Maggie's Farm

Why the heck should anyone care about how health insurance agents will fare under ObamaCare?

Under the House bill, for example, the Small Business Administration will help businesses and individuals figure out how to obtain affordable coverage. (The bill provision is titled, “Assistance for Small Employers.”) Health insurance agents are not precluded from providing advice. But, the SBA will be allowed to bypass agents.

A health insurance agent is required to complete initial and regular formal training courses in the subject (including ethics), pass initial and periodic tests, and are screened by their state and by insurance companies for criminal or personal conduct (including declaring bankruptcy) that may negatively affect their reliability to be licensed to provide agent services. In addition, through professional associations, through insurer education programs, through self-study, and through competitive pressures, health agents stay current on the latest laws and offerings from various insurers. Furthermore, almost all health insurance agents are independent businesses or work for independent agencies, not beholden to the insurers but to their customers. Importantly, individuals, small and larger businesses have priorities more important and pressing than becoming experts in health insurance or its interactions with other laws or aspects of their primary concerns, and heavily depend upon qualified, trusted health insurance agents. Lastly, many health insurance agents have extensive credentials and experience. For example, I attained earned, tested, rigorous certifications – Chartered Financial Consultant (ChFC), Registered Employee Benefits Concultant (REBC), Registered Health Underwriter (RHU), Chartered Life Underwriter (CLU) – that, along with other experiences outside health insurance (I was a senior financial and business operations exec for Fortune 100 and small companies for 15-years before becoming a health insurance agent) and years of experience as a health insurance agent (I’ve been at it for two-decades). This delivers wide-ranging values to my clients and of the interactions of their health insurance with their broader business, regulatory and financial affairs.

Does anyone expect the staff hired or created by the SBA to have this independence, experience or training? If so, get real!

Surely, there are some health insurance agents who are lesser or incompetent, or who are crooked, or who steer some business toward favored insurers for added volume bonuses. However, the less competent exist in a highly competitive market, where they lose business to the more energetic and competent in delivering value to clients. The crooked or shady are winnowed out similarly plus by stiff regulations and prosecutions.

This is just another aspect of the losses that individuals and businesses will suffer under ObamaCare.

A leading expert and opponent of Obamacare, Grace-Marie Turner, writes in the New York Post:

The 1,990-page bill the House leadership unveiled Thursday would impose a dizzying barrage of new regulations on employers, and force them to either provide government-specified health insurance or pay a penalty of up to 8 percent of their payroll.

Even firms that now provide health benefits get slammed -- since that coverage may not meet the government's definition of "acceptable." …

The head of the National Federation of Independent Business, Dan Danner, said the reform bill's huge cost "will ultimately come out of small business owners' pockets and prohibit them from growing, investing in their business and hiring new employees." …

The pain continues: The bill would also subject businesses and employees to a bigger, hidden tax -- a shifting of costs from public to private payers.

The legislation would expand Medicaid -- the joint federal/state program designed to insure low-income Americans -- to cover another 15 million people. But Medicaid payments to doctors and hospitals are well below market rates -- and often below their costs of providing care.

A study by the independent actuarial firm Milliman Inc. concluded that families with employer-based health insurance already pay $1,788 a year in hidden taxes to compensate for underpayments by government programs. That figure will plainly grow under the House bill.

For a final blow, the bill imposes surcharges on high-income individuals that will certainly hit many small business owners -- who pay business taxes through their personal-income tax forms.

Also, read The Worst Bill Ever.

For disclosure, I’m nearing retirement, and have shrunk my successful business. I am not going to directly suffer as a health insurance agent or small businessman, although I will as a taxpayer and as someone who cares about quality health care for myself and others if ObamaCare passes.

It was reported earlier today, here and here, that the machine-picked liberal Republican candidate whose poor polling -– and lack of support from Republicans -- led to her withdrawal from the race threw her support to the Democrat instead of to the Republican who challenged her – Doug Hoffman.  Hoffman is polling neck-and-neck with the Democrat for this upstate New York Congressional seat.  The outcome of this race will send an important signal to Washington waverers about what should be their upcoming congressional votes affecting the course of our country.

Congressman Darrel Issa just sent out an interesting and telling email about how important Obama sees this election:

Astonishingly, the Republican nominee in the special election has dropped out, and endorsed the Democrat! Just hours before she endorsed the Democrat, she received calls from Barack Obama's chief of staff Rahm Emanuel. She also received calls from the Chairman of the Democratic Senatorial Campaign Committee, Senator Chuck Schumer. Was Scozzafava promised something in return for her endorsement of the Democrat? Time will tell.

Issa says,

Volunteers continue to pour into upstate New York, but we are short of funds to pay for their transportation, lodging and meals. This race has turned into an all out battle between the White House and the conservative base of the Republican Party. Apparently all tactics are on the table.

Issa asks that urgent contributions be made via his own Political Action Committee to help elect conservative Republican Doug Hoffman, send the White House and Congressional Democrats the message that we’ve had enough of their ruinous tax-and-spend-and control our lives, send Republican hacks in Washington the message that truer Republican principles and support are required, and not let Obama and Emanuel run the Republican Party.

