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.
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.
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.