Noted healthcare blogger Alan Katz, a long time insurance broker and consultant, has made a proposal that seems pragmatic and will allow insurers to be protected from higher claims while making it incentivizing the public to buy in to private health insurance before they need it.
Writing on February 7, Katz proposes:
Writing on February 7, Katz proposes:
The PPACA imposes a fee (or a tax, depending on whom you ask and when) if an individual fails to obtain health insurance. This is the constitutional weak-link in the law. Those asking the courts to overturn the law describe this approach as Congress forcing Americans to engage in an economic activity or pay the equivalent of a fine to the government.
Instead of this government-centric approach, I proposed replacing the fine with alternatives enabling carriers to protect themselves from consumers who have waited until they are on their way to a hospital before seeking coverage. As has happened in New York and New Jersey, without such protections premiums skyrocket even faster and higher than medical inflation would normally require. Creating an open enrollment period (perhaps the applicant’s birth month) would counteract this dynamic. Allowing carriers to set premiums higher for those who have gone without coverage and to exclude pre-existing condition for some period of time, would help keep the cost of insurance lower, too. (These are financial disincentives imposed on individuals who fail to maintain medical insurance. Fairness would dictate that these disincentives should be commensurate with how long the individual went without coverage, thus the limited time during which a premium surcharge or benefit exclusion would be permitted).
Carriers would not be obliged to impose these penalties. If they were commanded to do so by law some would argue they are simply agents of the government and the Administration would be back defending the constitutionality of a government-imposed individual mandate. By allowing, but not forcing, carriers to use an open enrollment period, increase premiums, or exclude coverage for existing conditions, the government is out of the equation. And so are constitutional challenges – at least to this provision.
The impact of this approach on other provisions of the Patient Protection and Affordable Care Act is minimal. In fact, by shifting the enforcement of personal responsibility from the IRS to private carriers this alternative might even save money overall.
Being 68, I care about health care [no pun intended]. I think our main problem is overpopulation. It causes the health care crisis, but it also the main cause of qll other problems - pollution, poverty, wars, hatred, the depletion of natural resources, etc. Egypt has 80M people and adds 1M every year. Half of them live on $2 a day. Cairo alone has 17M people.
ReplyDeleteHow is that related to health care? First, we just cannot afford to provide health care to growing and aging population. It would exceed all our resources. Many people live well into their 90s and the cost of their care often exceed $1M (a bypass operation alone costs $100K, caring for an Alzheimer's patient is probably around $100K per year). If we have a million people whose health care expenses are $1M each, we already have $1T (T for trillion), which is the entire US budget.
On top of that, it is health care that is responsible for this huge growth of population, because it has eradicated the infectious diseases. And most of the growth takes place in the poorest countries. When I was born, the population of our planet was 2B, now it is 7B. All in all, we are moving towards a disaster.
Eugene