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Obamacare death spiral is already happening in states like New York and Washington

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Amy H. tweeted this this article from Reason, which talks about what happened to private health insurance in states that already implemented Obamacare-like policies.

Excerpt:

Delaying the individual mandate might seem like an obvious response to the ongoing failure of the federal exchange system. But it’s a rather drastic step. And, in isolation, a potentially problematic one.

That’s because the premiums that health insurers calculated for the exchanges this year were determined based on the assumption that the penalty for remaining uninsured would be in effect, and would encourage people to buy into the market.

If you change the enrollment requirements—by, for example, ditching the mandate—while leaving the law’s preexisting condition rules in place, health plan participation will likely be lower. The result, as one insurance official told NPR yesterday, is that insurers will want to change their premiums. And in this case, “change” means “raise.”

That’s where the real trouble starts. Insurers raising prices as a result of lower than anticipated enrollment is an early step toward an insurance death spiral, in which premiums spike and enrollment figures drop until the only participants who remain in the market are very people paying very high premiums. We know because we’ve seen it before—in New York, Washington, and handful of other states that enacted preexisting condition regulations similar to Obamacare’s but without an individual mandate.

New York state’s guaranteed issue and community rating rules—the two regulations that limit how insurers can charge based on health history and require them to sell policies to all comers—took effect in 1994. At the time, there were about 752,000 policyholders in the state’s individual market, or about 4.7 percent of the non-Medicare population. But by 2009, according to a Manhattan Institute report by Stephen Parente and Tarren Bragdon, the state’s individual market had practically disappeared, leaving just 34,000 participants, or about 0.2 percent of the non-elderly population. Individual insurance premiums, meanwhile, were among the highest in the nation—about $388 on average in 2007, compared with just $151 in California, another big Democratic-leaning state. In New York City, the annualized premium cost for individuals was more than $9,300 and more than $26,400 for a family.

The result, in other words, was a combination of sky-high premiums and far fewer insured individuals.

Around the same time that New York was overhauling its insurance market, Washington state was implementing a similar set of health plan rules. Insurers faced new regulations regarding plans sold to individuals with preexisting conditions, and the requirement that they sell to everyone. For a brief period, there was a coverage mandate, but that never went into effect. The state’s individual market deteriorated. One insurer raised premiums by 78 percent in a three year period. As premiums rose, relatively healthier people left the market, and insurers were left covering a lot of very sick, very expensive individuals. In the end, many insurers simply dropped out of the market rather than lose money. According to a report on the reforms commissioned by the insurance industry, there were 19 carriers in the individual market in 1993. By 1999, there were just two—and they weren’t taking new applicants.

The individual market was effectively killed off by the reforms.

Why do these policies of “community rating” and “guaranteed issue” cause the death spiral?

Investors Business Daily has a look at the chain of causation.

Excerpt:

For years, ObamaCare critics focused on its least popular feature — the mandate that everyone buy insurance — taking their fight all the way to the Supreme Court.

But as ObamaCare’s official launch date approaches, even its backers are beginning to admit that the law could actually create powerful incentives for millions of people and thousands of businesses to drop their coverage, despite the mandate.

There is growing concern, for example, that the law’s market reforms will cause a huge “rate shock,” particularly for those young and healthy.

A February survey of major health insurance companies in five cities across the country found that they expect premiums for this group to climb an average 169%.

The cause of this rate shock is simple: ObamaCare imposes what is called “community rating” on insurance companies, effectively forcing them to charge the young and healthy more so they can charge older and sicker consumers less.

The five-city survey, for example, found that while the law will jack up rates for the young, it will lower them an average 22% for older and sicker customers.

At the same time, ObamaCare also forbids insurance companies from turning anyone down — a reform called “guaranteed issue” — which also will provide an incentive for some to drop coverage, knowing they can get it back any time.

“Even with the tax penalty … some healthy people would avoid purchasing coverage until they are sick,” Howard Shapiro, director of public policy at the Alliance of Community Health Plans, told regulators .

