Public Plan
Obama Gave Up the Pharm
Published August 06, 2009 @ 09:20PM PT
As part of building a narrative of momentum for health care, the White House rolled out a couple of “deals” with players in the health care industry. Hospital associations and Vice President Biden rolled out a deal for a more favorable timeline on reducing payments to hospitals for uncompensated care in return for $155 billion in savings to Medicare. That was impressive! Sen. Baucus announced that Big Pharma had agreed to help partially close the “doughnut hole” in Medicare Part D by offering beneficiaries who fell into the gap in coverage a half-price discount on their prescription drugs – up to $80 billion over 10 years. That was less impressive. And now it looks like it comes at far too high a price.
I gave the deal decidedly mixed reviews when it was first announced:
It's also a big deal for PhRMA, who gets to burnish its pro-reform credentials at fairly minimal cost - Dean Baker calculates this commitment is about 2% of what the pharmaceutical company makes off of Medicare Part D. [But] don't expect this to translate into savings for the larger health care reform effort, or to necessarily mean Big Pharma will go any easier if health care reform bites into their bottom line through negotiated drug prices for a public plan [emphasis not in the original post], or more investment in comparative effectiveness research that asks "Why am I paying for drug A at $15 a pill, when drug B is roughly as effective at $0.15 a pill?”
In the short term, when we didn’t know all the details, the deal seemed relatively positive. President Obama had few options to keep his campaign promise to help close the doughnut hole without going to war against the pharmaceutical industry, who would have then gone to war against health care reform. Senior citizens on Medicare are already the hardest audience to convince that health reform creates benefits them directly. This doughnut hole deal was an easy, unambiguous win for seniors – one the House was quick to codify into their bill. And, of course, it’s kept the industry group PhRMA co-sponsoring the next generation Harry and Louise ads that are pro-reform, rather than running ads to kill the plan. It allowed Rahm Emmanuel to boast, “The very groups we have been talking to have been the most vocal opponents of health care reform; they are now becoming the vocal proponents for health care reform.”
But now the truth has come out. Part of the negotiations between the Congressional Progressive Caucus, the Blue Dogs, and Rep. Henry Waxman that allowed HR 3200 to pass out of committee was a new amendment that would allow the public option to negotiate drug prices like the VA does (and very un-like Medicare Part D). As predicted, that was the moment when Big Pharma stopped going easy on health care reform. In a shocking display of chutzpah, PhRMA president Billy Tauzin took the rest of the deal public via the NY Times. He had assurances from the White House and Sen. Baucus that Big Pharma would be shielded from further cuts to their bottom line from reforming health care. The NY Times reports: “The $80 billion in savings would be over a 10-year period. ‘80 billion is the max, no more or less,’ [Tauzin] said. ‘Adding other stuff changes the deal.’” Tauzin’s clearly going public for one reason: to kill the House bill provisions.
After all, in 2006, the top 10 pharmaceutical companies made over $39 billion in profits. I’m sure they’d be on their way to the poorhouse if they were forced to make only $30 billion.
Let’s be honest: capping savings in our health care system from PhRMA is giving away the farm. The whole point of a public option is that it has incentive to lower costs and a large enough member base to get good discounts, like any other big group health insurance plan. One of the reasons the VA has been able to deliver high quality care and lower costs than Medicare is the ridiculous provision in Medicare Part D that prohibits negotiating for the best rates (provisions, it should be noted, written by Mr. Tauzin when he was in the House). For all the talk of a “level playing field,” this gives private insurance plans a marked advantage over the public health insurance option, and betrays one of the key reasons for health care reform: that we can take common sense steps to lower costs.
It’s unacceptable. Now that it’s out in the open, we need to tear it up and start over.
Write to Congress and the President -- tell them to tear up this deal!
(Photo credit: pawpaw67 on Flickr.)
Health Care Reform Is Not About Ben Nelson's Comfort
Published August 01, 2009 @ 11:20PM PT
Even though Congress will be in recess for most of August, that merely shifts the ground for the struggle to get comprehensive health care reform passed. The big money conservative lobbyist groups Americans for Prosperity and FreedomWorks have sent out a memo on how to deliberately disrupt any town halls with local officials. We can also expect advertising a-plenty, both pro and con. As such, it’s worth watching how many elected representatives respond like Sen. Ben Nelson of Nebraska – by saying, “Advertising doesn’t affect me – and here’s 7 paragraph defensive statement to prove it.”
