Health insurance for some

March 13, 2017

This Times Union story is disheartening, but not surprising.  It’s about legislators hiring rich cronies for part time jobs that pay little but provide State-subsidized health insurance, which is top-of-the-line and costs the employee very little (full disclosure — as a full-time, non-political State employee, and now as a State retiree, I too enjoy this benefit).

What the story doesn’t address, and what should be of broader concern, is the pricing policy for employees and retirees, who are required to pay a share of the cost of their policies.  There are two prices — for individuals with no dependents, and a higher family price for those with any number of qualified dependents.  Thus, the employee with a spouse and no children pays the same premium as the employee with a spouse and 15 children.  I do not know whether the cost to the State is the same regardless of the number of the employees’ dependents, but I do know that State employees with small families are paying a lot more per person for their health insurance than State employees with large families.  While this policy is great for State employees who have large families, it’s not so good for those making up the difference.  Even worse, it’s not a transparent policy — those who are making up the difference are not aware of who they are or how much they are paying.

I’m not saying the policy is indefensible; for example, where government jobs sometimes pay less than the private sector, the family insurance plan may make it practicable for someone with a large family who is an attractive candidate to take a lower-paying State job, which could benefit the public. And it is a way to make health care more affordable to those with larger families and, presumably, less disposable income (though that may not be the case of the part timers in the TU story, one of whom claimed a net worth of over $8 million). What I am saying is that it also presents apparent fairness issues and, as the TU story indicates, an incentive for abuse.  Open discussion of the issue — one that most taxpayers probably are not aware of — might benefit everyone.

 

 

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Health care conundrums

February 17, 2017

As I advance in age, I am exposed more and more to the health care industry, despite having enjoyed relatively good health until recently.  As a retired New York State employee, I am blessed with excellent health insurance that covers most doctor visits, medical tests and procedures, as well as prescription drugs, with only a relatively modest co-pay. Here are a few observations:

First, it appears that many of our health problems are what a friend of mine calls “diseases of affluence.”  More appropriately, they should be called “diseases of lifestyle,” since they affect people of all socioeconomic strata.  A lot of these are directly influenced by government policies.  For instance, our auto-centric physical infrastructure minimizes the opportunities for and pleasures of walking and cycling, and cannot help but contribute to obesity and other problems based on lack of physical activity.  Our government subsidies to cane sugar and corn (the main ingredient of high fructose corn syrup) help make junk food and sugared soft drinks attractively priced.  This is especially so for the poor, since the SNAP program (formerly known as Food Stamps) allows their purchase with SNAP benefits.  If we collectively spent more on complete streets that were friendly to pedestrians and cyclists, as well as cars, how much could we save on health care (not to mention on school transportation)?  How about if we stopped subsidizing sugar?  I think it would be worth a try.

For all the criticism leveled against it, the Affordable Care Act (“Obamacare”) has achieved something great — it has shifted the dialog from whether health care insurance should be extended to many of those who don’t have it to how the present system should be replaced or improved.  Neither Trump nor his minions are suggesting that those who obtained health insurance through Obamacare should lose it, meaning that they recognize that there is no going back on government’s commitment to growing numbers of its citizens.  Whether things actually get better or worse remains to be seen, but at least no one is talking a bout a pre-Obamacare “reset.”  To me, that is yuge.


Election aftermath

November 12, 2016

Much has been written about the recent national elections, and I only wish to add to it if I can say something original.  Here it is:  in large part, I blame the result on the New York Times, which for weeks had listed Hillary Clinton as having a virtual lock on the election and which, earlier, had done all it could to support Clinton over Bernie Sanders, even if it meant crossing the heretofore sacrosanct line between reporting and editorializing, a line it later admittedly obliterated when the finalists came down to Clinton and Trump.  The Times contributed to the naming of Clinton as the nominee, though she represented the party’s past, not its future.  And its unrealistic assessment of her chances justified the decision to stay home of those who did not support her, but otherwise would have come out to hold their noses and vote for her to defeat Trump.  Commendably, in some of its post-election navel-gazing pieces, the Times admitted that, in assessing Clinton’s chances as unrealistically high, it ignored the majority of voters outside of its bubble.  I have not yet seen an apology for its disregard of journalistic standards in its biased coverage of her campaigns in the primary and general elections.

Not that Clinton didn’t sabotage her own candidacy.  Her monetization of her prior service by giving paid speeches to Wall Street firms, the content of which she refused to disclose, and her misuse of e-mail, which almost surely revealed government secrets to those not authorized to see them (though I am not aware that the nation ever was placed in danger), among other things, were, to be sure, not as bad as many of the things Trump has done and said.  But the “false equivalency” argument is not a winning one.  Her weaknesses were enough to take the issue of character out of the race for those otherwise inclined to vote for Trump.  Had the democrats fielded a candidate with less questionable character, many people would have seen Trump for what he is and would have refused to vote for him, even if his ideology – to the extent it could be ascertained from his rambling, contradictory statements – might be more palatable to them.

So here we are.  The losers are not happy, as many violent demonstrations show.  I hope all the protesters were Clinton voters.  Obama, ever the class act, vows cooperation in the transition (see, by contrast, the way in which the Bill Clinton administration left the White House) and Trump, after a long meeting that undoubtedly opened his eyes as to what lies ahead, appears accepting of the advice he received.  He already is tacitly acknowledging reality by pulling back on his promise to “repeal and replace” Obamacare, realizing there is no easy way to preserve insurance for its 20,000,000 or so beneficiaries while removing its “objectionable” features.  Even with his party dominating both houses of the Legislature, expect more reality-dictated compromises to follow.  While such compromises may result in a lot of buyers’ remorse among Trump’s supporters, they could avert disaster at home and abroad.

 


All that’s wrong with New York’s government

May 23, 2016

This startling story in yesterday’s New York Daily News shows an almost criminal disregard by our Legislature for the taxpayers’ dollar.  It’s another example of how wastefulness or ineptitude by government can turn liberals into conservatives.  Those who would like government to do more ultimately decide that our government should not do more, because it either won’t do the job well or will do it at an unreasonably high cost (some of the overage going to the “corruption tax”).

Consequences of governmental inefficiency are unmet needs, or privatization of traditional government functions. Traditional public education in New York is threatened by charters and alternatives because of its high cost and mediocre results, accountability for which proves elusive.  People vote with their feet and leave the State for places with lower taxes and services that are not appreciably worse than they get here (for example, I can’t think of anywhere, including the deep South, that has roads in worse condition than those in our area).

While people with differing ideologies can and do differ as to the scope of government’s role in our lives, there should be absolutely no disagreement among honest citizens that what government is called upon to do should be done as efficiently and effectively as possible, for the benefit of all, not special interests.  Maybe that is an idea that all citizens can support, putting aside their ideological differences until after it is achieved.