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Last week I responded to an argument that we ought to open Medicare to all and let it compete with the private sector health insurance. One of my responses was that since the government gets to run Medicare and regulate private health insurance, it was a bit like letting a referee both officiate and play in a game.

You can get a good glimpse of this by looking at Medicare Part C, which was supposed to let private insurance companies offer health savings account-type policies to seniors (called medical savings accounts (MSAs) under Medicare). However, Part C was weighed down by so many regulations that virtually no private insurance plans bothered.

Apparently the Centers for Medicare and Medicaid Services (CMS) decided to revamp the application process. Under "Downloads" on the CMS website, there are nine different links for "useful information" and memos before you get to the applications.

The application for the MSA program puts a zip file on the desk top, and the resulting file has three word documents, a three page application, a thirty-eight page set of guidelines, and a twenty-two page initial contract application. "Initial"?

(God forbid if you download one the files for the applications for one of the other types of plans.)

This makes me wonder, who has the time to fill out these applications and go through the endless process of getting CMS to approve a plan? Probably only the big insurance companies, which means that the effect of these regulations is to limit competition. I wish I could believe that the end result was not intended, but after reading Tim Carney's book, I doubt it.

Oh, the new procedures came out on July 10th, and you had until August 10th to finish the applications.

topics:
Medicaid, Medicare