Many, many months ago, Ben Nelson was an avowed opponent of the public health insurance option, and declared he would gather a coalition of like-minded centrist Democrats to defeat it. That coalition never materialized, President Obama began pushing hard on the public option, the idea became all kinds of popular, and the Change Congress campaign also began airing ads pointing out Nelson’s $2 million plus campaign contributions. Suddenly Nelson was pretty neutral and coming around on the public option.
Nelson has kept a super-low profile on health care since then. He’s not on any of the relevant committees. But given his less than stalwart support for reform and his tendency to side with whatever conservative Democrat is trying to water down legislation, he’s far from a safe vote for a real change on health care. To kick off the August recess, the Progressive Change Campaign Committee [name corrected since original post - Ed.] and Democracy for America are airing ads to once again remind Nebraskans of Nelson’s past comments and his ties to the insurance industry.
It’s a great ad, but I wouldn’t have even thought to have mentioned it except for Nelson’s lengthy and disproportionate response. For someone attempting to claim advertising won’t affect him, he seems, well, pretty affected. In one statement, he claims past ads have “backfired” and defensively lists all of the health care programs he does support: “He supports Medicare, TRICARE and S-CHIP, and each is a public plan. He also helped establish Kids Connection, Nebraska's public-plan health insurance for children.” But he spends most of his time talking about how this will somehow doom health care reform, and ends on the ominous note: “If this is an indication of the politics going into August, then health care reform may be dead by the end of August.”
Yikes! Seems like the progressives hit a nerve. And it seems like the Senator from Nebraska missed the point. It’s not about you, Sen. Nelson. You have health insurance – and a generous benefits package at that. It’s about Mike Snider and the over 150,000 Nebraskans praying that their kids don’t get sick.
Blue Dogs' Bark Worse Than Bite
Published July 29, 2009 @ 11:39PM PT
The House is back on track. The Energy and Commerce Committee began marking up HR 3200 again this afternoon and will likely finish in the next few days. At that point, all three committees will be done, their staff will work on reconciling discrepancies between the committee mark-ups, and when the House returns in September, a historic full health care reform bill will open for debate on the House floor. All it took was a deal with the Blue Dogs – self-proclaimed fiscally conservative Democrats who effectively shut down Energy and Commerce until their demands were met.
The fact that the deal was struck is a positive – the process can roll on. But most folks are worried first and foremost about what progressives in the House had to give up.
Surprisingly, not a whole heckuva lot. Irate progressive Democrats are already calling this “a sop to the insurance industry,” but the insurance reforms and regulations are intact. For those concerned that the disproportionate weight of the Blue Dogs and their pro-business tendencies would cause the House bill to be watered down, not much water was added. Probably the biggest change – and the one least expected – was that originally the federal government was going to entirely pick up the tab for increasing Medicaid eligibility to all adults at or under 133% of the federal poverty line, as well as all of the cost for increased reimbursement, particularly for primary care, of the most anemic rates in Medicaid. Now states will be asked to pay for 7% of the costs, at lest on the eligibility piece. They’ll whine. A lot. But this still leaves the federal government paying for 93% of the cost.
What now seems like ages ago, the Blue Dogs aggressively suggested they only wanted to see a public health insurance option with a “trigger” – a five year “head start” for private insurance to take advantage of all the new customers and subsidies in the Health Exchange, with a public option kicking in to keep them honest only if private insurance fails to make health insurance affordable on its own (the sound you hear is me laughing so I don’t cry.) They haven’t mentioned that in a while. Instead, they held firm for a public option that does not use Medicare rates at all, but negotiates reimbursement with its providers. It's a change. But the House public option was always going to transition away from Medicare rates and towards negotiate with providers after three years. The Senate HELP committee likewise uses provider rates from the get-go. The negotiation with the Blue Dogs just anticipated (and resolved) a likely sticking point for reconciliation between the House and Senate bills. The compromise also allows for states to set up their own co-ops. The co-ops won’t replace the public option-- they’ll just be an additional choice. No big whoop.
The element I was most nervous about was the cut in subsidies for those towards the high end of eligible income -- $43,000 for an individual and $88,000 for a family of four. But the premiums for this income level will be 12% of their income instead of the original 11%. Talk about tinkering around the edges.
As their main bragging point, the Blue Dogs pushed for small business exemption on the employer mandate to go up to payrolls with $500,000 (instead of $250,000). Really, this is moving money around – robbing Peter (subsidies on individuals) and Patrick (Medicaid money from the states) to pay Paul (small businesses). But not really paying Paul that much.
