Wednesday, March 25, 2009

One Small Step Towards Universal Health Care

Contrary as I am, several years ago I began answering health coverage insurance ads received on the Internet and postal mail.

They promised a blissful, worry-free life in what is laughingly referred to as my "golden years" for a "very small premium or no premium at all." Right.

In each case, the happy talk from the insurance company sales people switched from euphoria --calling me Jerry or Mr. Remmers (usually mispronounced) to sir -- to funeral parlor tone.

That's when I told them I had a "pre-condition" of uncontrolled diabetes, congestive heart failure, kidneys functioning at 40% and some scar tissue in my lungs, the result of a half century of smoking cigarettes.

This was always followed by two responses:

  1. The insurer does not cover pre-conditions.
  2. The insurer covers pre-conditions for a premium affordable to only the rich and famous.

Mercifully, there is a safety net for people as me living on Social Security. It's called Medicare and Medi-Caid, two government-run health care programs. Despite their arcane rules and bureaucratic inefficiencies, the system works.

Through those programs, I was able to subscribe to Health Net's senior HMO network. The benefit plan meets my pocket book. Everything is covered with no copay with few exceptions. A ride in the ambulance costs $50. A few things cost 15% of what Health Net's share of cost is. When that runs out, my state's Medi-Cal kicks in for the princely sum of $640 deductible PER MONTH. (At that point, if the bill doesn't kill me the disease will).

Now, I don't especially relish the idea of living off your dime. The lone rationalization is that I ponied up thousands of dollars into the government systems during my income-producing days as a newspaperman and small business owner. Yeah, by now, I may be a tad overdrawn.

I'm fortunate. I figured out how to work the system. So be it.

But, there are an estimated 47 million people walking around our nation either uninsured or underinsured. That's sick, if you pardon the pun.

So, it was with great relief I stumbled across a story in today's on-line New York Times http://www.nytimes.com/2009/03/25/washington/25health.html?ref=politics that the biggest stumbling block to universal health coverage may be removed.

We are told representatives of the health insurance industry would be willing to end the practice of charging higher premiums if Congress adopted a comprehensive reform plan requiring all Americans to carry insurance.

Eureka! It finally opens the door to civil discussion on President Obama's health reform package.

Insurers remain staunchly opposed to creation of a government-run health insurance plan. But the industry’s willingness to change its rate-setting practices could make it easier for Congress to reach a consensus on legislation to overhaul health care.

The industry’s new position, which came as a surprise to lawmakers, could narrow the issues on which insurers are ready to fight the Democrats now controlling Congress and the White House.

In effect, insurers said they were willing to discard an element of their longstanding business model — pricing insurance policies, in part, on the basis of a person’s medical condition or history.

In the past, insurers have warned that if they could not consider a person’s health status in setting premiums, the rates charged to young, healthy people would need to soar. But they said Tuesday that they were exploring ideas to prevent such sharp increases by spreading the risk and costs broadly across a larger population, including the healthy and the unhealthy.

Insurers said they could accept more aggressive regulation not just of their premiums, but also of their benefits, underwriting practices and other activities. Such strict regulation, they said, would make it unnecessary to create a new public insurance program offered through the federal government.

The insurers set forth their position at a Senate hearing on Tuesday and in letters to the chairmen and senior Republican members of the two Senate committees primarily responsible for health care legislation.

2 comments:

Anonymous said...

When do the poor health conditions caused by 50 years of smoking and probably poor diet resulting in diabetes become personal responsibility? Why do they become my problem and why do I have to subsudize this poor behavior. I am totally tired of this discussion.

Lou Brennan said...

You eat and smoke yourself into poor health and you want me to pay. Get real!