0bama is trying to use the bully pulpit to promote his takeover of our health care system. Being a member of the PowerPoint generation, he has his eight-point presentation. Let us take each point seriatim:
1. No Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
First, we must acknowledge the locus of the problem. When one moves from one employer’s group plan to another’s, one is not denied coverage for pre-existing conditions. It is mainly a problem with people trying to get individual insurance. The solution is not to force insurance companies to accept customers with pre-existing conditions. That is akin to buying an auto insurance policy after one has been in an accident, and the insurance company is prohibited from refusing coverage and is required to pay for the repairs. Just as with an auto accident, the policy in force when the diagnosis is made should be held responsible for treatment.
2. No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
That should be up to those buying the insurance. Less expensive insurance policies have higher deductibles and higher out-of-pocket caps.
3. No Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
That should also be negotiable. Many people have such coverage, but don’t use it. Studies have also shown that most health care expenses come in the last few years of one’s life. Preventive care delays that (at some cost, of course), but does not eliminate it. (Fortune) This is also akin to having your car insurance pay for oil changes and tire rotations. (And it adds 20% to the cost, too.)
4. No Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
This goes back to the pre-existing condition issue. A company could drop a seriously ill patient, but that would not affect its liability.
5. No Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
I do not know whether men are more expensive to insure, or women are. Again, this is generally only an issue for individual policies, not for employers’ group policies. Still, if men are more expensive to insure, they should pay more. If women are more expensive to cover, then women should pay more. Young men pay higher auto insurance rates because they have more accidents. The same should obtain in health insurance. If a group is generally more expensive to insure, then members of that group should pay more for their insurance.
6. No Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
Once again, this should be negotiable.
7. Extended Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26
Not a bad idea, but States can already do that. It will, of course, raise the price of family coverage.
8. Guaranteed Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.
This is really just a restatement of #4. Once again, if the insurance policy in force when a diagnosis is made is required to cover the care, then this is a moot point anyway.
0bama’s proposals, particularly that of requiring insurance companies to pay for coverage of conditions that were diagnosed before the insurance policy is purchased, will drive companies out of business. There will be no option except the public option. This proposal will also make “0bama-gap” policies, which would cover what the public option does not (because of the rationing which is sure to be needed to reduce costs), illegal.