Writing in U.S. News, Dr. Bernadine Healy has some prescriptions for the health insurance crisis that would likely be a step in the right direction-- tax credits or vouchers for those without employer-based care, help in maneuvering through the SCHIP forms for parents of children who should already be covered by the government, and for healthy young people who are currently gambling that they can do without coverage, an innovative new type of insurance.
This last suggestion, the HRA, or health reimbursement arrangement, was actually something I looked at recently in the very large paper, which longtime readers might recall dealt with medical savings accounts. MSAs are a fine idea that years ago Ted Kennedy successfully squashed in its embryonic state with regulation. And since then, Congressional Democrats have blocked free and unfettered medical savings account ownership. The Republicans keep trying to loosen the regulations and make MSAs a permanent option for everyone, but so far they have had minimal success. There were provisions to liberalize the restrictions on MSAs in the Patients Bill of Rights (anyone remember that vital piece of legislation?) that passed the House, but not in the Senate version. And, of course, I haven't heard anything about a conference on that bill for more than a year now. For better or worse, Congress has not been able to focus its attention on health care issues. Anyway, even as I slaved away this spring writing about MSAs, to the great detriment of my blog, I held out little hope that Congress would act to make them widely available anytime soon.
And then suddenly in June, a lovely thing was done by-- wait for it-- the IRS. They blessed an arrangement which, though different in structure from an MSA, was very similar in effect. This arrangement, the HRA, was already being offered by some firms to their employees. And because the Service said it was kosher under current tax law, no action by Congress would be required to allow others to use them.
Unlike an MSA, an HRA involves an account that is owned by the employer. But like an MSA, this account may be used by a worker even beyond his term of employment. Both arrangements involve catastrophic health insurance accounts to fund out-of-pocket medical expenses and cushion the risk of high deductibles.
I think Dr. Healy is right that this new arrangement could be attractive to young workers. Many young people do not choose to purchase insurance because they enjoy good health. Faced with the risk of getting sick and the risk of spending discretionary income on premiums for insurance that they likely will not use, they often choose the former. In my own experience, I've known exactly one person in their twenties who actually purchased insurance outside of an employer program, and she already had a serious medical condition. But when only the sick purchase insurance, you can expect that premiums will be high.
Dr. Healy argues that the entire health care system needn't be overhauled just because 15 percent aren't covered. After all, it works for 85 percent of us-- why not just help the others get coverage?
Since moving to the mail client update in Jaguar, I have been spared an awful lot of spam. And the move appears to have been exquisitely timed, as it coincided with an unprecedented increase in the amount of unworthy mail in my inbox. Just yesterday, I received a little more than 100 messages, of which 78 were spam of the most useless sort.
Just as they warned before the Afghan campaign, aid groups say Bush risks disaster in Iraq. They want into Iraq before the war starts, but it seems rather more prudent to keep them out. The last thing we need is to start shipping Saddam human shields, especially ninnies like these. At least they are honest about their fears, though--
Oh, the horror!
U.S. aid managers fear that in the event of war, the U.S. military will end up filling the void, dropping humanitarian aid from planes and helping reconstruct the country.
They worry that, inevitably, soldiers would favor those sympathetic to the U.S. cause instead of providing the neutral assistance aid workers are trained to supply.Yes, heaven forbid there might be no kind aid worker to give Saddam the same sort of peanut butter rations that the other refugees enjoy.
Interesting juxtaposition of headines on the Poynter media news site:
Editor: "The last thing we want to do is feed this maniac's ego" right next to
Near crime scene, Geraldo treats Hooters waitresses to butt autographs
An interesting review of Imagine There's No Country: Poverty, Inequality, and Growth in the Era of Globalization, a new book by an Indian economist that promises to do for globalisation what Bjorn Lomborg did for environmental issues. According the book's author, Surjit Bhalla:
In the two decades from 1980 to 2000, the proportion of poor people in the world has fallen from 44 per cent to 13 per cent.In these two decades, commonly regarded as the new era of globalisation, poor countries have grown twice as fast as rich ones (3.1 per cent against 1.6 per cent annually).
Every 10 per cent increase in the income of the non-poor has been accompanied by an increase of 18 per cent in the income of the poor.
The saddest thing about a book like this that promises to be so full of good news is that the people who claim to care the most about the world's poor won't read it and they wouldn't believe what it said if they did. They get far too much satisfaction from their sanctimonious and kneejerk opposition to all forms of development to care about what could actually end the unsustainable poverty of the Third World.
Those in favor of global market reforms should really work more on their moral preening, seeing as how they actually support policies that help reduce poverty.