The problem is that if the young and healthy drop coverage, the result would be what the industry calls a “death spiral.” Premiums will climb as the pool of insured gets sicker, causing still more to cancel their policies.

This is just what happened in states that imposed strict community rating and guaranteed issue reforms in the past. In fact, of the eight states that did so, most ended up either dropping the reforms or loosening the rules after they saw enrollment decline and premiums climb.

It’s very important to understand that what Obama did with his health care plan will not cause premiums to go down. On the contrary, they have gone up and they will go up.

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Study: abortion more than doubles the risk of child abuse

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Here’s a report from Life News about a new study out of Bowling Green State University.

Excerpt:

For decades, evidence has existed showing abortion contributes to a rise in child abuse. Now a new study by a post-abortion research institute and Bowling Green State University professors finds that women who have abortions are more likely to abuse their children.

Published in the medical journal Acta Paediatrica, the study found that women who have had abortions are 2.4 times more likely to physically abuse their children. Pro-life advocates say it proves the need for providing women with post-abortion counseling to help deal with the emotional trauma of the abortion.

Led by Priscilla Coleman, a professor at Bowling Green, researchers looked at data taken from a survey of 518 low-income women in Baltimore who were receiving Aid to Families with Dependent Children and who had at least one child aged 12 years or younger.

The data compared rates of child abuse and neglect among women who had experienced either an involuntary (miscarriage or stillbirth) or voluntary (induced abortion) pregnancy loss.

Women who had a miscarriage or stillbirth were more likely to physically abuse their children as well, but the increase was much less significant than for women who had abortions.

The authors suggested that “emotional difficulties and unresolved grief responses” from pregnancy loss, whether voluntary or involuntary, could have a negative impact on women’s mental health and lead to unhealthy parenting responses.

According to the Illinois-based Elliot Institute, which released information about the study’s findings, prior surveys “have linked pregnancy loss to an increase in grief reactions, anxiety, depression, sleep disturbances, and symptoms of post-traumatic stress disorder, all of which can have a negative impact on parent/child relationships.”

The post-abortion research group also points to a 2002 study published in the Journal of Child Psychiatry and Psychology that found abortion has been linked to an increase in substance abuse and thoughts of suicide, which could also contribute to child abuse.

The new study also found that women who had more than one miscarriage or stillbirth were more likely to engage in child abuse than women who had just one. However, women who had abortions were more likely to abuse their children whether they had one or more than one abortion.

“Regardless of the specific mechanisms at play, maternal history of one induced abortion does appear to be a marker for increased risk of physical abuse,” the authors concluded.

In legalizing abortion, we have changed the way that adults view sex and the way adults view children. Instead of thinking that sex is something that is reserved for marriage, we now think that it is OK for women to have sex for fun with men who have no intention and no capability to take on the traditional male roles of protector, provider and moral/spiritual leader. And when those irresponsible choices produce other human beings, we have taught ourselves that murder is a morally permissible option. What does it mean? It means that children have no rights. It means that we can kill things we create if they annoy us. And that attitude spills over from unborn children to born children. It is going to result in more child abuse, when more people accept these views about what sex is supposed to be for, and what our obligations are to children.

But this is not the only study that shows the harm that abortion does.

Life News reports on the latest studies confirming the link between abortion and breast cancer.

Excerpt:

A newly-published study shows the highest-ever abortion-breast cancer risk for women of any previously-published study on the link between the two.

A Bangladesh study published in the Journal of Dhaka Medical College on risk factors for breast cancer, led by Dr. Suraiya Jabeen, found a statistically significant 20.62-fold increased risk among women with abortion histories. The new study on the abortion-breast cancer link is by far the highest risk elevation reported among 73 published abortion-breast cancer studies.

Physical inactivity, being menopause, positive family history of breast cancer and history of induced abortion were found important risk factors,” the authors wrote.

Professor Joel Brind, a professor at Baruch College, City University of New York who is an expert on the abortion-breast cancer link, said the reason why the risk elevation is so high is because it’s “a measure of relative risk.”