Finally, the total package will be shaved by $100 billion. I’m by nature irked by cutting money just to say you cut money, rather than actually cutting in order to make a bill better. But in this case, I just don’t see that the bill has lost anything. Negotiating with the Senate is likely to change the reform legislation by an order of magnitude more than anything we’ve seen from negotiating with the Blue Dogs, for all of their barking.
That’s why I agree with the dominant sentiment – this was about stalling for time. It’s basically impossible for a House vote before the recess at this point (so Henry Waxman and House leadership agreeing to delay a vote until September is a “no duh”). Hopefully, the Senate Finance Committee – who has an extra week before recess – has a reasonable chance of getting their act together (defined solely as finally producing a draft bill, in this case). As Jon Cohn writes, “[Blue Dogs] want to wait and see what the Senate produces. If they have to take what they consider a hard vote--to raise somebody's taxes, to change the way Medicare pays for medical services, whatever--they don't want to stick their necks out any more than is absolutely necessary.”
That’s why the Blue Dogs bit off so little of what makes HR 3200 work. Once the vote was delayed, the rest was gravy anyway.
(Photo credit: eepie on Flickr.)
Max Baucus Apparently Frozen in Block of Ice
Published July 28, 2009 @ 08:36PM PT
I was going to title this “Max Baucus is the Red Queen,” after the famous quote in Lewis Carroll’s Through the Looking Glass: “Now, here, you see, it takes all the running you can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!” But I think frozen in a block of ice like Captain America is actually the better description.
When the Senate Finance Committee more or less dissolved into Max Baucus’ “coalition of the willing” – 4 Republican and 3 Democratic senators huddled in a room to work out one last stab at a “bipartisan” health care reform package – we were talking about taxing health benefits as income (at least partially), an amorphous and ill-conceived health co-op as a substitute for the public health insurance option, cutting out subsidies for a family of 4 making between $66,000 and $88,000 per year and delivering weaker private insurance regulations. Now, over a month from when Baucus and Grassley first estimated they’d be voting a bill out of committee – well, we still don’t even have a draft bill. But we do have a trial balloon floated courtesy of the AP. And guess what they’ve come up with? Taxing benefits, the co-op, cutting subsidies, weaker private insurance regulations – oh, and also tossing out the employer mandate for good measure.
In reaction, the progressive blogosphere has collectively thrown up. Advocates and pundits are commenting on everything from the makeup of who’s in the room, to the states these senators come from, to who takes what money from what insurance company, to whether the anti-democratic tendencies of the Senate in a highly charged partisan atmosphere make “big change” legislation an impossibility.
But my main question is, were any staffers for these senators paying attention to what happened in between? The answer appears to be no. That’s why the “encased in a block of ice” metaphor is better than the Red Queen. Not only are we making progress, this trial balloon is oblivious to progress.
Things I learned in the past month that the “coalition of the willing” did not:
- You can incorporate hundreds of Republican amendments in a bill to make it bipartisan, and most (if not all) of them will still vote against it.
- If you include an employer mandate (even a weak one) and a public health insurance option in your plan, it costs $400 billion less over ten years than if you don’t.
- Health care co-ops take, no joke, decades in order to be high-performing and competitive with private insurance.
- Oh, and Republicans also won’t vote for the co-op if it’s seeded with federal money.
- Including an employer mandate doesn’t actually “undermine [employer-based insurance] or create a perverse incentive” as Olympia Snowe, one of the “willing” fears. It actually leads to a net increase in employer-based coverage. So says the Congressional Budget Office, anyway.
- Not only can you supply subsidies to $88,000 for a family of four and have your price tag come in at or under $1 trillion, you’ll still be leaving middle-class people like Mark Barnes behind.
Other than that, Mrs. Lincoln, how was the play?
Nate Silver at FiveThirtyEight.com has the best summary of the whole package:
This is a pretty poor combination of attributes for a health care reform bill to have. If Baucus & Co. wanted to get the cost below $1 trillion, they could have chopped the subsidies down to, say, 350 percent of poverty, while keeping the employer mandate and the public option. As a very rough guess, a bill like that might insure another 30-35 million people at a gross cost of about $850-$900 billion. The actual Baucus bill is going to cost about the same but will be lucky to insure half as many.
