Sharing a graph this evening on Twitter, I prompted a response from a friend and Ricochet member who noted that his insurance premiums were rising by 9 percent this year. "We're looking almost 4 bills a month now," he said.

premiums

He's at least the seventh or eighth person who's informed me of a premium hike in that range, but still in single digits. This doesn't surprise me. After all, one of Obamacare's many consequences was giving U.S. Dept. of Health and Human Services Sec. Kathleen Sebelius the power to "review" and increases she deems "unreasonable" - and the threshold for that review kicks in at 10 percent.

“For too long, when it came to health insurance, consumers were left in the dark. In the past, insurance companies could often raise your rates without any transparency or accountability. Many insurers were under no obligation to give you any explanation as to why they felt an increase was necessary,” Sebelius said in a statement. “This year, in every State and for the first time ever, the Affordable Care Act requires insurance companies to publicly justify their actions if they want to raise rates by 10 percent or more.”

You've seen The Price is Right, so I'm sure you know how this goes.

As you might expect, insurers are already trying to avoid that threshold as much as possible, shifting costs to other states to make up for the difference. Some of them have run afoul of it. But keep in mind: Sebelius has no actual power to do anything. This is just a shaming exercise, and since insurers are becoming more and more like public utilities, they generally don't want to play that game.

But what would happen if Sebelius actually had the power to put some teeth behind her threat? Back in January, I asked you to consider such a possibility:

Imagine a marketplace where you have to receive government approval for setting prices on your product, where you have to show your math for every decision made, and where you are "granted" the ability to increase the cost of your product only after first being approved by government bureaucrats.

Welcome to Massachusetts, where Governor Deval Patrick and Attorney General Martha Coakley are concerned about the continued rise in costs under their health care system. But don’t worry, they have a plan - double down on more price controls:

Attorney General Martha Coakley’s office is quietly circulating a proposal to more tightly regulate hospitals and doctors and the prices they are paid to care for patients. Coakley’s staff has drafted legislation and has briefed providers, business leaders, key legislators, and the governor’s office on the plan to contain health care spending…

Legislative leaders have been promising for months to file cost-control legislation, but the timing and details are still unclear. Governor Deval Patrick filed a bill more than a year ago to rein in health care costs and has since urged the Legislature to take up the issue quickly…

Unlike the governor’s proposal, Coakley’s plan would give patients specific information in advance about how much they would be required to pay out-of-pocket for a particular test or treatment. They generally would not be responsible to pay more than the disclosed amount.

Similar to the governor’s plan, Coakley wants to give the Division of Insurance the explicit authority to review the prices insurers pay to providers and reject them if they are “excessive, inadequate, unreasonable, or predatory.’’ After Jan. 1, 2015, rates that are more than 15 percent above or 15 percent below average would be disapproved; after Jan. 1, 2017, the range would decrease to 10 percent above or 10 percent below average.

While insurers in Massachusetts already are heavily regulated, Coakley wants to increase provider regulations. The public health department, for example, could initiate a market impact review if it believes a provider is engaged in unfair competition.

What’s happening in Massachusetts is nothing less than a total government crackdown on the insurance/provider relationship, and it foreshadows a future should Obamacare survive even in part. Not content to merely regulate insurers out of the marketplace, Coakley now intends to regulate providers to a greater degree—eventually reaching a point where the government has total and unmitigated say over what providers can charge and what insurers can charge, turning the entire spectrum into the equivalent of a public utility. They will set prices on both ends, and competition will disappear.

As Reason's Peter Suderman commented when I cited this: "Subsidize buyers. Mandate purchase. Control premiums. Control industry prices. But don't call it a government takeover!"

There's something more, too. Coakley’s actions are certainly objectionable, but they’re consistent with the statist ideology of the left, where no market forces have any place, and Dr. Berwick's "leaders with plans" always know best. It’s an inevitable consequence of an approach that promised vague cost-savings without actually delivering anything of the sort, and sought to solve the mythical free rider problem through methods that invested the taxpayers in a process where high health care costs put greater and greater strains on state budgets.

On the whole, this incident illustrates the danger of a technocratic approach, even with good intentions. History is littered with examples of failed technocracy, systems arranged by smart people who have no concept of the blowback from increasing the power of government and leaving tools for the anti-market, anti-liberty left to use toward the ends of their choosing. This is why expansionist government policies used for “conservative ends” have no extended life within an electoral system. The tools are left in place for perversion by the next crew in power, and they are used with gusto. The only way to stop this overreach is to destroy the tools themselves, taking power back from the hands of those in Washington or the statehouse and putting them in the hands of the people themselves.

Comments:


Zoon Politikon
Joined
Jul '10
Zoon Politikon

I am self-employed and buy my own insurance plan for my family through my small business.  I've seen the premiums go up at least 9% per year over the last two years. It had been going up modestly before that but took a very big jump each of the last 2 summers when i renew. It got so bad I actually had to take what was already a "bargain" plan and finagle it to get the increases in a reasonable range. 

Ben Domenech
Zoon Politikon: I am self-employed and buy my own insurance plan for my family through my small business.  I've seen the premiums go up at least 9% per year over the last two years. It had been going up modestly before that but took a very big jump each of the last 2 summers when i renew. It got so bad I actually had to take what was already a "bargain" plan and finagle it to get the increases in a reasonable range.  · 16 minutes ago

As I noted in my last post, self-employed people are getting the worst of it. Note the comparison between you and the small group/large group markets.