Observing that women in Bangladesh have very traditional childbearing patterns that reduce breast cancer risk, he explained: “Almost all the women are married (97% currently married; the rest widowed) and with child by the time they are 20, and all of the kids are breastfed. Ninety percent had their first child at age 21 or younger (99% of controls did). They typically neither take contraceptive steroids nor have any abortions. Nulliparity (childlessness) or abortion before first full term pregnancy (both of which mean no breastfeeding) in a population in which breast cancer is almost unheard of, makes the relative risk very high.”

Brind continued: “Although the authors did not include a measure of their abortion link’s statistical significance, their raw data was complete enough to calculate a 95% confidence interval of 12.85-32.51, making abortion by far the strongest and most significant risk factor observed in these Bengali women. In plain English, women in this population who had any induced abortions were more than 20 times as likely to get breast cancer, compared to women with no abortions.”

According to the study, additional minor reproductive factors influencing breast cancer risk included: use of oral contraceptives (1.47-fold increased risk); early first birth at or before age 21 (0.35-fold reduced risk); having two or more children (0.29-fold reduced risk); and increased number of months spent breastfeeding (0.30-fold reduced risk).

But that’s not all.

Life News reports.

Excerpt:

A study in the Asian Pacific Journal of Cancer Prevention shows abortion increases the risk of breast cancer for women.

C. Yanhua of the First Peoples’ Hospital of Kunming in Yunnan province and his colleagues found the abortion-breast cancer association after comparing data from 263 cases of breast cancer and 457 controls without the disease. Their analysis covers the years 2009-2011.

The authors examined information on disease diagnosis, demographics, medical history, and reproductive characteristics of the patients involved and also looked at short menstrual cycle, old age at first live birth, never breastfeeding, history of oral contraceptive use, postmenopausal status and nulliparity to determine in abortion-breast cancer link exists.

They write that “multivariate model analysis revealed the significant independent positive associations with breast cancer of shorter menstrual cycle, older age at first live birth, never breastfeeding, history of oral contraception experience, increased number of abortion, menopause status, and nulliparities.”

“Number of abortion showed an increasing higher risk of breast cancer,” they added, while saying that women who had one live birth lowered their risk. “As far as women who had once a live birth, it showed decreased the risk of breast cancer compared to nulliparous.”

“This study showed an increased risk of breast cancer with times of abortion. The association between abortion and risk of breast cancer in a study in China showed that the risk factors of female breast cancer included abortion times more than two (Li et al., 2006),” they continued. “Another study found that risk was raised among women reporting at least one abortion, but no trend was seen with number of abortions (Heuch et al., 2008). In a meta-analysis study, pooled odds ratio for number of abortions greater than and equal three was statistically significant (95%CI:1.68-5.36) (Tao et al.,2011).”

“In conclusion, in this study the estrogen related risk factors of breast cancer included woman who had longer menstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions more than one. Therefore, it is recommended to women with these risk factors perform breast cancer screening tests earlier and regularly,” they said.

Previously, another study was published in Oxford University’s European Journal of Public Health, and the abstract is posted on PubMed.

Here are the results:

With statistical controls for number of pregnancies, birth year and age at last pregnancy, the combination of induced abortion(s) and natural loss(es) was associated with more than three times higher mortality rate than only birth(s). Moderate risks were identified with only induced abortion, only natural loss and having experienced all outcomes compared with only birth(s). Risk of death was more than six times greater among women who had never been pregnant compared with those who only had birth(s). Increased risks of death were 45%, 114% and 191% for 1, 2 and 3 abortions, respectively, compared with no abortions after controlling for other reproductive outcomes and last pregnancy age. Increased risks of death were equal to 44%, 86% and 150% for 1, 2 and 3 natural losses, respectively, compared with none after including statistical controls. Finally, decreased mortality risks were observed for women who had experienced two and three or more births compared with no births.

Life Site News adds more:

A single induced abortion increases the risk of maternal death by 45 percent compared to women with no history of abortion, according to a new study of all women of reproductive age in Denmark over a 25 year period.

