Mike the Mad Biologist

Republican Dick Armey supports an option to enroll in Medicare. Which isn’t socialism. Or something.Hunh? Dick Armey in an interview with The Economist:

If you in fact freely choose to enroll in Medicare that’s a wonderful gift, it’s a charity, it’s something I applaud. But when they force you in, that’s tyranny.

That’s what the strongest version of the public option–Medicare for All–would entail. You have a choice between private plans and a public one.

[jaw hits floor]

The incoherence from the right is staggering, although still effective.

I CAN HAS FREEDOM NOW?

Comments

#1 Tyler DiPietro
August 31, 2009

Medicare for all is the most sensible and workable idea for reform given our active healthcare infrastructure than anyone has had thus far. But as usual, the Democrats made preemptive concessions and put forth the weakest and most ineffectual options as a starting bid. There is nothing more useless than a Democrat.
#2 D. C. Sessions
August 31, 2009

In a novel, the Democratic leadership would reluctantly agree to accept his proposal as a compromise.

Alas, our Lords and Masters apparently aren’t quite as clever as Br’er Rabbit.
#3 Gerry L
August 31, 2009

I don’t think Armey is promoting the Medicare-for-all option. I’ve seen him on several talkingheads shows complaining that everyone over 65 has no choice but to enroll in Medicare. He says that once you are over 65 you are not allowed to buy insurance on the open market. It has sounded to me as though once he and his teabag armies have derailed healthcare reform (or health insurance reform, as they are calling it now), he intends to go after Medicare.

Does anyone know whether his contention that he is not legally allowed to buy insurance on the open market correct? I haven’t had time to look it up.
#4 Minty
September 1, 2009

>Gerry L:

As someone who’s spent the bulk of her professional life in the healthcare field, I thought I could answer your question.

No, it’s not true that you can’t buy health insurance after 65. Geriatric patients have difficulties enrolling in new private health insurance plans because of “pre-existing conditions.” As in, “you’re 65, which means you’re a good candidate for high blood pressure, high cholesterol, and other cardiovascular problems. As a result, you are at greater risk for a heart attack or stroke than a 25-year old. Therefore, we have classified you as having a weak heart, which, as a pre-existing condition, disqualifies you from enrollment.”

That’s why most senior citizens HAVE to enroll in Medicare; they simply don’t have any other option.

Well, that and the cost of private health insurance, but I won’t go there right now.
#5 erotik shop
October 1, 2009

erotik shop
#6 Ken N.
March 11, 2010

Gerry L:

I believe you may be mistaken.

You wrote, “No, it’s not true that you can’t buy health insurance after 65.” Your explanation explains (1) why premiums would rise considerably for persons aging past 65, but it does not explain (2) why insurance companies would disqualify them from enrollment at any price. However, I have found the latter to be the case.

It is as if state insurance commissions and the insurance companies that they license to sell in each state are acting as cartels, preventing residents of each state from buying insurance from foreign insurance companies that sell expensive primary health insurance to persons over 65 years of age.

If know that you are not mistaken, please provide a counterexample of an insurance company that does sell individual primary health coverage (not supplemental medicare coverage) to individuals over 65 in any of the United States.
#7 Neoabolitionist
March 12, 2010

My experience in the marketplace is the same as Ken’s. The federal government continues to permit the states to block interstate purchase of insurance, and the government in my state licenses only insurance companies which have agreed to deny primary health insurance, at any price, to all applicants over 65 years old.

Those of us who want to buy private primary health insurance, rather than burden younger generations of Americans, are only free to refuse Medicare and die without any healthcare coverage whatsoever. Clearly, the hidden agenda of advocates of Obama’s “healthcare reform” is to make all but the billionaires dependent upon government for our very lives. That is tyranny!

Despite Gerry’s “professional life in the healthcare field,” I also believe she is mistaken. I challenge Gerry to post the name of an insurance company which sells primary coverage to person’s over 65 at any price.
#8 Neoabolitionist
March 12, 2010

My experience in the marketplace is the same as Ken’s. The federal government continues to permit the states to block interstate purchase of insurance, and the government in my state licenses only insurance companies which have agreed to deny primary health insurance, at any price, to all applicants over 65 years old.

Those of us who want to buy private primary health insurance, rather than burden younger generations of Americans, are only free to refuse Medicare and die without any healthcare coverage whatsoever. Clearly, the ulterior motive of advocates of Obama’s “healthcare reform” is to make all but the billionaires dependent upon government for our very lives. That is tyranny!

