Writings and observations

Probably doesn’t feel that way right now to the Boise advocates – Mayor David Bieter among them – of a downtown streetcar, but in denying federal money to the city for that project, the feds may have done those advocates a big favor.

This marks the opportunity, which maybe some of them have been quietly hoping for, to back off.

No doubt Bieter was very serious about creating such a project; it would much change the look and feel of Boise’s downtown, and some positives likely would have come of it. But the questions about how and why it would work, and whether it was the right priority for the area, were almost overwhelming. We’ve been struck by the number of Boiseans who have been long-time passionate supporters of mass transit who could not see their way to supporting this one, even if most of the money for it was federal. Polling suggests that Boiseans overall are highly skeptical.

Streetcars are not necessarily a bad idea. Portland has a good streetcar system (linked to its light rail and bus operations), and picked up $23.2 million today for its program. Tucson and Dallas got money for streetcars too.

And for now at least, Boise city officials indicated they won’t be giving up.

But they may be well advised to see today’s decision as an opportunity to take a pause, step back, and rethink.

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Idaho Oregon

Here is what health insurers would have you believe: That the free market works best when when the sellers of a product get to withhold virtually all information about it, and the consumer are best served by being left in the dark.

The Oregon Insurance Division has “finalized changes to its health insurance rate review process that make all information submitted as part of an insurance company’s rate request open to the public.” (Note that this applies only to some individual, small business and portability plans; most health insurance in Oregon is not regulated by the state at all.) The rule changes follow up on 2009 state legislation.

You might wonder that this information hasn’t been public all along. You might wonder how Oregonians could possibly assess the work of its insurance division when much of the information submitted by insurers is sealed away from public view.

There’s no wondering on the part of the insurers: They are furious at the new rules, and are threatening everything from lawsuits to pulling out of the state in response.

The Lund Report, a fine Oregon health care blog, reported:

Oregon’s five largest health insurers along with the national trade group, America’s Health Insurance Plans, argued in comments to the Division that the new rules would expose trade secrets, harm competition and increase rates.

Several implied they might sue. A representative for LifeWise called the rules unconstitutional, but none put it quite as succinctly as Theresa Neibert, manager of regulatory advocacy and consulting for Kaiser. “These new rules will invite instability, confusion, uneven treatment of carriers and litigation,” Neibert wrote. “This may embroil the division in costly litigation.”

The Insurance Division basically called their bluff.

Lund also notes that in theory, “Rate filings were made public starting in 2006, but consumer advocates who’ve tried to challenge premium increases since then have faced difficulties because insurers were allowed to redact key information. A case against a 26 percent increase on Regence individual health plans in 2008 is still ongoing.”

You have to know that something dark is going on when the fight to keep information – that affects our health and even lives – under wraps is this ferocious.

Kraig E. Anderson, vice president of underwriting and actuarial, ODS Companies (odious?): “We believe that larger competitors, with greater capital resources, could price their products in such a way to gain market advantage. This type of predatory pricing could lead to higher rate increases for consumers, or a situation where it is necessary for ODS to leave the market.”

Ah yes, the great threat to leave the market, should the public ask for basic information about what it is that requires insurers to pump up their premiums so massively every few months, kicking people by the millions off of health coverage and running our country fast over the cliff into bankruptcy.

Sounds from here like the insurers are making an airtight argument for a public option.

At a time when so much fear is mongered about a public health insurance option, what realistic defense of our current health insurers is even possible? There’s only one realistic answer: Health insurers have money, tons and tons of money. And money talks.

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Oregon