Instead of sending your contributions via Issa, send them directly to Doug Hoffman’s campaign.  The link is here to donate and to learn more about Hoffman.

We already know that Obama-style politics is payola politics, trying to buy off votes and power with our taxes and earnings. Say ENOUGH!

When I left New York City in 1968, after graduating college, I like many of my fellow graduates from working and lower middle-class families sought our opportunities elsewhere, and most metropolitan elsewheres were better than NYC.  The job market was still strong in NYC, but opportunities for advancement better elsewhere, the costs of living and taxes lower, the public services better, public safety higher.

Today, the New York City disease has spread more widely around the country.  Most major metropolitan areas, the hub of most states, have seen their infrastructure serving the upward mobility and the financial and personal security of their upward-striving or holding-on working and middle class deteriorate over the past 40-years.

Still, there’s striking differences among the states, and the results show.

William Voegeli writes in today’s Los Angeles Times, "The Golden State isn't worth it."  Voegli compares California to Texas, “Our high-benefit/high-tax model no longer works, especially compared with low-tax states like Texas.”  Voegeli says, “These alternatives, of course, define the basic argument between liberals and conservatives over what it means to get the size and scope of government right….[T]he superior public goods that supposedly justify the high taxes just aren't being delivered.”

It’s not ideologues who are moving.  For example, I recently ran into a couple I was friendly with in San Diego during the ‘90’s, he a French doctor-scientist and she a Dutch-Indonesian.  They compared San Diego favorably in all respects (except cuisine) to living in Europe, and were happy to be here.  Then they moved to a better job in Silicon Valley, where despite higher income they could afford a house half the size and they felt surrounded by selfishly aggressive strivers.  Then they moved to Austin, Texas, where they could afford a much larger house for their family, in an excellent neighborhood with top schools, the cultural life is vibrant, and the daily courtesies among residents are welcoming and provide good role models for their children.  These products of Europe are a reality test of America.

Voegeli continues: “Overall, the Census Bureau's latest data show that state and local government expenditures for all purposes in 2005-06 were 46.8% higher in California than in Texas: $10,070 per person compared with $6,858.”  Between 2000 and 2007, “16 of the 17 states with the lowest tax levels had positive "net internal migration," in the Census Bureau's language, while 14 of the 17 states with the highest taxes had negative net internal migration.”

Why?

The high-benefit/high-tax model can work only if things are demonstrably not equal -- if the public goods purchased by the high taxes far surpass the quality, quantity and impact of those available to people who live in states with low taxes.

Today's public benefits fail that test, as urban scholar Joel Kotkin of NewGeography.com and Chapman University told the Los Angeles Times in March: "Twenty years ago, you could go to Texas, where they had very low taxes, and you would see the difference between there and California. Today, you go to Texas, the roads are no worse, the public schools are not great but are better than or equal to ours, and their universities are good. The bargain between California's government and the middle class is constantly being renegotiated to the disadvantage of the middle class.

How?

None of this happens by accident. California's interlocking directorate of government employee unions, issue activists, careerists and campaign contributors has become increasingly aggressive and adept at using rhetoric extolling public benefits for all to deliver targeted advantages to itself. As a result, the political reality of the high-benefit/high-tax model is that its public goods are, increasingly, neither public nor good. Instead, the beneficiaries are the providers of the public services, and certain favored or connected constituencies, rather than the general population.

What to expect?

The recession will eventually end, and California's finances will get better. Given its powerful systemic bias against efficient and effective public services, however, the question is whether the state will ever get well. California's public sector has pinned its hopes for avoiding fundamental reform on increased federal aid to replace dollars the state's fed-up taxpayers refuse to surrender. In other words, residents in the other 49 states -- the new 49ers? -- would enjoy the privilege of paying California's taxes. Their one consolation will be not having to endure its lousy public services.

If, on the other hand, America's taxpayers (and China's bond buyers) succumb to bailout fatigue, California may reach the point at which, after every alternative has been exhausted, it is forced to try governing itself competently.

It’s not just California, or New York City, but throughout much of America today that we’re seeing the hollowing out of the infrastructure and services and opportunities that built America’s uniqueness and success compared to the rest of the world.  And, big-government advocates are clamoring for yet higher taxes. The New York Times reports today that “Faced with anxiety in financial markets about the huge federal deficit and the potential for it to become an electoral liability for Democrats” the White House and congressional Democrats are seeking some way to reduce the huge federal deficits they have created, and that more taxes are their prescription.

Government  workers and their unions are prime beneficiaries of our heavy taxes. Most of even the made-up stats recently released about jobs saved or created by the federal appropriation of the near $1-trillion “stimulus” show relatively few and most of those among government workers.  The $1-trillion, likely to be much more, cost of the wholesale upheaval of 1/6^th of the US economy in health care – which really only serves about the 25% of those who truly need it who don’t have insurance at the expense of the 85% of Americans who do have coverage -- will fall heavily upon the working and middle class.  The $trillions of indirect and direct taxes of the “cap-and-trade” illusory environmental bill will also add $thousands each year to each American's costs of living, to the economic benefit of profiteering fat cats and their politicos who garner contributions.