Despite Gerry’s “professional life in the healthcare field,” I also believe she is mistaken. I challenge Gerry to post the name of an insurance company which sells primary coverage to persons over 65 at any price.
#9 Troublesome Frog
March 13, 2010

Your explanation explains (1) why premiums would rise considerably for persons aging past 65, but it does not explain (2) why insurance companies would disqualify them from enrollment at any price. However, I have found the latter to be the case.

I suspect that it’s similar to the reason that the credit markets don’t truly clear like you’d expect. The basic rules of supply and demand would imply that anybody (anybody!) can get a mortgage if only they’re willing to pay a high enough rate. In reality, there are people who cannot get a mortgage at all. Yes, there are all sorts of laws and regulations, but the rationing rate is typically far too low to be hitting those regulations.

The answer falls out of the asymmetric information problem and adverse selection. Up to a certain point, lenders (and insurance sellers) will take a risk on you if the reward is great enough. At some point, your willingness to pay is a signal that you’re a bigger risk than your background information would imply. If I ask for a mortgage and say that I’m willing to pay 35% APR, your first thought should be that I’m up to something and you’re never going to seen that money again. Who is willing to pay 35% APR on a mortgage? Nobody you’d trust with a mortgage, that’s who.

Combine that with the existence of Medicare, and it seems unlikely that any private insurers could really play in that market at all. They’d be dealing with the worst risk pool (like, way out in the asymptotic region of the distribution) with a government funded competitor.
#10 Neoabolitionist
March 14, 2010

Your analogy between mortgages and health insurance fails because, whereas willingness to pay higher interest rates implies poor creditworthiness, willingness to pay higher health insurance premiums with age merely implies acknowledgment of increased risk of the onset of new health problems with age.

My private health insurance premiums have risen with age, but they have been lower than many my age because of my excellent health profile. While I would expect premiums to continue to rise as I get older, there is no medical reason for premiums to suddenly jump to infinity at age 65.

Refusal to be a Medicare beneficiary does not imply that one is hidding a health risk. It merely imnplies that one has an ethical and/or political reason for non participation.

When President Obama said that existence of a public option for those under 65 would not lead to individuals losing their private insurance, he was apparently dead wrong, silnce it already has led to that consequence for those over 65. I guess SC’s Congressman Joe Wilson was correct: Obama prevaricates.
#11 Troublesome Frog
March 15, 2010

Your analogy between mortgages and health insurance fails because, whereas willingness to pay higher interest rates implies poor creditworthiness, willingness to pay higher health insurance premiums with age merely implies acknowledgment of increased risk of the onset of new health problems with age.

Well… yes. That’s basically it. If you’re willing to pay a ridiculously high premium, then you believe that you’re likely to run into an expensive illness. You know those deep dark secrets far better than an insurer does, so it’s reasonable for an insurer to take your self-assessment as a high risk person at face value.

While I would expect premiums to continue to rise as I get older, there is no medical reason for premiums to suddenly jump to infinity at age 65.

No, there wouldn’t be, unless there was some sort of government subsidized health care program that starts to compete with them at age 65. Given a person’s ability to get subsidized health insurance, I’d take their willingness to pay gobs of money for additional insurance as a strong indication that they’re adverse selection run-off from the cheap government program.

Refusal to be a Medicare beneficiary does not imply that one is hidding a health risk. It merely imnplies that one has an ethical and/or political reason for non participation.

Distinguishing between the two classes beforehand is essentially impossible. My instincts tell me that the former class outnumbers the latter class substantially, and since they’re a far greater risk than the latter class is a reward, I wouldn’t waste my time setting up an insurance scheme to compete with Medicare either. It’s a lose-lose.

When President Obama said that existence of a public option for those under 65 would not lead to individuals losing their private insurance, he was apparently dead wrong, silnce it already has led to that consequence for those over 65.

I’d argue that it’s quite possible that a public option would cause some people to lose their private insurance, but only if that private insurance was somehow unable to compete with the public option. Medicare is a special case because it’s basically free money from the government. The notion of a public option (on paper) was that it would not be subsidized. If you get beaten out of the market by an unsubsidized government option, then you probably deserve to go. If you lose to a subsidized entity, that’s a different ball game.

In the absence of meaningful government subsidies, when people describe nightmare scenarios like, “They put my private insurer out of business, so I have to go with the public option,” it could just as well be said that people flocked away from your current insurance scheme because it sucked enough to be beaten by a reasonable public option. Not exactly what I’d call a major policy failure.