The study found that each additional abortion is associated with an even higher death rate. Women who had two abortions were 114 percent more likely to die during the period examined, and women had three or more abortions had a 192 percent increased risk of death.

Elevated rates of death were also observed among women who experienced miscarriages, ectopic pregnancies or other natural losses. Among women with a history of multiple pregnancies, women with a history of both abortions and natural losses, but no live births, had the highest mortality rate.

Women who had never been pregnant had the highest mortality rate overall.

However, women with a history of successful deliveries were the least likely to die during the 25 years examined.

The study is the second record linkage analysis of Danish mortality data to be published this month.

The earlier study was limited to comparing mortality rates following only the first pregnancy outcome. It found that abortion of a first pregnancy was associated with a higher rate of death compared to death rates among women who delivered a first pregnancy. The higher death rate among women who had abortions persisted for each of the first ten years following the first pregnancy outcome.

[…]Dr. Reardon is the director of the Elliot Institute, which funds research related to abortion. He believes further research is needed to explore how the outcomes observed in this latest study may be influenced by abortion’s impact on natural pregnancy losses. A new population study from Finland, for example, has found that abortion is associated with higher rates of preterm delivery, low birth weight delivery, and perinatal deaths in subsequent pregnancies.

And another from Life News.

Excerpt:

A new study published in the Asian Pacific Journal of Cancer Prevention in February reported a very statistically significant increased risk of breast cancer for women with previous abortions as opposed to women who have never had one.

The study, consisting of 1,351 women and led by researcher Ai-Ren Jiang, reported a statistically significant 1.52-fold elevation in risk for women with induced abortions and a “significant dose-response relationship between (the risk) for breast cancer and number of induced abortions,” meaning the risk climbed with a higher number of previous abortions.

For premenopausal women who have had abortions, the numbers were relatively small, and the observed 16% risk elevation was not statistically significant. However, for those with three or more abortions, the risk climbed to a statistically significant 1.55-fold elevation.

“The results have revealed that induced abortion was related to increased risk of breast caner. Premenopausal women who had ≥3 times of induced abortion were at increased crude odds ratio (OR) (2.41, 95%CI: 1.09-5.42) and adjusted-OR (1.55, 95%CI: 1.15-5.68),” they wrote. “Postmenopausal women with a previous induced abortion were at increased crude OR (2.04, 95%CI: 1.48-2.81) and adjusted-OR (1.82, 95%CI: 1.30-2.54), and there was a significant increase trend in OR with number of induced abortions (p for trend: 0.0001).”

[…][A] Chinese study in 1995 by L. Bu and colleagues, including Janet Daling of the Fred Hutchinson Cancer Research Center, reported a statistically significant 4.5-fold elevated risk among women with previous induced abortions who developed breast cancer at or before age 35, compared to older women (who experienced a statistically significant 2.5-fold elevated risk)

Here’s another study from the Journal of the American Medical Association (JAMA), showing that excessive consumption of alcohol is a rish factor for breast cancer.

Excerpt:

Consumption of 3 to 6 alcoholic drinks per week is associated with a small increase in the risk of breast cancer, and consumption in both earlier and later adult life is also associated with an increased risk, according to a study in the November 2 issue of JAMA.

“In many studies, higher consumption of alcohol has been associated with an increased risk of breast cancer. However, the effect of low levels of drinking as is common in the United States has not been well quantified,” according to background information in the article. “In addition, the role of drinking patterns (i.e., frequency of drinking and ‘binge’ drinking) and consumption at different times of adult life are not well understood.”

Wendy Y. Chen, M.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues examined the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption. The study included 105,986 women enrolled in the Nurses’ Health Study who were followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments. The primary outcome the researchers measured was the risk of developing invasive breast cancer.

During the follow-up period, there were 7,690 cases of invasive breast cancer diagnosed among the study participants. Analyses of data indicated that a low level of alcohol consumption (5.0 to 9.9 grams per day, equivalent to 3-6 glasses of wine per week) was modestly but statistically significantly associated with a 15 percent increased risk of breast cancer. In addition, women who consumed at least 30 grams of alcohol daily on average (at least 2 drinks per day) had a 51 percent increased risk of breast cancer compared with women who never consumed alcohol.

