Benny's World

Monday, March 09, 2009

Dean Baker Makes Too Much Sense

Dean Baker wrote a column for Truthout today called Competing Views of Government. Baker, who is a progressive thinking economist, addresses the problems of health care reform and the conflicts ahead between those who believe in reducing costs via more access, and those who spend a lot of money to keep costs down by denying treatments or coverage to those who need it.

Those who think that the role of government is to serve the public good are likely to favor some form of universal Medicare. Such a system would almost certainly save a huge amount in administrative costs at the level of insurers, providers and government oversight.

Private insurers spend more than 15 percent of the money they collect in premiums on administrative costs. By contrast, Medicare spends about 2 percent. Part of the insurers' administrative expenses go toward marketing - an expense that would be unnecessary in a universal Medicare system.

The other major factor driving administrative costs with private insurers is associated with their efforts to game the system. Gaming is the best way to make profits in the current system. If insurers can find effective mechanisms for either keeping sick people from being insured, or finding ways to deny coverage for expensive care, then they stand to make large profits. Naturally, profit-maximizing insurers will therefore devote substantial resources to trying to avoid ways to provide health care to people who need it.

What's being proposed by Obama is similar to what JRE and EE have advocated, which is to make private insurers compete with government plans. The difference, of course, is that Obama's is still optional and not mandated. But it is a step in the right direction. As Baker concluded:

The insurance industry already recognizes that it will lose out in this sort of competition. A government-run plan will be more efficient. We already know this based on the experience with Medicare. When private insurers have competed side by side with the traditional government Medicare plan, in the absence of government subsidies, the overwhelming majority of beneficiaries opted to go with the traditional Medicare plan.

This is why the insurers are yelling that they don't want to face "unfair" competition from a government plan. But, their complaint should be all the endorsement that the public needs to support a public Medicare-type plan. The public plan will be cheaper and better than what the private insurers have to offer. Why shouldn't the public then have this option?

We all know that the insurance industry executives and the company shareholders want to make lots of money, but maybe they should try to find an industry where they can compete. If the government can provide health insurance better and cheaper, then why do we need private insurers?

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