We’ll see what they actually come up with. My guess is nothing will change. But it’ll be challenging to get this past what perhaps we should call “the coalition of the unwilling”: Schumer, Stabenow, Rockefeller, perhaps Wyden – progressive Senate Finance Committee members who have been out of the loop – plus what is certain to be united resistance from Hatch, Kyl, Bunning, Crapo, Roberts, Ensign and Cornyn. If it gets through that gauntlet, you have reconciliation with the members of the HELP Committee who can be justifiably proud of their own bill. And then you have the House, where at least 50 Democrats have gone on record saying they’ll vote against health care reform without a public option.
So there’s plenty of baseball still left to be played.
(Photo credit: Köttbullekvist on Flickr.)
No One Will Be Forced into the Public Plan. Period.
Published July 27, 2009 @ 09:48PM PT
The title of this post isn’t my most frequently-typed pair of sentences this week – but it’s close. So I’m going to type this up, put it up in the “Featured Posts” section so it’s easy to find, and be done with it.
The public health insurance option, as envisioned in the health care legislation that we’ve seen in the House and the Senate, would be one option out of many. You’d have a range of qualifying plans, from Aetna to UnitedHealth, and “Plan USA” or “Community Health Insurance” or whatever they decide to call it will be listed alongside it. Same subsidies, same rules of the road, same basic benefits (which standard is actually set by the private insurance marketplace – as in “equivalent to the average prevailing employer-sponsored coverage”). It’s one out of many options – most of them private. Nevertheless, the persistent myth that gets kicked around is that unless you have benefits through your employer, you’ll get the public plan. There’s a secondary persistent myth that the public plan is tantamount to single-payer. Believe me, no one will quickly set you straight on that point than an advocate for single-payer! (By the way, if you are advocate for single-payer, you might want to stop reading now. The rest of this post is probably just going to make you really, really angry all over again that a plan that basically coddles for-profit insurance is what’s moving in Congress.)
In the past, I’ve tried to refute that by pointing out the logical fallacy – that if you choose to go with a plan with a cheaper rate and better quality, you’re not being forced to do anything. You’re just being a smart consumer (wassup, Free Market Boyz!) If you want to be a dumb consumer and buy from WellPoint, no one stops you.
I’m still getting the question, though, so let me try a simpler argument – math.
It’s not even fancy math. It’s subtraction.
Simply put, there are exactly zero studies that show the public plan coming putting private insurance out of business. Not the Lewin Group, not the Commonwealth Fund and, most important, not the CBO.
Let’s start with Lewin – which I’ll quickly mention “is wholly owned by UnitedHealth Group, one of the nation's largest insurers.” Lewin’s vision of the public plan is twofold – 1.) what if it’s open to all individuals and business, a configuration that no body of Congress has proposed, and 2.) what if it’s open to uninsured individuals and small businesses, the configuration envisioned in the Senate HELP bill and for the first few years of the House bill. If it’s 2 – the version actually in pending legislation, private plan enrollment would decrease by 83.4 million. Does that seem like a lot? Well, in 2006-2007, there were 159.3 million people in employer-based insurance.
159.3 million
- 83.4 million
75.9 million people who would still have private insurance, in the rosiest of scenarios for the public plan.
Suffice to say, when you get closer to what’s in the bill, the argument becomes even less conclusive. Lewin Group says that option 1 – the one that actually bears resemblance to what’s in the legislation -- would decrease private plan enrollment by 34.9 million, leaving 124.4 million people in private insurance. Anything that leaves 78% of people right where they are is a pretty crummy attempt to force anyone to do anything.
But the Lewin Group can say what they want – the real umpire is the Congressional Budget Office. Their analysis is not ambiguous. The House bill's version of an Exchange with a public plan would actually lead to a net increase in people enrolled in private insurance, including employer-based coverage:
All told, we estimate that, in 2016, about 9 million people who would otherwise have had employer coverage would not be enrolled in an employment-based plan under the proposal.
The net effect of the proposal on employment-based health insurance reflects larger changes in the other direction, however. We estimate that about 12 million people who would not be enrolled in an employment-based plan under current law would be covered by one in 2016, largely because the mandate for individuals to be insured would increase workers’ demand for insurance coverage through their employer. On net, therefore, about 3 million more people would have their primary coverage through an employer [emphasis mine] under the proposal than under current law...
And why doesn’t the public plan force all of the U.S. into its low-administrative-cost arms? Because the barriers to entry are so low (individuals and microbusinesses) that CBO just doesn’t see more than 10 million people signing up.
So if you think that you’ll be forced to have the public plan if you don’t want it – I’m sorry, your numbers don’t add up.