Mel Foil
Joined
Jun '10
etoiledunord

Mine's risen more like 12%.

Esquire_of_Dirt
Joined
May '10
hippopotomonstrosesquipedaliophobia

Try north of 20% and that's with a high deductible HSA that's supposed to be the savior. Makes me a 'consumer'. Try asking your doctor what something will cost. They look at you like your insane. Someone else can tell you. Then try and go someplace else for a lower cost. Impossible. Have to move your medical records. It's nuts to view this like any other economic product. We are irrational in our decisions, you can purchase an almost unlimited amount while unconscious. Dems are wrong that the government can administer it but conservatives miss it trying to treat it like any other widget. You have to view it as bankruptcy insurance until everyone gets the mind set normal maintenance isn't covered (colds, physicals) and we can shop procedures). Had two CT scans last year. Same machine. One was $59.99 (no mistake) one was $600. We may get there with technology but not if Obama transforms us into a European democracy first.

Diane Ellis

For tax purposes, I'm self employed and I buy my own health insurance. Since 2010, my premiums have gone up 84% and the increase  happened in about five increments.

Chris Campion
Joined
Jul '11
Chris Campion

Imagine a marketplace where you have to receive government approval for setting prices on your product, where you have to show your math for every decision made, and where you are "granted" the ability to increase the cost of your product only after first being approved by government bureaucrats.

By the way, this is exactly how it works in defense contracting.  Apparently applying a procurement model for physical goods and services will be applied to the insurance market, except a) the gov't isn't procuring the services, the individual is, and b) um, why again, is the gov't telling insurers what their costs are, which is what drives price? 

The government.  We're here to help you make the best decisions you obviously can't be trusted to make all on your lonesome.

Paul A. Rahe

This year, at least, our premiums at Hillsdale College did not go up one red cent. We have long had Health Savings Accounts to cover ordinary expenses and an insurance component for anything large. What next year will bring I do not know.

Paul A. Rahe

On the whole, this incident illustrates the danger of a technocratic approach, even with good intentions. History is littered with examples of failed technocracy, systems arranged by smart people who have no concept of the blowback from increasing the power of government and leaving tools for the anti-market, anti-liberty left to use toward the ends of their choosing. This is why expansionist government policies used for “conservative ends” have no extended life within an electoral system. The tools are left in place for perversion by the next crew in power, and they are used with gusto. The only way to stop this overreach is to destroy the tools themselves, taking power back from the hands of those in Washington or the statehouse and putting them in the hands of the people themselves.

Amen. What is happening in Massachusetts today was baked in the cake called Romneycare. Romney opened the door. Patrick and Coakley are walking through it.

Crab bait
Joined
Apr '11
Crab bait

The state of Massachusetts is asking for hospitals to collude on prices and/or for providers to ignore patient ailments that are not profitable. None of which will aid patient satisfaction, care or long-term well being. This all strikes me as very foolish as a way to run a business in the service sector.

James Of England
Joined
Apr '11
James Of England

Paul A. Rahe: 

Amen. What is happening in Massachusetts today was baked in the cake called Romneycare. Romney opened the door. Patrick and Coakley are walking through it. ·

If you look at the data, and the law, you can see that this claim is harder than it looks. Before Romneycare, Massachusetts health insurance premiums were going up faster than, for instance, Texas premiums. After Romneycare, Texas premiums go up faster, and the differences are big both before and after. 

In terms of meddling, much of the impetus for Romneycare came from the degree to which Massachusetts already meddled heavily with the law. The pre-existing conditions exclusion requirements, for instance, pre-dated Romneycare, as did a huge body of specifications for what insurance policies should and should not contain. It's simply not the case that absent Romneycare, Coakley and her ilk would not have had the incentives, the inclination, the means, and the support to engage in this sort of stuff.

This isn't to say that Romneycare isn't a terrible assault on liberty, awful for healthcare etc., but that doesn't make it responsible for all healthcare ills. Note Ben's more thoughtful and accurate framing.

Zoon Politikon
Joined
Jul '10
Zoon Politikon
hippopotomonstrosesquipedaliophobia: Try asking your doctor what something will cost. They look at you like your insane. Someone else can tell you. Then try and go someplace else for a lower cost. Impossible. 

I buy a dental program that is not insurance, but gives you pre-defined discounts on some services and flat rates on others. Its pretty cheap, and, while my family is young, is totally worth it.  However, whenever I need to get a "discount" type of service and inquire about cost i get the same "are you out of your mind" reaction.

show tnc's comment (#12)
Thomas Culp
Joined
Jun '11
tnc

Interesting... I'm self-employed and my insurance covers myself and our 18 month old daughter. It's a high-deductible + HSA plan and our rates went up by just shy of 12% this year.  My wife's individual policy went up by 6% which we were quite happy about...sadly.

Paul A. Rahe: This year, at least, our premiums at Hillsdale College did not go up one red cent. We have long had Health Savings Accounts to cover ordinary expenses and an insurance component for anything large. What next year will bring I do not know. · 7 hours ago

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