Hi Mr. Sprinkles,
So, you are arguing that in Great Britain's NHS decision to withhold the availability of drugs is evidence of the free market at work? Are you seriously making that argument?
It was not a decision to withhold the availability of drugs. Read your own article -- at least get to the subtitle. It was a decision to make consumers pay for their own drugs instead of having the government paying for it.
Let me clue you in on a few things about the free market; in the free market the government wouldn't be making decisions about who gets healthcare and who doesn't.
That's right, in the free market big corporations will be making the decisions and lots of people will not get healthcare. Like the "tens of thousands" who will have to pay high costs or suffer "excruciating pain" unless the British government steps in and pays for the drugs.
And, there isn't a free market for healthcare in the U.S. So, any claims about the ‘free market’ approach to healthcare in the U.S. are a bogus claim.
That is true, it is not a free market since the health insurance industry is heavily subsidized, thanks to the patriotic efforts of heroic industry lobbyists and their millions of supporters -- little, green, rectangular supporters. But it seems to be pure myth that insurance companies do not compete across state lines.
The point I'm making is that in countries with government-run healthcare it is the government that decides who gets treated and who does not get treated. And when that is a case, the decision is out of the patient's hands.
No, not true, not even according to the very article you cited. A decision was being made that certain drugs would no longer be covered on the UK public insurance plan. People living in the UK would be forced to buy expensive private insurance which covers the drugs, or pay out of pocket -- which is exactly what Americans are forced to do today. Sure, public insurance won't cover everything -- just like private insurance.
This article:
Triage: Purchasing insurance across state lines: a good idea?
From the Chicago Tribune seems to believe that there is a law preventing the purchasing of health insurance across state lines. And Judith Graham speaks to an insurance lobbyist and guess what Mr. Sprinkles; the insurance lobbyist thinks it is a good idea that we cannot buy health insurance across state lines.
This is a blog. The author speaks to an elected official, not a lobbyist. And here is a list of the Blue Cross Blue Shield plans you cannot buy in what looks like all 50 states, plus an American possession:
http://www.bcbs.com/coverage/find/plan/
Here is where Aetna offers its illegal health plans to students in what appears to be every state:
Aetna Student Health
This is the website where you can click on any state to find the nonexistent and illegal United health insurance plan that is right for you:
Medical Insurance and Individual Health Insurance | GoldenRule.com
Humana only offers its nonexistent multi-state insurance plans in 21 states:
http://www.humana-one.com/?kc=1005019688&cm_mmc_o=ZAFzEzCjC1bELlCjCZAFzEzCjCZBFw5zTw
Seriously, explain to me how they aren't competing when they clearly all offer insurance plans in most if not all states and territories. I don't get it.
These were precisely the first few insurers that I checked, I could probably go on....
Yes, companies like having monopolies and in terms of health insurance the insurance companies have monopolies in each state.
Perhaps you are right that a practical monopoly exists in most states -- I haven't rigorously checked this myself, and you appear to be totally wrong about the idea that insurers can't compete across states. But let's assume you are right. (1) Cartels and monopolies, as you know, inevitably arise in a free market system and it takes some regulation and oversight to break up big companies and avoid this natural progression; (2) Big companies and near-monopolies are at an especially big advantage in the insurance industry (for reasons explained in a moment); (3) We don't want small insurance companies, anyway. Insurance works by collecting a pool of shared risk. A single adult hemophiliac costs $250,000 per year to treat, as a base cost. No small-time insurance company can afford to cover a family of people with this genetic disease. Medical catastrophes are supportable only if you have a big pool of shared risk.
As best I can tell, what the conservative talking-point "let's let insurance companies compete across state lines" comes down to is this: let's have massive federal intervention which trumps the inhomogeneous insurance regulations at the state level. This will not allow insurers to compete, but it might allow them to compete more profitably. So much for states' rights and keeping big government out of markets. And if the private system tends to evolve into a few insurers mopolizing the industry at the state level, why wouldn't the same thing happen at the national level? How does increasing the scale of the problem fix the problem? It's possible that the inhomogeneity of state regulations does tend to favor insurance near-monopolies in individual states while also staving off an insurance near-monopoly of the entire nation.
As for insurance companies listing all the states, that's because each state has their own regulations on health insurance so the plans slightly vary from state to state. But, we, as consumers can only purchase health insurance from an insurance company in our own states.
I don't see how this is different from any other business competing across state lines. Company X sells cars. You can buy cars from Company X in any state where Company X chooses to sell cars. But, like any product, if you live in Ohio Company X can only sell you cars that conform to Ohio law (e.g. safety and emissions standards). Just like any other inter-state business.
Again, I think the real issue here is not "let them compete across state lines" but "let's have massive federal regulation of this industry which trumps state regulation", since this contradicts supposed conservative principles I suspect "conservatives" are simply being duped into backing corporate interests (again).
I would think hypothetical free-market conservatives would call for ending government subsidies for the health insurance industry before introducing more federal intervention.