Late Saturday night, the United States House of Representatives passed landmark health care legislation by a vote of 220-215. Over the next few days, we'll be taking a look at what's in the bill and what it means for you. Rather than tackle everything at once, I thought I would focus on one part per day (and perhaps the strands that trail out from that) and discuss it.
Many of you have asked me why I support a bill like this even though there are items in it that I would not find agreeable. For the first couple of days, I'm going to talk why I supported this bill singling out those specific points which I think have merit. The first one is the ejection from the capsule of pre-existing conditions. Thank God.
Under this new bill, a person can't be denied coverage because of a pre-existing condition. Not only do I support this from the point of view of a human being but it also makes sound financial sense. If someone is denied coverage but ends up in the ER or in ICU, the rest of us will still end up paying for it through higher premiums. Without this regulation in place, less and less people will be able to afford health care because insurance companies will simply raise their rates. Has anyone ever seen them go down?
Of course, the argument could be made that we could just let these people die but I think we are a better country than that. Somehow, their care is going to have to be paid for and whether it's through the government or private insurance, we will be the ones to pay. The insurance industry has shown that it has done a poor job regulating itself. Even with their higher premiums, they still needed to be bailed out by Uncle Sam (AIG etc) and then used that money for lavish vacation retreats (see: US plutonomy).
The government certainly isn't the perfect mechanism for this but what is the alternative?
4 comments:
M, the first thing you need to grasp is the difference between health insurance and health care. Affordability in one does not automatically make the other one affordable.
So, effectively, someone could present with symptoms at an ER, discover they have cancer, leave the ER, ring Blue Cross and demand they cover him. That seems reasonable. Not.
You're supposed to buy insurance BEFORE you need it.
Mark... it only took me knowing one detail of this bill for me to fully understand what the rest of it contained. The moment I read that it would require any restaurant chain of more than 20 outlets to list the nutritional values of all their dishes on the menu... I knew that this bill had nothing to do with health care and everything to do with control. The items of health care it does address are also about control over how people seek out their health care and from who.
We live in a capitalistic society in which the one with the lowest cost often wins... even if it is of lesser quality. What do you think a Government ran health Care Option is going to do? It tilts the favor of the Government plan and away from those businesses already doing the job.
I would never stand here and say that our current insurers are doing their very best... I think they could do a whole lot better. But then they have had to contend with one government intrusion after another that dictates how and to who they must offer coverage. Who knows what they might have been able to do on their own without government interferance. The only thing a government option does in regress our country further into an economic downward spiral... regardless of how good it might be for some people.
A significant problem with the discussion of health care reform is the simple lack of understanding of what insurance companies do. They are not in the business of providing healthcare, no more than my auto insurer is in the business of paying for all my oil changes (as has been said on this blog before). Insurance companies are in the money management business. They manage pools of money fed by contributions, called premiums, from their customers and make that money available under pre-defined conditions. While I am on record as saying I want pre-existing conditions covered,I for one understand why they do it. What they are doing is simply denying access to the accumulated pool of money to those who have not contributed to the pool. All those who have contributed to the pool by responsibly having coverage previously should applaud their insurance companies for prudent exercise of their fiduciary responsibility.
Since I’m not one of those who show up here only to toss accusations of racism around, hurl juvenile insults around, and only talk about "the right", I’m going to propose some solutions. If you don’t put forward your own ideas, can only go into diatribes about how the current system is screwed up and can only talk about "the other side" – nut up or shut up. When you are last in line at the gang bang, it gives you more time to think.
If I switch banks or stockbrokers, it's easy to transfer the funds from one account to the other. Last in lines proposed solution #1 - Why can't we have similar mechanism for the money we have contributed to health insurance pools?
Insurance companies are going to be forced to cover preexisting conditions if any of these bills are signed into law but the resulting product will not be insurance. You cannot insure against something that has already happened. It will merely become a bill-paying mechanism...which is what I have always thought a lot of the bills supporters want – someone else to pay their medical bills.
Since pre-existing conditions aren’t going to go away, we have Last in lines proposed solution #2 – offer insurance against uninsurability. A truly effective insurance policy would combine coverage for this year's expenses with the option to buy insurance in the future at a set price. Employer-based coverage (which plenty of folks on here agree is a problem) covers this years expenses but not next years expenses. A guaranteed renewable individual insurance policy could be the simplest way to deliver coverage for now and future years. Once you sign up, you can keep insurance for life and your premiums do not rise if you get sicker. UnitedHealth already lets you buy the right to future insurance - insurance against developing a pre-existing condition. Sure some refining will be necessary but we can have insurance policies that could separate current insurance and the right to buy future insurance. Then, if you are temporarily covered by an employer, you could keep the pre-existing-condition protection. If it was emplyer based, your current company could pay out a lump sum so that a new insurer will take you with no change in your premiums. If you got sick but had something like a health-savings account to help pay for premiums, you could always get new insurance. Since I’m a free market guy, I think innovations like these would catch on quickly in a vibrant, deregulated insurance market that is centered around the individual, not the employer. Just throwing things out there.
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