurance resources, not bigger government, is the answer to the United States' healthcare challenge.
Attached Files
- Hawaii's Lesson in the Perils of Universal Health Insurance, PDF, 158.3 KB
by Carrie L. Lukas
3 Comments
janice golden | April 23, 2009, 9:32pm | #
to whomever wrote this odd article about health insurance:
this is the most optimistic report about the possibility of universal health care which i have read since about 1990.
why is it that when i listen to or read rightwing radical neoconservative extremists-that i have to conclude that either 1. you live in a different world/reality 2. you're all crazy, and you think you live in a different world/reality , or 3. you're so full of attack report training that the truth is turned upside down for you to use in order to confuse the issue into oblivion, or 4. you just enjoy lying your lovin' heads off just to make each other laugh at the absurdity you're able to create. - like , a way to be creative, sick as it is in terms of the effects that you produce.
(i love how this "expert" "journalist" looks about 20 years old. leastwise, you write like you don't know jackshit and/or you work for the business, and someone is telling you what to write -for the business- BUSINESS- it's not healthcare, everthing is not a business, like education is NOT a business..)
you been studying too much with closed minded anti-intellectual propagandizing corporate money-loving fashion elite rich fascist-leaning neocon-artists, honey. you been skipping too many history classes- like the ones about slavery, colonization, serfdom, iran-contra, the depression, the killing of jfk, rfk, mlk, and the vietnam war, kent state, seattle, katrina, poverty, genocide, wiretapping, torture, and the way that millions of americans are getting robbed by the richest people in this country,(read:bankers, military contractors, oil companies, telecoms, security contractors etc.), etc. etc.
guess you're lucky to have a job, though, writin'- no matter if your writing is screwy and serves like propaganda for rich healthinsurance companies and helps to insure the screws upon the lives and health of TONS of regular Americans who can't afford ANY damn health care, and who are SICK AND DYING EVERYWHERE AROUND THIS BLOODY COUNTRY AND CAN'T GO TO THE DOCTORS AND CANT STAY IN A HOSPITAL AND CAN'T GET THEIR KIDS CHECKED OUT AND CAN'T GET THEIR PROBLEMS LOOKED AT AND ETC AND ETC..AND WOULDN'T CARE WHO RUNS A DAMN PROGRAM -- IF ONLY THEY COULD GET SOME HEALTHCARE!!!! god, i love america.
get a life . write about something you know about.. and i don't mean the value of your stock in health insurance companies. though that WOULD make sense for you to write about. jeez.
Robin | May 6, 2009, 3:45pm | #
Your solutions won't help very many people, and will actually hurt some. You want to tax my health benefits? How is that going to make my healthcare more affordable? Tax credits would be so low that they wouldn't make much of a difference to people who can't afford insurance in the first place. The hidden "gotcha" in opening up all states to all insurers is that the companies wouldn't have to abide by state consumer protection laws. Please tell me how you're trying to get healthcare for all, and not just trying to enrich the coffers of the insurance industry? How can you be so against Obama's proposals when he hasn't even proposed them yet? You're not looking for new solutions; you're just hawking the same old tired "fixes" that won't fix anything at all.
Michelle | August 21, 2009, 1:00pm | #
Excellent article. The left seems unwilling to openly consider the ramifications in the states where universal health care has been tried. Tennessee's TennCare was a disaster, and quickly consumed 30%+ of their budget - they actually kicked people out of the plan. Maine's program also failed miserably. The current proposal shares an almost identical structure.
The Netherlands, rated # 1 healthcare system in Europe in 2008, ABANDONED their public national insurance and reformed with private insurers only in Jan of 2006. Gov't stipulates basic package details, all players must provide that basic package at a set premium, eveyone must buy at least that package. They have 99% compliance in the populace - only 1% fail to buy a policy - because there is a fine of 130% of the basic premium. Insurers can sell suplemental policies above the basic - and they do, 90% of the Dutch buy themselves enhanced coverage. Insurers can set rates on the suplemental piece. They have substantial subsidies to help low-income afford it...99% are insured - it works. Unlike Maine where their system was successful only in enrolling 10% of the uninsured - and did it at a crippling cost - Netherlands costs are down dramatically - that's righ actual savings.
Germany invited the Netherlands to give a speech about their reform, and Germany is now starting to allow some of their hospitals to operate at a profit. 69% of the UK think their system needs fundamental reform.
We need to look at what has failed and what will work, our debt is in too precarious a situation to screw it up, and there is NO evidence this type of a plan will reduce costs, in fact just the oppposite.
Robin, to make the change to open-nation-wide marketplace, the state consumer protections would simply be moved to the national level not abandoned....and you ought to dial into a few quarterly calls of the insurers. I used to work for a health care insurer, and you categorization of that industry is unfair.