The researchers also found that when examined separately, alcohol consumption levels at ages 18 to 40 years and after age 40 years were both strongly associated with breast cancer risk. The association with drinking in early adult life still persisted even after controlling for alcohol intake after age 40 years.

Binge drinking, but not frequency of drinking, was also associated with breast cancer risk after controlling for cumulative alcohol intake.

Now let’s take a look at some other factors that raise the risk of breast cancer.

Abortion and breast cancer

Many studies show a link between abortion and breast cancer.

Study 1: (September 2010)

Based on the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2), breast cancer is classified into several subtypes: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2-overexpressing (ER-, PR-, and HER2+) and triple-negative (ER-, PR-, and HER2-). The aim of this case-control study is to determine reproductive factors associated with breast cancer subtypes in Chinese women. A total of 1,417 patients diagnosed with breast cancer in the First Affiliated Hospital, China Medical University, Shenyang, China between 2001 and 2009 and 1,587 matched controls without a prior breast cancer were enrolled.

[…]Postmenopause and spontaneous abortion were inversely associated with the risk of luminal tumors. By contrast, multiparity, family history of breast cancer and induced abortion increased the risk of breast cancer.

Study 2: (March 2010)

OBJECTIVE: To explore the risk factors of breast cancer for better control and prevention of the malignancy.

METHODS: The clinical data of 232 patients with pathologically established breast cancer were investigated in this 1:1 case-control study to identify the risk factors of breast cancer.

RESULTS: The history of benign breast diseases, family history of carcinoma andmultiple abortions were the statistically significant risk factors of breast cancer, while breast feeding was the protective factor.

CONCLUSION: A history of benign breast diseases, family history of carcinoma and multiple abortions are all risk factors of breast cancer.

But wait, there’s more.

Birth control pills

Many studies showed that taking birth control pills caused an increased risk of breast cancer.

Study 1: (March 2003)

RESULTS: Among the youngest age group (<35 years, n = 545), significant predictors of risk included African-American race (RR = 2.66: 95% CI 1.4-4.9) and recent use of oral contraceptives (RR = 2.26; 95% CI 1.4-3.6). Although these relationships were strongest for estrogen receptor-negative (ER-) tumors (RRs of 3.30 for race and 3.56 for recent oral contraceptive use), these associations were also apparent for young women with ER+ tumors. Delayed childbearing was a risk factor for ER+ tumors among the older premenopausal women (Ptrend < 0.01), but not for women <35 years in whom early childbearing was associated with an increased risk, reflecting a short-term increase in risk immediately following a birth.

Study 2: (October 2008)

Oral contraceptive use ≥1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (Pheterogeneity = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (Pheterogeneity = 0.02 and 0.01, respectively).

All of this research shows that abortion is bad for women, but I also should mention that abortion is always bad for the unborn child, especially sex-selection abortions, which target women more than men.

Conclusion

The total cost for breast cancer treatment, which raises medical insurance premiums (private health care) or taxes (single-payer health care), has been estimated to be between $1.8 billion and $3.8 billion dollars. In addition, the government spends billions of dollars each year on breast cancer research. All of this spending is costing taxpayers a lot of money, as people demand more and more government funding of breast cancer research and breast cancer treatment (with either private or single-payer health care).

Commentary

The meaning of marriage: a lecture at Google by Tim Keller

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Disclaimer: I have reservations about Tim Keller. I consider him to be too liberal for my tastes, especially on scientific (intelligent design) and political/economic issues. However, I think he did a good job explaining marriage in the lecture below.

Here’s the the video:

Details:

Timothy Keller visits Google’s New York, NY office to discuss his book “The Meaning of Marriage.” This event took place on November 14, 2011, as part of the Authors@Google series.

Timothy J. Keller is an American author, speaker, preacher, and the founding pastor of Redeemer Presbyterian Church in New York City. He is the author of several books, including “The Reason for God: Belief in an Age of Skepticism.”

