Jonathan Cohn at The New Republic wonders how many lives the Public Option has in the health reform debate. Hopefully, at least one more.
Will health insurance reform without a public option be a good deal? With the elimination of requirements to prove insurability, the exclusion of coverage for pre-existing conditions, and elimination of annual and lifetime limits on health coverage, consumers would seem to win. But if that comes at the cost of a mandate to buy health coverage, if the carriers that sell coverage continue to enjoy the McCarran-Ferguson exemption from federal antitrust laws, and if fewer carriers compete in the marketplace, I’m betting health insurance costs will soar without a cost-competitive public option. Between 1987 and 1999, the number of health insurance carriers in the U. S. dropped 34.7 percent according to the National Association of Insurance Commissioners. I predict this trend will only continue as more health insurers exit the business as the regulatory climate changes, making it difficult for the small group and individual health insurers to earn big profits by denying coverage, rescinding policies, and enforcing pre-existing condition limitations. Without a strong public option, consumers will likely have fewer choices and even higher costs.
Posts
2 comments:
Ralph,
I just finished reading your blog. Interesting information and thoughts.
For some time I've thought that insurance pools would be a good thing. Large state-wide or multi-state pools in the case of states with smaller target populations, like large companies, could negotiate better deals for their pool members, such as elimination of pre-existing condition. But that in itself is complicated.
I read some interesting information on pools at: http://www.chcf.org/topics/healthinsurance
/index.cfm?itemID=117082
It gives good insights on the difficulties in forming a pool and why the federal government should play a necessary role.
Additional federal regulation and oversight on insurance, pharmaceutical, and durable medical supply companies will be necessary.
Insurance and Medicare fraud must be addressed.
Tort law also needs an overhaul.
At the very least, this is a complicated subject, and all of the things I mentioned above will require government involvement.
Steve H.
Thanks for reading, and for the link you provide. The article points out the difficulty of building risk pools that avoid adverse selection. If we were all covered by a single-payer health plan, our risk pool would be an average risk pool by definition. We'd also save billions of dollars we spend sending claims to thousands of health plans, having providers deal with thousands of health plan phone numbers for coverage questions and utilization review authorizations, coordinating benefits between multiple plans, enrolling and dis-enrolling members, verifying kids are full-time college students, and therefore eligible to be covered by a parent's plan. But I don't sense any public support for a single-payer plan today.
Post a Comment