A place for Liam to post essays, comments, diatribes and rants on life in general.

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Thursday, October 15, 2009

Health Insurance Reform

So, let me see if I understand this correctly. I admit, I haven't read all of the Senate Finance bill, but...

It requires all American citizens to have insurance.
It has minimal enforcement of the above.
It has no cost controls on the insurance companies.
It has no public option.
It does nothing to increase competition.
It makes rejecting anyone for insurance illegal.

So... tell me where I'm wrong here...

Doesn't this mean that:

A) a lot more people will buy into the system than before, giving the insurance companies a lot more customers.
B) with those customers required to have insurance, what little incentive there may currently be for insurance companies to keep their profit margin down goes almost entirely away.
C) this means that the insurance companies can charge even higher rates and deny even more claims, and we can't leave because we're required to have insurance.
D) add together the weak enforcement of the insurance mandate and the fact that insurance companies are enjoined from denying anyone coverage who applies for it, there are going to be people who say "the heck with that, I'm not paying for coverage when I don't need it", and will try to buy into the system only when/if they get sick.

So tell me how this bill does anything but guarantee rate increases?

Republicans water the bill down. Insurance companies get their bought Senators on both sides to water the bill down. And what we're left with is a license for those companies to make obscene profits at our expense, and this solves the problems we have with health care in this country how?

This is what I talked about when this whole health care thing started: There is no reform that works and solves all of the problems without at a minimum a strong public option, and better still, a single payer system. A system like TriCare and Medicare, both of which work quite nicely, thank you.

We have a real problem. I haven't run into too many people who disagree on that point (except, of course, for the insurance companies themselves). We need to solve it, and to do so, we need something radical. What they're proposing here will only make the problem worse... and then the people who argued for watering down the bill and argued against a public option or a single payer plan will, come a few years from now, be crowing about how they were right, and what a cluster-**** the "reform" was... without ever admitting or perhaps even realizing that it was they, themselves, who turned a vital reform into something that made the problem worse.

It makes me absolutely sick.

3 Comments:

Anonymous Anonymous said...

Tricare is managed by contractors. Veterans buy supplemental insurance plans to fill in the holes, just like Medicare recipients do. Neither is sufficient nor work quite nicely, thank you.

Friday, October 16, 2009 8:38:00 AM

 
Blogger Liam said...

To the first anonymous: Most beneficiaries of both systems that I know wouldn't trade them back for the private system the rest of us are under if given the option.

That may not mean they are perfect (they're human created entities, they can't really be perfect), but it certainly means that they are preferable to the private options available.

To me, in order to overcome the "government can't run anything well" argument against a public option, you don't have to prove perfection, only that it's as good or better than the private options.

Monday, October 26, 2009 6:24:00 AM

 
Blogger Liam said...

And to the second: I'm concerned about that as well, but...

Insurance isn't supposed to be about lining the pockets of insurance companies. Insurance is supposed to be about spreading all of our medical costs across as wide a population as possible (the very essence of socialism, in some ways), so that catastrophic health problems do not also bring catastrophic financial ones.

And so when the profit margins of these companies go from 5-10% (90-95% of premiums being paid out in medical costs) to something on the order of 25% and in some cases even higher, and when in order to keep these inflated profit margins, the companies happily take your money right up until you start needing to be one of the beneficiaries, the system is broken.

I want a robust public option. Not a limited one that's only available to those who "can't" get coverage anywhere else or to employers who meet very strict guidelines, but a fully competing option. I want it to run in a cost neutral way, so that we get back to a 5% expense margin at most and use some of that recovered 20% to lower premiums and cover a few of the people who, having faithfully paid premiums for years, reasonably expect to be covered when something comes up.

If you COMBINE that with not allowing the regular insurance companies to drop or deny coverage to people, then the public option doesn't become the dumping ground for all of the unprofitable cases, and if the insurance companies try to sustain their 25+% profit and expense margins, they'll lose, because there's a much cheaper option people can go to.

There's a lot of distrust of government out there, if the insurance giants stop being greedy pigs and start living on a 5-10% profit margin (as they'd have to if they weren't exempt from anti-trust legislation, by the way, and had real competition), there are a lot of people who will stay with them.

That's all the public option is really for: To add an honestly priced competing plan. It's the way competition works: If you charge more than your competitors, you'd better also have demonstrably better service, or you lose customers. That's not "the evil of the public option" as some have said, that's the nature of capitalism.

What I want, in the end, is a system in which people who choose to participate, and who faithfully pay premiums starting when they are healthy (or at their earliest opportunity if they're born with a defect) get to participate fully in the plan for medical necessities and no one is forced to declare bankruptcy in order to qualify for medicare or medicaid before they can afford their needed medical care.

And I want that without opening up a huge loophole that allows the selfish among us to not pay into the system until they're guaranteed to get more out of it than they put in.

Liam.

Monday, October 26, 2009 6:39:00 AM

 

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