Posted on 03/07/2019 5:45:23 AM PST by DoodleDawg
Five failures - Georgia, Wyoming, Maine, New Hampshire, and Kentucky. Those five states have laws allowing for the purchase of health insurance from out-of-state providers. Not a single out-of-state provider has sold a policy to their residents.
The states are acting as co-conspirators. A healthy, competetive, private insurance market is not want bureaucrats want on either the state or federal level.
Gaia forbid that people be allowed to purchase the products that they want!
Because companies like Premera, Humana, Blue Cross, Cigna, and the like are willing to go to the expense of establishing networks of providers. If an insurance company chooses not to then there is no way they would want to sell a policy in a state without one.
Why would the company in Iowa want to sell a policy to a customer in New York if they do not have a network of providers set up there?
We are in the process of a new start up biz. We have to be registered in every state. Every state has different rules and regs and reporting requirements. Some states require a surety bond.
Why should any other biz be any different?
As much as I hate Obamacare, I have to admit half of the problems with it already existed at the state level in many states. For instance, when I was young we could buy catastrophic-only insurance which had low premiums because it didn't cover normal doctor visits. So anybody could afford insurance. But state regulations in Alabama and almost every other state made those go away, you know to help us have only "good" insurance policies to choose from (read: expensive only). Then Obamacare came and made it a national problem too. (Among with the many other things Obamacare brought.)
The only thing good about Obamacare IMHO was dropping the in-state-only regulations most states had. Of course, it didn't matter to prices because the same Obamacare mandated all insurance polices be sorry in quality and expensive in price (to cover pre-existing conditions).
How would establishing networks in Iowa and New York be different from establishing networks in, say, Sacramento and San Diego, or Jacksonville and Miami? Insurance companies are already handling the problem of geographically separated networks that don’t share customers. I don’t see how whatever they’re doing to handle it at the state level wouldn’t scale up to the national level.
Hey, I have a plan. Let us buy and pay for the insurance coverage we want and need, sort of buying a new car. I can cross state lines and buy the things I need or want, why not insurance?
Here's my rationale:
You only read about this when it comes to discussions about health insurance -- not life, auto, or homeowners insurance. That's because "health insurance" barely even qualifies as insurance coverage at all. Medical claims are so frequent, and the inability of an insurance company to decline coverage so absolute, that an insurance company can't even underwrite risk at all.
You can buy a car in another state, but you eventually have to register it in your own state ... and if your state has a sales tax, you have to pay a sales tax on the transaction when you register it.
for starters, see post # 12 above ...
And the states are free to tax an insurance transaction too.
I was considering it from the flip side: If they wanted to do business in a particular state, and they had their organization set up to adequately service that state, then why not offer coverage? The obvious answer to the question as you posed it is that they probably wouldn’t (want to sell a policy).
I would posit that the selling of insurance across state lines is not intrastate regulation of insurance, it is interstate regulation of commerce.
This is not a matter of can’t but instead a matter of DON”T WANT TO because the divide and conquer process they have is too sweet to give up.
The argument against national sales of health insurance is weak at the very best. The arguments are simply excuses and nothing like reasons.
The system is broken. Broken very badly.
So, are the five pursuing the same approach?
Do you know how many experiments Thomas Edison had to do before he came up with a working light bulb?
“There are logistical hurdles: It’s pretty hard to set up a network of doctors and hospitals that will work for patients in both Iowa and New York.”
PPO deals are collusion between insurers and medical providers that are all to the gain of the parties in those deals more than they are to the gain of health care consumers. They restrict patient choice and impede healthy health care competition.
Insurers should have one thing - what they cover and how much they will reimburse for that item. The rest is what is on the consumer. Let the consumer find providers that meet that combination of cost and service that THEY desire and/or require. Make collusion between insurers and health care providers illegal, like any other “restraint of trade” would be.
You don’t “buy” insurance. You enter into a financial services contract with another party. Each state has their own laws regarding financial service contracts, including but not necessarily insurance.
Probably not a lot, but there is a time and expense involved with negotiating with the providers and establishing the network. If a company does not currently do business in California or Florida then why would they go to the expense of setting up a provider network for a handful of customers?
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