“The Meaning of Marriage” touches on topics that all readers can relate to, starting with the role of marriage in our culture, its history and the pessimism that is often associated with it. The Kellers also discuss the feelings of and acts of love, romantic relationships, gender roles, singleness, and the role of sex in a marriage.

I saw a lot of things in his lecture that echo my own views. One point where we agree is on not just looking for traits and virtues in the other person, but in seeing how they handle conflict and solve problems with you.  You have to give the other person things to do and see if they make progress and work cooperatively with you. Wes, who linked me the lecture, introduced the link by saying that this is the way that Christians should explain marriage to non-Christians. I agree, and I’ve added the book to my cart.

Here’s an article entitled “You Never Marry the Right Person“, that discusses one of the points in the lecture.

Excerpt:

In generations past, there was far less talk about “compatibility” and finding the ideal soul-mate. Today we are looking for someone who accepts us as we are and fulfills our desires, and this creates an unrealistic set of expectations that frustrates both the searchers and the searched for.

[…]The Bible explains why the quest for compatibility seems to be so impossible. As a pastor I have spoken to thousands of couples, some working on marriage-seeking, some working on marriage-sustaining and some working on marriage-saving. I’ve heard them say over and over, “Love shouldn’t be this hard, it should come naturally.” In response I always say something like: “Why believe that? Would someone who wants to play professional baseball say, ‘It shouldn’t be so hard to hit a fastball’? Would someone who wants to write the greatest American novel of her generation say, ‘It shouldn’t be hard to create believable characters and compelling narrative’?” The understandable retort is: “But this is not baseball or literature. This is love. Love should just come naturally if two people are compatible, if they are truly soul-mates. “

The Christian answer to this is that no two people are compatible. Duke University Ethics professor Stanley Hauerwas has famously made this point:

Destructive to marriage is the self-fulfillment ethic that assumes marriage and the family are primarily institutions of personal fulfillment, necessary for us to become “whole” and happy. The assumption is that there is someone just right for us to marry and that if we look closely enough we will find the right person. This moral assumption overlooks a crucial aspect to marriage. It fails to appreciate the fact that we always marry the wrong person.We never know whom we marry; we just think we do. Or even if we first marry the right person, just give it a while and he or she will change. For marriage, being [the enormous thing it is] means we are not the same person after we have entered it. The primary challenge of marriage is learning how to love and care for the stranger to whom you find yourself married.

Hauerwas gives us the first reason that no two people are compatible for marriage, namely, that marriage profoundly changes us. But there is another reason. Any two people who enter into marriage are spiritually broken by sin, which among other things means to be self-centered—living lifeincurvatus in se. As author Denis de Rougemont said, “Why should neurotic, selfish, immature people suddenly become angels when they fall in love … ?” That is why a good marriage is more painfully hard to achieve than athletic or artistic prowess. Raw, natural talent does not enable you to play baseball as a pro or write great literature without enduring discipline and enormous work. Why would it be easy to live lovingly and well with another human being in light of what is profoundly wrong within our human nature? Indeed, many people who have mastered athletics and art have failed miserably at marriage. So the biblical doctrine of sin explains why marriage—more than anything else that is good and important in this fallen world—is so painful and hard.

When you are courting, don’t worry about appearances and feelings and passion so much, because that is all subject to change over time, and those things won’t help you with the real challenges you’ll face in a marriage. Worry about whether they are the kind of person who can make commitments and love other people self-sacrificially – even if they are unlovable. In the long run, their ability to read and understand issues, to care for others and serve them, to keep promises, to be respectful and supportive, to argue respectfully and reasonably, and to solve problems constructively, will all be far more important than appearances and feelings and passion.

And let me be clear again: give them things to do that challenge them during the courtship and see how they handle being given responsibilities – giving a person hard things to do is a much better way to test a person than recreational nights out with recreational drinking, recreational dancing and recreational sex. Marriage means commitment and hard work, not recreation. And that’s what you should test for – the ability to work hard at the relationship and to keep promises and commitments and to communicate reasonably and to work through difficulties fairly.

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