Consumer Reports cautions about buying your own health insurance; McCain, Guiliani should listen

Consumer Reports magazine, published by the Consumers Union, chronicled in their January 2008 issue (they really are ahead of themselves) the difficulty the self employed and those working for small businesses have in finding health insurance. This is particularly timely since several of the Republican presidential candidates are talking about moving away from employer-sponsored health insurance and pushing people into buying individual health insurance on their own. Individual health insurance is so popular that a whopping 7% of Americans already get their insurance that way. It's great if you are young, in great health, and will never need to use it. But many others might as well have a giant red stamp on their forehead saying "UNINSURABLE." The article details the stories of those who thought they were in good health, but upon applying for health insurance on their own, without an employer-sponsored pool to spread out the risk, were unable to obtain sufficient coverage due to conditions as common as high blood pressure or asthma. Since Consumer Reports doesn't put much of their magazine's content on the web (it's kind of hard to make money putting stuff for free on the web if you don't sell advertising like other news sites do, but that is what gives Consumer Reports such credibility), I cannot link to the article. But it starts out with a great analogy:

Imagine that shopping for a new car worked like this: If you really didn't need the auto and lived two blocks from work, any dealer would sell you a car for a song. If the commute was 50 miles, much too far to walk, no one would sell you a car at any price. You wouldn't get to see a full contract until you plunked down your cash. Your monthly car payment would go up 20 to 30 percent every year, and, by the way, the steering wheel might be extra. The auto industry doesn't work like that, of course, but the market for people who buy their own health insurance does.

The article reveals Consumer Reports' findings:

• 71% of those on individual plans had overall complaints with their coverage, compared to 53% for those on an employer plan.
• 55% of those on an individual plan said their insurance covered most costs, while 81% of those covered by their employer did.
• 52% covered by an individual plan said their premium was too high, compared with 29% on employer plans.
• 45% on individual plans said they postponed needed medical care due to costs, compared to 31% covered by employers.

In Arizona, 24,000 folks are in a state-sponsored, high risk pool called Healthcare Group. These are people who pay significant monthly premiums for their health insurance, are employed, and are not eligible for health insurance through their employer. What they do get through Healthcare Group that they do not get in the private individual market is coverage for their pre-existing conditions. As is always the case with a pool of high risk (sick) people, it costs a lot to insure their health. Healthcare Group has been operating in the red, and the legislature is still determining the future of the plan, and whether the 24,000 Arizonans served by it will continue to have coverage. While the plan is administered through our Medicaid agency, AHCCCS, Healthcare Group was told by the legislature to be financially independent and for several years did not receive taxpayer money. Enrollment in Healthcare Group has now been closed and premiums have been increased, which tends to create a further "death spiral," since no new (and younger) people may join the plan, while those on it will usually get older and sicker. There is not silver bullet, but when someone says everyone should just be responsible for going and buying their own health insurance, it simply is not that easy.

Oh, and cities have a budget crisis too, affecting you more than you think

So I've written about budget problems at the federal and state governments. But are cities suffering? Of course! As an article on the front of today's Arizona Republic pointed out, cities are suffering from the same economic slowdown, especially from declining sales tax revenues as fewer of us are making big purchases lately. So what's the effect this could have on us? Potholes not getting fixed? Libraries closing earlier? Well, cities do provide some important services, including the roads that are barely keeping up with growth, aging sewer systems that badly need upgrading, removal of graffiti, and even funding for domestic violence shelters. Arizona's cities may further be hit by state budget cuts, because our cities get some of their revenue from the state's income tax, which gets shared with city governments in exchange for cities not adding their own taxes to our income (filling out two income tax forms every April is enough!). In the past, when times got tough, the state has reduced revenue sharing for cities. Meanwhile, the Bush Administration has proposed eliminating or reducing several important block grants to cities. One, the Community Development Block Grant, is used in the City of Phoenix to shelter domestic violence victims, enforce anti-blight laws against slum lords, provide job training to help people be self sufficient as they leave public housing, and install new sewer lines. This money also funds something very important in my central city neighborhood: graffiti removal. Last year, Graffiti Busters removed graffiti from over 34,000 sites in Phoenix, and distributed thousands of gallons of free paint to volunteers to remove graffiti. So how much money does the federal government provide cities for uses like this? Well, the annual cost, which President Bush considers too high, is about what we spend in Iraq every two weeks. Moreover, the way the federal government distributes aid to cities favors older cities like Detroit rather than fast growing cities like Phoenix, Mesa, or Tucson. Check out these graphs from the City of Phoenix Congressional Briefing Book:

So I ask our Congressional delegation, even if you aren't fans of lots of government spending, can't you at least make sure Arizona gets its fair share of the tax dollars we send to Washington back here in our own communities?

