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Health System NOT Broken: Health Insurance Is

Posted Mar 03 2010 12:00am

Our overall approach to health care delivery has resulted in the most technologically advanced system in the world.  In addition, as a nation, we actually provide via our market system more persons with health insurance than the combined TOTAL populations of Germany, France, the United Kingdom, Italy and Holland.  That is right.   Even with the all the talk about the uninsured, over 270 million Americans have health coverage in form or another.  That is a tribute to the system that has evolved over time.  Actually, you can make up a number of combinations of major socialist democracies in Europe and arrive at the same conclusion.  That is that for a nation a large (geographically and population wise) and as diverse as the United States, our system has done on the whole a pretty good job.

Now some have argued that this still leaves 46 or so million without insurance. First, we take issue with that figure. Even the President has been careful to remove the estimated 12-15 million illegal aliens from the list.  That leaves about 30 million CITIZENS without coverage.  To be sure, that is a problem, and one that we have addressed over and over with real health reform solutions.

Having said that, is it clear that there are numerous issues related to simple regulatory action which need to be addressed in relation to health insurers. In light of the recent news of the profits generated by the five major health insurers, it should come as not surprise that many on the left are after those ill gotten gains.  We rarely would agree with that perspective, but in this case, some qualification has to be made.

We believe in the market and profits.  We love capitalism.  We think that health insurers have a right to make a profit in order to stay in business.  Our complaint is not with that per se, but with the rules they use to make those profits.  In other words, they are setting the risk rules and self adjusting those rules in order to generate profits. We think the rules should be set and then they compete under those rules.  What rules are we talking about?

First, cover everyone. If I can pay the premium, I can buy a policy. No pre-existing conditions exclusions.  No annual caps on payments.  No lifetime limits on payments. Eliminate any sub-group rating.   Rate based on entire population at risk under coverage. Interstate sale of insurance should be allowed, with regulation to be sure that predatory marketing does not again selectively effect any given state. This should not be a problem if I have to sell to everyone in the population. What about those who try to game the system?  Deal with them separately via fines, penalties or late application ratings.  If they cannot afford those then they can look to Medicaid or some as yet developed subsidy to private firms to insure those miscreants.

The much ballyhooed Health Summit, convened by the President, in the end was an embarrassment to both sides. There seemed to be much upon which all agreed, but no one willing to take the reigns and say, we will write a bill that does these 10 things this week and pass it next week.  Instead all parties ended up retreating to their talking points, with Republicans still standing too close to health insurers and Democrats still too wedded to their inflated bills, filled with tawdry deal making and payoffs for votes.

In the end, we may get the current bills – both figuratively and in reality as another $75 billion in costs have been tacked on thanks to Mr. Obama’s additions.  If that is the best this Congress can do, which is sad, we will all have to work very hard to correct the problems in the bills with subsequent legislation.  We have no doubt that will happen.  It is sad, because real health reform was achievable without all the fuss, rancor and the cost that is going to be laid upon the shoulders of  American taxpayers . . . obi jo and jomaxx

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