At root this may be an ideological battle, as Voegeli says.  But, it is really a practical battle between those who aspire and work for a better life and those relatively few who would squander its underpinnings for their own greedy benefits.  The real populist revolt is already shaking Washington and state capitals, and much more is to come.

Democratic Congressmen and Senators should think twice about whether they'd rather have an angry wife by lining up for Pelosi and Reid.

In a recent poll of women, Obamacare is rejected by most women.  This is important because there are more female than male voters, because women are usually more involved with and sensitive to medical coverage, and because women are most influential in making decisions about medical coverage.

Although John Hinderaker’s conclusion is telling that the various ObamaCare proposals from Congressional Democrats all add up to socialized medicine, the rejection of ObamaCare in this poll is even high among Democrat women.  The poll identifies political leanings, but the questions are not ideological.  Practical and personal concerns are polled, and are primary over ideology.

After several decades of experience in health insurance brokerage and consulting, I can tell you that women are far more concerned and demanding as to their coverage.  At least before middle-age, women have more health care issues and make more visits to their doctors.  Women  are most often the decisive influence on the choice made in the workplace, including that most HR people are female, and the wives of the senior executives or owners make their desires quite clear to their husbands. For example, try to separate a woman from her favored gynecologist or their children from their favored pediatrician and the broker usually faces  a fight, the women willing to even pay higher premiums to retain their favorite personal doctors.

A conservative-leaning organization, The Independent Women’s Forum, hired an independent pollster to question in depth what appears to be a representative national sample of female voters about their preferences in the health care legislation debates.  The poll analysis is here, and more details of the questions and responses are here.

Some of the key poll results:

75% want few to no changes to their own healthcare (40% ?? be modified, but mostly left as is; 35% ?? be left as?is) while 19% want it to undergo dramatic overhaul.

67% of women agree with the following statement: “I would prefer that United States Senators and Member of Congress not support poorly?crafted or rushed healthcare legislation. It is more important to get it done right than to get it done fast.”

When asked how much should be spent on healthcare reform, most put the acceptable amounts in the thousands (16%), millions (24%), or billions (16%). Only 10% say that $1 trillion (5%) or more than $1 trillion (5%) should be spent on healthcare reform.

66% of women describe the quality of their health insurance as “excellent” or “good.” 74% use the same terms to describe the quality of their healthcare. 29% say their health insurance is “fair” or “poor” while 24% say the same of their healthcare.

By a margin of 64%?27% of women would “rather have private health insurance than a government?run health insurance plan.”

55% think that the CBO projection of $829 billion is an underestimation of how much will ultimately be spent on healthcare reform. 17% think the figure is too high and 12% think the guess is about right.

46% of women predict that “increased federal involvement in healthcare” will result in more doctors leaving the practice of medicine while 12% think it will cause more to join; 34% think the ranks will remain unchanged.

58% disagree and 29% agree that “more federal involvement in healthcare will improve the relationships members of my family have with their doctors.”

51% of women think more federal involvement will cause declines in the quality of healthcare they and their families receive; 15% feel it will lead to improvements; and 28% believe the quality will remain unchanged.

Among Independents, 73% would be less likely to support a “candidate for Congress knowing he or she favored moving people from their private healthcare plans to government?run healthcare plans.”

Among Independents, 47% would be less likely to support a candidate “knowing he or she supports this new $829 billion healthcare bill,” 31% would be more likely.

Among small business owners, 65% trust that the private sector does a better job of providing choice in healthcare; 25% think the federal government does.

Among small business owners, 56% believe the private sector can offer lower costs while ensuring high quality healthcare; 36% give the federal government the advantage.

Majorities of voters in all age, regional, and educational attainment cohorts believed the private sector to be superior when it comes to providing choice in healthcare. Pluralities of selfidentified Democrats (45%) and liberals (49%) agreed, as well as majorities of self?identified Independents (64%), Republicans (81%), moderates (54%), and conservatives (74%).

Two?thirds of women objected to government paying for abortions in the healthcare bill, including majorities of women of all ages, races, regions, marital and parental statuses, and political parties (55% of self?identified Democrats, 66% of Independents, and 84% of Republicans). Even 39% of “prochoicers” qualified their views with their unwillingness to pay for it.

When informed that “one of the reasons why the deficit is expected to decrease is because the federal government is going to decrease how much it spends on Medicare,” 77% of women deemed this tactic a “mostly bad” one. Just 13% considered this approach a “mostly good” idea. Majorities of women of all ages, races, regions, marital and parental statuses, incomes, educational attainments, political parties, ideologies, and regions considered these cuts to Medicare to be a “bad idea.” At least 70% of women in every age cohort not benefitting from Medicare rejected this.