And by the way, this is a phenomenally frustrating post to write. To have to point out basic arithmetic is rubbing my nose in how week the proposal for the public plan is compared to what Jacob Hacker once dreamed up and what Obama, Edwards and Clinton ran on. The proposals for the public plan in legislation haven’t been gutted, but they’ve been severely hampered. Only individuals without insurance and employees at small businesses will even be eligible for at least three years, and possibly longer. Our legislators have catered so much to those on the “If you like your coverage, you can keep it” end of the spectrum, that those who don’t like their coverage are high and dry. More to the point, as the CBO has scored, even this weak public option is a cost-saver as part of the total health care reform package. Even tying one hand behind its back, it gets the job done.
How much money would we be saving -- and how many more customers fed up with their insurance plans would finally have an option -- if we’d allowed it to be strong?
(Photo credit: Patrick Haney on Flickr.)
What's In It for Me? (At $45,000 a Year.)
Published July 25, 2009 @ 05:08PM PT
On a previous post, Mark Barnes wrote in the comments, “No matter where I go, I never find details pertinent to the individual. Could someone please tell me what the House Democrat plan will cost me?” I emailed Mark and asked if I could get some more information in order to answer his question in depth. The results are below. Big disclaimer – I only asked enough questions of Mark to get a rough idea of his life situation. So my answers are about someone generally in Mark’s situation and may not be his exact situation. I’m applying the most likely -- and usually the most conservative -- numbers in evaluating what health care reform means for Mark based on the House Bill HR 3200. This is a thought exercise based on the proposals on the table, and a thousand variables could change between now and the implementation of a health care reform bill -- including what's in the bill!
Keep in mind the reason that I was motivated to write about his case is because it’s atypical. Mark is single and uninsured, but works full time and makes over $45,000 per year, placing him solidly between 400% and 500% of federal poverty. I’m counting Mark as an individual – if you’re a family of four, it’s the equivalent of making $91,728 a year. The majority of the uninsured are under 400% of poverty, and the House bill is set up to address their situation directly. People who make just $3,000 less than Mark does will see huge benefits.
But this is the challenge – what are the benefits in health care reform for someone like Mark? What’s in it for him?
The Present
First, let’s explore Mark's situation in the here and now. How atypical is it to be uninsured at this income level, exactly? Well, there are approximately 2.5 million Americans in the same boat according to the studies done by the Department of Health and Human Services – that’s the smallest uninsured rate for all of the income “bands” measured by HHS. Nevertheless, you may be surprised that someone so solidly middle class who works full-time is uninsured – so is HHS: “That the uninsured comprise non-trivial percentages of middle and upper income individuals is surprising. Those with incomes above 300% of poverty should generally find employer insurance affordable.”
Ah, but there’s one of the big problems with employer-based insurance. Mark is what’s colloquially called a “permatemp” – someone working full-time on an ongoing, permanent basis, but as a “contract” employee. The number one reason why companies hire permatemps is to avoid giving them benefits, including health insurance. Why? The high cost of health care. Mark is above the age of 50 and lives in San Francisco. I googled through some online insurance brokers. To get a comprehensive plan that includes primary care, has a deductible under $2,500 and no office visits, the bids ranged from $4,560 for Kaiser to $7,404 for Anthem Blue. (By the way, Mark, I’d warn you against buying from Anthem Blue as an individual, as those in the Bay Area were socked with a 30% increase in premiums this year.) That’s between 10% and 16% of Mark’s salary. Quick note – I’m not doing a check on insurance plans with super-high deductibles or that don’t include doctor’s visits. That’s the very definition of “underinsured,” and I want Mark to actually benefit from having health care.
For-Profit Insurance Needs a Hug
Published July 23, 2009 @ 10:17PM PT
Much to the chagrin of those who have championed a single-payer system for years or even decades, the mantra of the debate in Washington is “If you like what you have, you can keep it.” But of course opponents of reform are telling anyone who listens that you won’t be able to keep your private insurance, that Big Government is coming to beat on private insurance unfairly, and that the real solution to our health care woes is to leave what Jon Stewart of the Daily Show referred to (tongue-in-cheek) as a “benevolent free market operator” alone. Are the forces of the status quo onto something? Should we have more sympathy for private insurance?
Claim #1: Private insurance is in rough enough shape in this economy – it shouldn’t be forced to compete with a public health insurance option.
