I'm just looking over the August NBER digest. It covers five NBER articles, of which three may be mildly interesting. The first has the scary title, Public Insurance Expansions Crowd Out Private Health Insurance by Jonathan Gruber and Kosali Simon. We learn that: For every 100 children who are enrolled in public insurance, 60 children lose private insurance." Thank God that George Bush had the courage to stand up to the radicals and threatened to veto an expansion of child health coverage. Otherwise, they might lose their private insurance.
2 comments:
Scary title indeed. This is a complete linguistic hash. All that Gruber & Simon have shown is that so much of private insurance is so crappy that whenever there is any new public insurance available that working people with private insurance choose to go to the better insurance.
The word is "crowd-out" is completely confusing to ordinary people even if you want to technically define it as declines in private insurance. I have heard right wing people use it as verbal scimitar to wound public insurance expansion.
The real problem that Gruber and Simon have discovered and nimbly fail to emphasize is not public v. private insurance as it is with employer based private insurance.
The problem is that the employer seeks the minimum expense that keeps the worker. So the fact that many employers (predominantly but not exclusively low-wage) seek to keep their packages worse (they particularly like to exclude services that might prove costly so public insurance becomes the default provider of people with chronic issues) exactly so their employees seek to use public or spousal coverage.
It is a race to the bottom for most employers and whether we acknowledge it or not governments in the US spend more on health care per person than anywhere else in the world (and that includes ALL the places where the government provides UNIVERSAL coverage).
It is really amazing how out of touch our chattering classes are with the realities of health care insurance and delivery.
Excellent comment. Keep in mind that Gruber is one of the "giants" of conventional economic thinking about healthcare. Terms like "crowding out" and "loosing private insurance" as if he were willing to do anything to help provide access to good private healthcare suggest an Orwellian mindset.
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