Saturday, January 29, 2011

Health Care Reform? I Have a Better Idea

So with the whole "Obamacare" health care reform bill, a lot of us are finding that our insurance premiums have gone up. Ours went up so much that even after a raise, after insurance premiums our take-home is even less than it was last year. Of course, the government and media tools that "estimated" how our costs would change with the new plan told us that we should expect no difference.

As soon as the bill came out, insurance companies, as they are legally required to do, revealed the expectation of large financial losses. Not as some sort of retaliation, but because the effect of the bill on their finances made the losses inevitable, and the government insists on such expected losses being made public.

So our costs have gone up, our care has stayed the same, and the whole bill has done jack for me except make me wonder where the heck all of the deficit money that's paying for this BS is going. So I have a better plan that won't cost us anything, and requires the insurance companies to change the way they do things.

The government should, instead of becoming an actor in anyone's personal medical care (beyond what they already do with medicare/aid), make a simple legislation:

"Group plans" as provided through employers and "individual plans" that unemployed or self-employed people purchase can no longer provide differing levels of coverage or differing costs simply because of whether they are part of a "group" or "individual" plan. Employers may offer a monetary health care allowance (tax free) to employees as a benefit, but may not determine which insurance company or medical providers the allowance is applied to. Every US citizen will be able to choose any level of coverage from any insurance company, and will be treated as if they are on a group plan, and not discriminated against based on health, age, or on any other criteria currently protected from discrimination by the federal government for other situations, such as employment or financial services.

So that's my plan. I have a big problem with how where you work affects your costs of care, or even what care you can get. At IL, we had United Health Care. It sucked. We only had the option of using the one plan the company chose. The company was small, and couldn't afford much, so the plan was bad, and our premiums fluctuated a lot based on the health issues of people we worked with. They had no coverage for the only Rx heartburn medication that worked for me, and only covered $10 of my visits to a therapist.

On the other hand, with Tim working for GT, we had several options for plans, and knowing my needs and our plans to reproduce, we got the one with the most coverage. It's expensive, but it covers IVF to some extent, makes hospital stays cheap (which is good because our family had a total of four months in the hospital), and gives us a good knowledge of what our annual costs will be no matter what happens. None of this "80/20 split for that test your doctor says you need but we don't want to pay for" BS. It's lovely. And if we wanted less coverage, we could get that too, for cheaper.

Honestly, I think everyone should have access to whatever health care they want. The scaling up of prices works, because it's based on how much care you expect to receive, and how much protection you want from paying for big things (or small things!). I believe in government systems that subsidize or pay for plans for those who can't afford them. I also believe that completely "free" care will crowd our medical establishments and overburden doctors. Some monetary disincentive to go to a doctor's office needs to be there so that people reach a reasonable level of concern before they go asking for antibiotics or a hospital bed. Finding a balance between allowing the poor the care they need and keeping those with "free" care from overcrowding hospitals and clinics is not what I'm getting at here.

I'm just saying that if everyone had access to the same insurance options, no matter who they worked for or if they worked at all, we'd have a lot more equality of care than we do now. It's not completely solving the problem of those without care, but it will reduce costs for those not on "group" plans, and it helps people who work for small companies, don't get benefits, or do freelance work. And talk about a boon to the currently unemployed! Again, just a little government legislation, and the rest just means changing the way you buy medical insurance to more like the way you buy car insurance - you shop for the best deal on the coverage you want!

***A note on the "group plan": Insurance companies make "groups" to even out medical costs between people who use a lot of care and people who only use a little. They're all paying the same premiums, and the money for the care theoretically comes from that pool, but certain people draw on it more than others. That's how insurance companies decide on premiums for certain groups - how much the group as a whole is actually using, plus the part they skim off the top to make money. Individual plans cost more and cover less because the insurance company expects the insured to cover all of their own costs through premiums (plus pay the insurer's cut), which kinda' defeats the purpose. So I say insurance companies should make all of their customers one "group" and charge the same premium to everyone. And none of that BS about waiting for coverage even if you had prior insurance.

And with no restrictions as far as who you can buy your plan from, if your company is charging too much, you just go somewhere else. That'll keep prices competitive, rather than your insurance company having you by the balls if you feel like you're paying too much, as is the case when you can only get a group plan from your employer's chosen company.


Columbus Health said...

We need reform but not the destruction of a system. I always felt as if we should attack this problem in pieces...not all at once in the middle of the night.

Lisa said...

I agree that purchasing individual health insurance SUCKS. Apparently if your company doesn't provide insurance, you shouldn't have kids. Lovely.

Jenny said...

The US health care system is so ugly. When I lived there I had a good job with good coverage and just assumed it must be a good system. Now that I live in Oz I know better and I feel horrible for people who are not able to get the coverage they need/want. I don't know what the solution is but the current system just doesn't seem to work.

Also - I've awarded you a blog award (or three?). If you feel like participating the details are over on my page.