Editoria (views not necessarily those of HCfA NC)THE WAY IS CLEAR: HEALTH INSURANCE MUST ENDHealth insurers developed the concept of pre-existing conditions to exclude the sick from insurance coverage and applied liability-style risk rating to health insurance premiums, which reduced the premiums for the young while making insurance unaffordable for the older population. Thus, risk rating of premiums effectively ended the subsidy of older people by younger people. The risk-based premium approach is appropriate for auto liability insurance, because people are responsible for their own driving records. But risk rating is totally inappropriate for human beings who cannot control their genetic inheritance, which plays a large role in their overall health. However, risk rating and pre-existing condition exclusions did protect the for-profit health insurance companies from the adverse risk of health insurance by denying access to insurance to those who need it most.Another major problem is the total number of health insurance plans offered by the health insurance industry and the lack of any real regulation to ensure that they adequately cover the needs of the enrollees. The huge numbers of plans challenge doctors and hospitals to figure out what services are covered by what plans. Such choice drives the administrative costs for both the insurers and the providers higher than any other health insurance system in the world. It is profitable for the manufacturers of large mainframe computers and billing software vendors, but it adds billions to the administrative costs of the health-care system, and still hospitals cannot get our bills straight. The U.S. health-care system has the greatest number of administrative personnel of any country in the world. It is no wonder that our per-capita costs are 1.6 times other countries, even though millions have no health insurance. It is time to acknowledge that there are absolutely no market solutions for the chronically and mentally ill in a for-profit health insurance system. Boards of directors and executives of for-profit health insurance corporations aim to maximize the income of the corporations for investors. If for-profit and not-for-profit insurance companies with their plethora of plans are kept alive, it will be impossible to control costs, free the billions of dollars that today go to administrative costs and make these funds available for patient care. The current insurance system is both morally and financially bankrupt and cannot be sustained. It may not be possible to achieve all the necessary reforms quickly, but the direction we need to take is clear. |
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Formerly known as the NC Committee to Defend Health Care
PO Box #2235 Chapel Hill, NC 27515-2235
Phone: (919) 338-2535
Email: info@healthcareforallnc.org
