Spring is in the air, and apparently it is causing the internet to funnel a variety of stories on health insurance directly to me. By way of disclaimer, I have within the last few months been responsible for the purchasing of health insurance for our company. If you want to read more about healthcare and insurance considerations thereof, I strongly recommend bookmarking HealthyConcerns.
It began with this Associated Press article. A few minutes later I read this Reuters version of the same story. The bottom line is that more than one of every four moderate income Americans went without health insurance for at least part of last year. Not poor people, people with decent, living wage jobs. This morning, the nice folks at MoveOn.org sent me a note about how their ads on healthcare were working. You can watch the ads here. By the time an hour had passed, I’d seen this article from MSNBC about gambling on whether we really need health insurance, a couple of press releases stating that businesses are having a hard time getting affordable health insurance even though an overwhelming majority of voters want affordable health insurance, MarketWatch’s take on the over 40% of middle income Americans went without insurance story, and why the Massachusetts plan won’t work everywhere — assuming you beleive it will work in Massachusetts. And just for balance, we have doctors who have decided health insurance is not worth taking.
The system under which we pay for healthcare is seriously and utterly broken. And because that payment system is broken, real people are having a hard time getting healthcare, and a hard time paying the bills for their healthcare. Furthermore, this broken payment system costs so much money that it is adversely effecting job creation, automobile prices, bankruptcy rates, and almost certainly a half dozen other things which will ripple through our neighborhoods and our economy. It critically impacts our ability to respond to emergency situations such as natural disasters, terrorist attacks, or epidemics, let alone any theoretical future pandemic.
If FEMA is too broken to fix, what exactly is our excuse for letting the health insurance system remain as it is?
Lest I be accused of being yet another Democrat with no ideas, you can see my short list of proposals in the extended entry.
In Closing: Follow-up on Wolfowitz at the World Bank; the L. A. Times on Why Gas Prices Won’t Go Down; Wired on the impact of blogging on the English language; “Hey officer, nice shot!” My how times have changed! When I was in school I think I knew one kid with a legitimate reason to have a pager, let alone a cell phone! Of course we weren’t doing an hour long commute on the subway either. NYC parents upset that schools are enforcing the rules on cell phones. And finally, a war within Feminism rages: be sure to read the article she is ripping on, linked in the first paragraph. If I may summarize: Point A, “Oh come on, Feminism aside, use some common sense and stay out of dangerous situations! Just because you’re liberated doesn’t mean you’re invincible!” Point B, “Isn’t that a gussied up version of ‘she was askin fer it’? A crime was still committed, and not by the victim.” Common sense aside, don’t all of us have the right to go someplace without being assaulted? Don’t get me wrong, everyone needs to exercise care when out and about, but being someplace shouldn’t be an excuse to commit a crime against anybody.
Some things we can do to fix the system
Mix and match from this smorgasbord of possibilities:
1. Make insurance companies work as mutuals or not-for-profit companies in order to provide health insurance.
2. Encourage the existence of major medical policies. Not everybody needs common cold insurance; everybody needs hit by a truck insurance.
3. Remove barriers to individuals purchasing their own health insurance, including additional paperwork, higher fees, requiring proof of existing insurance, and “pre-existing conditions” rules. Not only does this eliminate a middleman, it reduces prices by allowing individuals to seek lower rates.
4. Require insurance companies to treat all insureds in a given geographical area (such as zip code or county) as a group for rate setting purposes.
5. Change the IRS rules to allow anybody to deduct their health insurance and healthcare costs.
6. More doctors “opting out” of the system, thus removing the dysfunctional middlemen.
7. More states following Michigan’s lead and requiring hospitals to be non-profits.
And if all else fails…
8. Universal single payer healthcare. Basic coverage for everybody, plenty of room to make money in the supplemental insurance business.
Forgive me if the allusion is painfully obvious, but does the blog title come from the quip
“Better to have loved a short woman than never to have loved a tall”?
“Remove barriers to individuals purchasing their own health insurance, . . . and “pre-existing conditions” rules. Not only does this eliminate a middleman, it reduces prices by allowing individuals to seek lower rates.”
Actually, when one removes the ability for a carrier to restrict or exclude coverage for pre-ex the prices actually increase.
“Require insurance companies to treat all insureds in a given geographical area (such as zip code or county) as a group for rate setting purposes”
This is another issue that increases rates overall. The young, healthy people opt out and what the carrier is left with is a group of mostly older, sicker individuals. Eventually claims in this disproportionate group will push premiums to the point of being less affordable than you would find absent the community rating mandate. A handful of states require community rating and their premiums are 2x – 3x higher than in neighboring states that do allow rating by age & condition.
“Basic coverage for everybody” seems to contradict “Not everybody needs common cold insurance; everybody needs hit by a truck insurance”
Bob:
Thank you so much for your well-thought-out comments. I assume from your url that you have stats to back up your thoughts on pre-ex conditions and community ratings driving premiums up?
Forgive me for not being clearer about “basic coverage for everyone.” By this I do indeed mean “hit by a truck insurance” and coverage for catastrophic/chronic health problems.
Hi This site is great