Friday, February 27, 2009

Free Market, Literally Shop till You Drop Health Insurance Reform.

I came across this definitive critical dissection of the Republican free market plan for health care reform that will explode the idea that this is a viable alternative. It’s based on deregulating the insurance companies, so your able to buy as little coverage as you can afford, from a menu board based on how healthy you feel right now.

You will hear all about this plan in the coming year as the Republican Party tries to sell the nightmare coverage described below. The line that stands out for me: “the proposals stay true to our guiding philosophy…” betray their true intentions. To hell with real solutions, just feed the now failed ridged ideological platform to anyone shortsighted enough to cheer these ghouls on. The Salt Lake Tribune:

Rep. David Clark, the speaker of the Utah House, is promoting his "slow process" of health-care reform. ("Slow process ensures better health-care reform," Opinion, Feb. 15). The problem with the proposed changes is that they move us in the opposite direction from what we need for a simplified and affordable health-care system.

Our current multiple insurance system (Medicare, Medicaid, Workman's Comp and myriad individual and employer-based private insurance plans), with its variety of deductible, co-pays, and reimbursement rates, is already much too complex and expensive for the patient, employee, employer, and health-care providers. Adding additional cafeteria-style insurance "products" will only further complicate the life of everyone involved in the health-delivery system.

Clark states that "the proposals stay true to our guiding philosophy that competition and markets are generally the best way to achieve value in our economy." He is right if he means by this that more dollars will flow to the insurance companies who will continue to maximize their profits by minimizing reimbursement to providers according to the market philosophy that greed is good.

A friend asked me about a low-cost health insurance product offered to him by his employer. It offered family coverage for $75 per month. Upon examining the fine print of the product it seems that the maximum benefit per year was $2,000. This is a real cheap product that is also worthless for any serious illness.

I can see that if you removed restrictions on health-insurance products, like we did for banking products, insurance companies could offer thousands of alternative premiums between $75 and $1,200 per month and adjust covered services, deductibles, co-pays and yearly maximums to maintain good profits for them.

For the buyer to choose the best product, Clark proposes an "Internet portal" that will provide a "single shopping point" in which we can not only compare different insurances but also "judge the quality and cost of different health-care providers." Such a magical portal would require for each of us to know which diseases we will suffer from in the future, what diagnoses and treatments will be needed and who has the best price-performance for such treatments.

The reforms proposed so far are based on the assumption that we can shop for health care like we shop for a car or TV. This is a total misdiagnosis of the health-care disease. To paraphrase Alice in Wonderland: If you don't understand the problem, any "slow cure" will make it worse. We need an affordable, uniform, universal health-insurance plan without thousands of options.

Andy Schoenberg retired from the faculty of the University of Utah Medical Center in 1999, where he worked in the rehabilitation medicine department conducting research in neuroprosthesis and providing rehabilitation services to clients with disabilities.

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