Research group health insurance
What should President-elect Joe Biden and Vice President-elect Kamala Harris do immediately after the inauguration in January?
Both should meet with the director and chief actuary of the Centers for Medicare and Medicaid Services. The president should instruct the chief actuary to offer contracts to independent consulting actuaries and, if possible, government actuaries in four Anglophone countries — Canada, the UK, Australia and New Zealand.
Purpose? To commission robust and uninhibited studies of America’s unique group health insurance — its nature, its meaning and its extraordinary consequences. Those extra-U.S. contractors will need knowledgeable and disinterested American liaisons to brief them on the backdrop of America’s actuarial schemes used to satisfy mostly obscure political ends.
Contractors ought to be strongly encouraged to partner with economists and others with big-picture credibility to nail down what the sequence of America’s actuarial schemes-group health, Medicare / Medicaid and SCHIPS- actually means. Have them get experts on excise taxes and internal tariffs and others as needed.
If you have a contractor team member calling the chief actuary asking, “What have you people been doing with these crackpot actuarial health care schemes?”, put that team member’s study as the opinion leader in the sheaf of other studies the chief actuary gathers.
Those extra-U.S. contractors will have to work fast, thoroughly and in complete secrecy.
Why commission studies from outside the U.S.? America’s journalists don’t have editorial latitude and even those able to work on spec lack the technical background to sort through the issues. The relevant academic literature is a disgrace — too compromised at multiple levels, massively inept and just plain wrong. Popular opinion is completely puppetized.
After the chief actuary reports to President Biden, the president should urge House Speaker Nancy Pelosi and Senate Majority Leader Mitch McConnell to recruit a joint House-Senate select committee on health care investigation. The iron rule for selecting committee members and their scope of inquiry ought to be no toe-rags, no whitewash. The committee ought to enjoy wide-ranging powers of inquiry, subpoena and referral of individuals and organizations for prosecution with maximum force.
After the committee wraps up its work, what then, Mr. President? It’ll be up to you, President Biden, to do the right thing.