The health care reform bills moving through Congress look as though they would do a good job of providing coverage for millions of uninsured Americans. But what would they do for the far greater number of people who already have insurance? As President Obama noted in his news conference last week, many of them are wondering: “What’s in this for me? How does my family stand to benefit from health insurance reform?”
Many crucial decisions on coverage and financing have yet to be made, but the general direction of the legislation is clear enough to make some educated guesses about the likely winners and losers.
As part of health reform, all insurance companies would be more tightly regulated. For Americans who are never quite certain that their policies will come through for them when needed, that is very good news.
The House bill, for example, would require that all new policies sold on or off the exchanges must offer yet-to-be-determined “essential benefits.” It would prohibit those policies from excluding or charging higher rates to people with pre-existing conditions and would bar the companies from rescinding policies after people come down with a serious illness. It would also prohibit insurers from setting annual or lifetime limits on what a policy would pay. All this would kick in immediately for all new policies. These rules would start in 2013 for policies purchased on the exchange, and, after a grace period, would apply to employer-provided plans as well.
Health Care Reform and You – http://www.nytimes.com/2009/07/26/opinion/26sun1.html?pagewanted=2&em
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It will be interesting to see what impact reform will have on the drug companies. The FDA has enabled profiteering by the drug companies for years…I’d like to see the President tackle that one…I bet that he doesn’t. Too much lobbyist money.
Profiteering is a term that is used, sometimes correctly and sometimes not. In the case of the pharmaceutical industry, it is true that they have been very profitable over the last half century. However, compared to many other industries, they recycle large amounts of their earnings into research and development which keeps the drug pipeline going and new drugs coming to the market. Overall, no one could say that the vast majority of new medications developed in the last half century have not in many ways revolutionized health care and public health. The American free enterprise system has allowed this happen. Excessive control by the federal government will lead to lower costs, but less R&D and fewer and fewer new treatments being available. Common sense regulation is called for and nothing more.
According to USA Today, July 28, 2009, 34% of Americans are obese. The obese have $1,429 more in medical cost each year. Using these figures, the obese are increasing the average medical cost and average person’s insurance premium by more than $475 a year for every American, obese or not.
There also needs to be a sugar, alcohol and tobacco tax to cover these costs. Think of how many less people there will be with diabetics, heart disease, rotten teeth, etc. if sugar became less affordable. It’s time for the people to take control of their own lives. It’s not fair for the person who chooses not to smoke, not to drink alcohol or not to drink a two liter of Coke each day to be responsible for paying as much as the person who chooses these unhealthy habits. The government is so quick to change the companies, but what are they doing to regulate what those who choose unhealthy lifestyles and drive up the health cost of health insurance premiums for us all?
Introducing a public health plan needs to be removed from the current legislative bill. Were in a recession and the government needs to realize they would be spending money on something that will hurt the economy and destroy an industry. There have been too many quick, not thought out and irrational decisions made by our government lately and it makes me wonder, do they want our economy to ever recover? There are far more important things this money can be used for and Washington needs slow down and focus on smart healthcare reform and getting it right the first time.
The insurance industry is already getting hit hard by the recession. Too much to quick will bankrupt the insurance companies and ultimately there will be bigger problems than there is now. The government needs to give insurance companies a chance under the new reform rules and each company should be required to prove themselves while getting used to all the new industry changes. A public option should be a last resort and done only if the health industry doesn’t improve. Give the companies a chance first.
As for the Exchange, it’s not needed. The administrative cost of the Exchange will be more than what agents get paid now. Government employees are more expensive because of all the benefits they receive from the government. Most agents are self employed and responsible 100% for their own benefits and retirement plans. Most people prefer having an agent help them apply and answer questions to eliminate errors. Why change something that already works. Most people prefer and already know what to expect with how things work now. If trying to reach someone at the Exchange is anything like trying to get someone on the phone at the Social Security or Medicare offices, we all can expect to wait on hold for at least 20 minutes before we finally get to speak with a live person. That’s 20 minutes of your or mine that is wasted.
Finally, the amount the government pays a doctor needs to be the same as what an insurance companies pay for the same service. It needs to be mandated that all companies and the government should all be on the same pay schedule, including Medicare. Let’s be fair.
Thanks for a thoughtful comment. You are correct in regards to lifestyle choices, personal habits and individual behaviors having large negative impacts on health. Taxes to some degree are helpful, but at some point become punitive and beyond acceptable limits in a democratic republic which values freedom. We agree that a public plan should be shelved and not on the table at this time. While many are suffering in this economy, it would be hard for us to accept that the insurance industry as a whole is suffering financially. They have the ability to adjust premiums at will, something that others in the health care system have little ability to do. We too are concerned about the bureaucracy of any health exchange. That should be avoided at all costs. As for fee schedules for hospitals and doctors, those are set by Medicare, Medicaid and private health insurers. All providers can do is essentially petition for redress or adjustment. Setting flat fees on a universal basis is one of the keys elements in anti-trust actions. It suggests market collusion and is potentially illegal. Any kind of change in fee structures will require extensive legal review to make sure it does not run aground of other legal issues. Please keep reading!
There is a lot of lobbyist money at work in both insurance and drug circles to ensure that federal lawmakers make legislation that does not damage profitability. That said, ensuring that everyone has basic access to health insurance regardless of preexisting conditions is about as fundamental a protection as can be provided.
The second part of that is however required as much is ensuring that patients cannot be dropped or cut off once they have cost the insurance company too much. With 3/4 of those who went bankrupt due to health reasons having started with insurance, it is fundamental that the unforeseen costs of insurance for an unexpected condition not have the ability to destroy people’s lives beyond the illness or injury itself.
Thanks for the comment. We have argued from day one the the most essential reform needed is insurance reform. That means that pre-existing conditions are not relevant. It also means you cannot be dropped if you get sick. You could be dropped for non-payment of premiums, but that is where federal input might be useful for those that have economic hardship due to illness. The solutions to out health care problems are much simpler than the complex, convoluted legislative proposals in Congress would have you believe. Common sense reform and regulation is all that is needed. Please keep reading!