Of all the sectors in the economy, health insurance seems to be doing pretty damn good. I’m basing this on the story two days ago that UnitedHealth Group, the largest commercial insurer in the country, more that doubled its profits from Q1 to Q2 and completely beat all Wall Street expectations. At $859 million of pure, red-blooded profit, it’s more than double the $337 million it made over the same quarter last year. That’s right, the bellwether for for-profit insurance has made more profits since the financial crisis than it did before – a 154% increase, in fact. Of course, some might claim this number is misleading. After all, last year’s Q2 profit might have been even higher – if it weren’t for those pesky class action lawsuits that cost it an additional $922 million in fines.
If you’ve been reading, the obvious question is how, at a time when more and more employers are dropping health benefits and millions have lost their coverage with their jobs, how is UnitedHealth actually doing better? Their explanation: “’We expect this year's revenue growth in public and senior business to continue to more than offset the potential for further pressure from the employer market,’ UnitedHealth CEO Stephen J. Hemsley said in a conference call with analysts.” Yes, that’s right. They’re making up for a 6% dip in employer-based customers with Medicare Advantage plans – which already compete directly with standard government-run Medicare – and through administering Medicaid HMOs.
So the industry that needs to be protected from government health programs is currently leveraging government health programs to achieve record-setting profits.
Claim #2: People love their for-profit insurance.
Yesterday’s Washington Post mentions how often Karen Ignagni of AHIP mentions that 77% of people like their insurance and presumably want to keep it. But then it goes one step further – and actually provides the context:
But the polls are not that simple, and her assertion reveals how the industry's effort to defend its turf has led it to cherry-pick the facts. The poll Ignagni was citing actually undercuts her position: By 72 to 20 percent, Americans favor the creation of a public plan, the June survey by the New York Times and CBS News found. People also said that they thought government would do a better job than private insurers of holding down health-care costs and providing coverage.
In addition, data from a Kaiser Family Foundation poll last year, compiled at the request of The Washington Post, suggest that the people who like their health plans the most are the people who use them the least.
Those who described their health as "excellent" -- people who presumably had relatively little experience pursuing medical care or submitting claims -- were almost twice as likely as those in good, fair or poor health to rate their private health insurance as excellent.
That, of course, is the funny thing about something like health insurance – it’s impossible to tell how good it is until you actually need it. And then the lesson can be painful, if not deadly.
Claim #3: People should be allowed to continue purchase individual plans outside of the Exchange.
This is what the “Page 16” brouhaha is about – the conspiracy theory that private insurance will be made illegal if the House bill passes. Not at all. When the Health Exchange is set up for individuals and small businesses to purchase coverage, most of the plans offered will be private insurance – they’ll just be more tightly regulated, required to provide a minimum standard of benefits and spend a fixed percentage on health care costs, and come with a subsidy from Uncle Sam if you can’t afford it. If the individual insurance market plans have the same minimum standard of benefits, the company can keep selling those as well. Now keep in mind, the individual insurance market only has about 16 million customers right now – and almost all of the companies that offer it are likely to have an Exchange plan post-reform. How shifting 16 million customers from one private insurance plan to another (and a subsidized one at that) will put private insurance out of business is beyond me.
People have still rushed to individual insurance market’s defense. So let me make this clear – it doesn’t deserve it. The L.A. Times reports on some findings from the Commonwealth Fund:
…among adults ages 19 to 64 with individual coverage or who tried to buy individual coverage in the past three years:
-- 47% found it very difficult or impossible to find coverage they needed.
-- 57% found it very difficult or impossible to find affordable coverage.
-- 36% were turned down, charged a higher price, or excluded because of a preexisting condition.Ultimately, 73% never bought a plan.
The report also found that:
"Even people enrolled in employer-based plans are spending larger amounts of their income on health care and curtailing their use of needed services to save money."
Even if you believe that for-profit insurance as a whole gets a bad rap, there is nearly nothing defensible about this niche of the market. If only 27% of customers who need your products can actually buy them, you’re a failure – pure and simple.
Let’s not pretend. Private, for-profit insurance will almost certainly continue to make a profit – at worst, it won’t be able to double its profit margin each year. It will be able to compete with a public health insurance option, particularly the somewhat hamstrung variants that have made it into the actual legislation. The more people have to use their insurance, the less they like their insurance company. And the individual marketplace probably ranks among the most fundamentally broken markets operating in our economy.
Save your hugs for those who are struggling with the high cost of health care in this economy, those who lost their family’s coverage because they lost their jobs, and the families of the 18,000 Americans who will lose their lives unnecessarily this year for no other reason than because they couldn’t afford health insurance.
(Photo credit: kalandrakas on Flickr.)
