Update: Health care antitrust laws

Robert Reich makes the case for ending the antitrust exemptions for health insurance companies that I mentioned in the "competition" section of my note on health care reform economics:

This can’t be the whole story, because big health insurers are making boatloads of money. America’s five largest health insurers made a total profit of $12.2 billion last year; that was 56 percent higher than in 2008, according to a report from Health Care for America Now.

It’s not as if health insurers have been inventing jazzy software or making jet airplanes. Basically, they just collect money from employers and individuals and give the money to providers. In most markets, consumers wouldn’t pay this much for so little. We’d find a competitor that charged less and delivered more. What’s stopping us? Not enough choice.

More than 90 percent of insurance markets in more than 300 metropolitan areas are “highly concentrated,” as defined by the Federal Trade Commission, according to the American Medical Association. A 2008 survey by the Government Accountability Office found the five largest providers of small group insurance controlled 75 percent or more of the market in 34 states, and 90 percent or more in 23 of those states, a significant increase in concentration since the G.A.O.’s 2002 survey.

Anthem’s parent is WellPoint, one of the largest publicly traded health insurers in America, which runs Blue Cross and Blue Shield plans in 14 states and Unicare plans in several others. WellPoint, through Anthem, is the largest for-profit health insurer here in California, as it is in Maine, where it controls 78 percent of the market. In Missouri, WellPoint owns 68 percent of the market; in its home state, Indiana, 60 percent. With 35 million customers, WellPoint counts one out of every nine Americans as a member of one of its plans.

Yesterday, the House passed this exact repeal, by a 406 - 19 margin!

I think this is a hopeful sign pointing towards changing the system, but we'll wait and see...

These vote to filibuster a bill, then vote FOR the bill...

Steve Benen makes a great catch: six sitting United States Senators, paid a very handsome salary with lavish benefits, vote to filibuster (kill) a bill, then, once it makes it past the filibuster, vote FOR the bill.

These senators supported a filibuster, but approved of the bill they tried to block:

Lamar Alexander (R-Tenn.)
Thad Cochran (R-Miss.)
James Inhofe (R-Okla.)
George LeMieux (R-Fla.)
Lisa Murkowski (R-Alaska)
Roger Wicker (R-Miss.)

(Two more GOP senators -- Orrin Hatch of Utah and Richard Burr of North Carolina -- missed Monday's vote, but joined with Dems today.)

So, we're looking at six conservatives who voted against a jobs bill before they voted for it.

This, alas, isn't especially new. For a year now, Republicans have repeatedly tried to block up-or-down votes on all kinds of bills and nominations, only to vote in support once their obstructionist tactics are defeated. For petty partisans like these GOP clowns to block votes on measures they end up voting for anyway is the height of cynical and pointless obstructionism.

What an embarrassment.

Indeed. But the party of Beavis and Butthead is shameless.

The case for health reform

Partisanship aside, the underlying question of why health insurance premiums are so high in America can be explained fairly easily by textbook economics. The solution to the problem is universal coverage, as has been known for decades, by lowering the average risk of the insured. The fact about the way that all insurance works is this: there are only two ways to reduce average premiums -- 1) increase the number of people who are in an insurance pool, 2) reduce the cost of the service/good being insured. Those who disagree aren't just wrong politically and morally, but are ignorant of basic economics. Krugman and Pollack explain the economics of recent increases in California insurance premiums in plain language, below are the economics concepts to consider:

The curse of being a (grown-up) Democrat

The GOP is using a filibuster on almost literally every vote in the Senate now. CNN confirmed Obama's SOTU claim that from 1949 to 1970, there were only 30 instances of using the filibuster -- and never more than 7 in any two-year session, while in 2009 alone, there were 39 by Republicans. This causes massive paralysis in our political process, where a 59-vote majority is not enough to get things done, leading to the public's cynicism with "the way Washington in broken"...hey, why would they do that?

Easy answer: their incentive is intrinsic to their ideology, which states that government is dysfunctional and cannot help people. If they can help perpetuate that belief by, for instance, preventing 70 qualified people from being appointed to necessary government posts by having an up-or-down vote in the Senate, they will. If they can turn a serious debate over substantive policy into an anti-intellectual joke, they will. By actually making government broken, they fulfill their own prophecies and attempt to cut off the possibility of hopefulness. By being the party of Beavis and Butthead, Republicans make government the butt of a joke, which ironically turns into their favor by running on a platform that says, "Elect me to be a joker. How can you hope for change?" That way, politicians who promise actual results and good things for the country are never believed (or elected). By exploiting cynicism, they win a political battle, but lose the larger war.

The burden of being the grown-up party is believing -- and actually behaving as if -- government must be force for good in its citizen's lives. That's why liberals conceded so much on health insurance reform: it is much more important to get something done to fix the broken system than to allow it to continue as it is over disagreements. And it's both the curse and the blessing of being right about policy matters that you become responsible for getting them enacted anyway when your opposition obstructs you for no good reason. I just hope our Senate doesn't become a Polish joke.