Posted on 12/10/2009 6:42:26 AM PST by JimPrevor
As a small-business owner, I’ve been selecting group health-insurance plans for a quarter century and living, day to day, with the actual impact such choices have had on my company and employees. In observing this process, I’ve come to the conclusion that two simple changes would both significantly increase access to health insurance and make it more affordable: Require insurance companies to offer their group plans to all companies, and require health-care providers to charge all patients the same rates.
(Excerpt) Read more at healthcare.nationalreview.com ...
More mandates. All this will do is raise premiums for everyone. Instead, we should follow the proposals set out by the CEO of Whole Foods. This will introduce low-cost insurance plans which will help more people.
“...require health-care providers to charge all patients the same rates.”
SO...we might then conclude that you, as a small business owner, charge ALL your customers the same rate for goods and services? I don’t think so.
Allow freedom to choose an insurance company across state lines.
Charge all companies and individuals the **same** rates.
The key there is the use of high deductible plans and health savings account to control costs. The US Department of Health and Human Services, Centers for Medicare and Medicaid Services, projected 2009 national government health expenditures of $3866 per capita. The 2009 Federal Benefits Handbook lists a high deductible health insurance plan for $3216 per year that includes 100% coverage for preventive medical, vision and dental care services, immunizations, as well as prescription benefits. In other words, the government could buy that plan for every single person and actually save $200 Billion per year! Everyone would have coverage and health care costs would go down.
If universal coverage and cost savings were the real goal, why wouldn't something like that be even considered? The problem is that the real goal of the bill being rammed through is government control.
Here's one problem: people like me. Several members of the family in these economic times don't have group health insurance - and it would be very easy for me to start a small business, add them as employees and give access to decent health insurance. A less ethical person might even wait until a medical crisis has happened...
Might not cause an unintended consequence - but should be considered.
If you’re talking about catastrophic health insurance, that’d be something nice to see on the market again. But anything that pays for minor cuts treated in the emergency room and doctor’s visits will result in continued increases with no end.
You don’t buy car insurance that covers your tires and oil changes. You’d have to pay a heck of a lot extra for insurance that does cover engine failure, whereas it is relatively cheap to buy insurance to cover your car hitting hitting another.
End drug prescription benefits, end doctor coverage, end basic emergency room benefits, and you’ll see the price of actual insurance fall. As a side benefit, car insurance rates and property insurance rates will fall as well, as exposure for costs minimizes as people will have their own health accident insurance to cover the medical costs.
Well, as a part owner of a small business, I can say we "do" charge all our customers the same rate for goods and services. And AFAIK, all our suppliers do the same. Of course, there "are" discounts for quantity purchases, but any customer is eligible for them.
Both of your proposed solutions are flawed.
First, health insurance for individuals should NOT depend on employment. The tax exemption for employer-paid health insurance should be terminated, and replaced by a “first dollar” exemption for individuals, without any deductible and in addition to the standard exemption. This should apply to 100% of insurance premiums, and to MSA allocations, but perhaps with a cap on this part. Also, individuals should be allowed to purchase such coverage through membership in associations of their own choosing, including religious, civic, community, and social groups.
Second, although every person must have access to insurance coverage - at any age, state of health, risk exposure, or present coverage - EACH of these conditions should be considered in setting the premium for INITIATING coverage. This is the way that Medicare “D” works - Once eligible, I MUST maintain “qualified” coverage, or I will pay a higher premium when I renew during the next enrollment period.
However, IF I have qualified coverage, I can change to a similar plan with a different insurance company during the annual enrollment period, at the same rating level. In other words, no denial of coverage or “pre-existing condition” rating. But note that if in the past I had a coverage lapse of 1 or more years, each uncovered year would increase my rating. And because age is a risk factor, I see no problem with premiums based on age - unless the initial contract specified “flat rate” AND continuous coverage was maintained.
The continuous coverage should begin at 18, OR at emancipation if the young person were covered until then by insurance provided by a parent or guardian.
For hardship circumstances, the insurance companies could provide an assigned risk pool for basic coverage, perhaps with support from government funding.
As far as people setting up phony companies I have two thoughts: First, under the contracts today, which would not be changed by this proposal, companies can only insure genuine employees. The insurance companies have the right to audit payroll records, etc. to make sure only employees are covered. So although people could set up companies for this purpose if they really are totally phony, they have pretty significant difficulties and expenses such as payroll taxes to deal with. Second, so what? People set up small businesses all the time because they or their family members are unemployed and need money and when they do so we praise their entrepreneurial spirit. Why is it any less acceptable to start a business because that is a good way to get health insurance?
But simply ripping up established social and economic arrangements across 20% of the economy and in a way that impacts almost every American is bound to have many unintended consequences even if it was politically viable.
Good point - I was thinking in terms of "real" because we'd have to make enough for everyone to help cover their insurance payments! Hmmmm, now for a great business idea...
My point was that EVERY part of any complex “solution” to a complex problem should actually address some specific part of the problem.
“Guaranteed issue” and “community rating” are feel-good non-solutions that guarantee only escalating costs and limitation of coverage. The insurance industry term for the results of guaranteed issue is “adverse selection” of coverage - that is, buy-in by consumers only after an adverse condition presents itself. And community rating totally divorces cost from all of the various risk factors, including the ones that are under our DIRECT, personal control.
The perfect should never be allowed to be the enemy of the good, but bad solutions that simply introduce new problems are NEVER the right way to go.
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