Thursday, August 9, 2018

Health Care and the poor

This is Joseph.  And I am confused.

Jon Chait:

The state-level Republican crusade to deny the Medicaid expansion also hurt insurers. Medicaid wound up soaking up costly patients, freeing insurers to cover a healthier population. (Two studies found this result.) That’s why, Solomon confirmed to me, “in most states [insurers] do support expansion in my experience.” The clear and consistent pattern is one of Republicans repeatedly threatening insurers, to the point of withholding payments they were legally owed, in order to prevent poor and sick people from getting insurance. It is bizarre that Ackerman concludes that the GOP doesn’t actually care about denying insurance to the poor and sick (a goal it has in fact pursued fervently) and instead cares about profits for insurers (a goal it has in fact undermined relentlessly).
This really does seem to be correct.  If profits were the goal, then this strategy seems to be an odd way to go about it.  It is true that there could be a larger goal in mind that suggests short term pain to keep health care profits high, but it sure is not a direct link.

It also suggests that we are heading towards some sort of tipping point in the United States.  Health care costs are getting higher and higher.  Regulations generally prohibit cheap substitution (you can't create a clinic with non-MD/RNs to service those who can afford nothing more) in the health care market and pricing transparency is low, making comparison shopping hard. It seems like a mild regulatory approach is unpopular and unsustainable, given the political polarization.

One way or another, there are some interesting times ahead.

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