Arizona legislature considers taking away health insurance from pregnant women, vaccines from kids, and $220m from schools

The staff of the Arizona legislature recently released 255 pages of possible cuts to the Arizona budget to deal with a $1 billion deficit. The possibilities include slashing health insurance for 18,000 low-income children, dropping hundreds of low-income pregnant women from AHCCCS health coverage as well, cutting out vaccines for children, cutting back on necessary safety inspections of child care centers, and removing $220 million from schools. While I have briefly glanced at the 255 page document, I haven't been bored enough to read it all. Rumor is that the proposed budget cuts are "hidden" on the internet (because the internet is a good place to hide things, after all) of a government budget office, so if you do an internet search, you may be able to find some very boring, but possibly important reading.

State Senators and Representatives have been quick to point out that no decisions have been made yet on budget cuts, that nobody wants to make all these cuts, but that they were merely prepared by staff so the legislature could see what was available to be cut. If you think it is important for children to have a good start in life by getting the prenatal care they deserve, or to go to child care centers where they are not abused or neglected, or that it is important to fund schools, well, you should probably call your state Senator and Representatives today and tell them that you feel it is a priority.

Renzi flip flops on funding schools

I buried in my November 7 entry on Pat Robertson and Rudy Guiliani a blurb about President Bush vetoing a bill funding the government for this fiscal year because it did not have his proposed cuts to Head Start, special education for the developmentally disabled, Pell Grants for college students, and early reading programs for young children. Apparently the bill had specific merits to people in rural Arizona. According to a press release by the office of Congressman Rick Renzi, the bill also funded teacher training in rural Arizona, as well as nursing programs in Pinal and Gila Counties. Renzi not only supported the bill, but promised to "continue to stand in strong support of legislation that helps improve the quality of education for all Americans." That is, until November 15, when Congress tried to override the President's veto of the bill. Then Renzi changed his vote and voted against teacher training in rural Arizona and nursing programs at two junior colleges in his rural district. Why? Renzi won't say, but since the vote to override the President's veto failed by just two votes, Renzi could have made the difference in funding education if he continued supporting the bill, instead of caving in to a President who wants to cut education at every level.

Unauthorized immigrants not a burden on U.S. health system, study finds

A new study by the University of California School of Public Health found that unauthorized immigrants to the United States use health care services less than the rest of our country, and use expensive emergency rooms at about the same rate as the rest of the population.

Good jobs in the U.S. declining

A report released this week finds that good jobs - jobs that pay at least $17 an hour and provide health insurance and a pension -- declined by 3.5 million between 2000 and 2006, according to the new report by the Center for Economic and Policy Research. Key to the decline was the erosion of employer-provided health insurance (down 3.1%) and employer-sponsored pension and retirement-savings plans (down 4.9%). The research defined a good job as one that pays $17 an hour, or $34,000 annually, has employer-provided health care and offers a pension. The $17 per hour figure is equal to the inflation-adjusted earnings of the typical male worker in 1979, the first year of data analyzed in the report. Over the 2000s, the share of women in good jobs declined 0.2 percentage points, undermining small gains made in the 1980s and 1990s. For men, the picture was worse, with a 4.4 percentage-point decline in the share of good jobs, compared to a 1.9 percentage-point decline in the 1990s and a 3.4 percentage-point drop in the 1980s. To read the full report, please visit: http://www.cepr.net/content/view/1352/8/

Sorry conservatives, but Arizona already has low taxes and is friendly to small business

A new report from the conservative-leaning Small Business & Entrepreneurship Council ranks Arizona as the 15th most friendly state to small business. Taxes were a big factor, and one in which Arizona did fairly well. However, showing that taxes are not the only factor contributing to a good business climate, SBEC also ranked states on crime and energy costs, areas where Arizona did not do so well (coming in dead last in crime if not for D.C. being included as a state). Arizona was ranked as having the 10th lowest gasoline tax in the country (since this pays for highways, perhaps this is why roads aren't keeping up with growth?), and the 3rd lowest worker's comp and unemployment insurance costs. Per capita state and local government spending is the 8th lowest in the country. So if I am reading this report right, if Arizona wants to improve its business climate, we do not need to focus much more on low taxes. We need to cut energy costs and cut crime, and that helps everyone living here, whether they own a business or not.
Read the full report here.

(And then there is that whole education thing, which this report did not even mention, but along with our low government spending, Education Week ranks Arizona 49th in the U.S. in per pupil funding of K-12 education)