Thoughts on health care reform
Honestly I haven't paid a WHOLE lot of attention lately to the ins and outs of who is saying what about health care reform. But I've been in a couple of conversations online about it lately, and as I've thought about it, this realization occurred to me:
Health insurance doesn't need to be tied to a person's job. At all. Car insurance isn't, so why should health insurance? (Life insurance SOMETIMES is, but people still have the freedom to purchase inexpensive policies privately.)
We would be able to shop around. Most of the time, an employer chooses one plan. And all the employees have that plan or none at all. Sometimes you might have an employer that has different plans with the same health insurance company (some employees might elect to use a POS plan versus an HMO plan, for example), but it's still the same company and still a limited choice. If we eliminated the employer's involvement, everyone would be able to purchase a policy from whatever company he/she wanted.
It would put everyone on an even playing field. An employer "feels" a premium less then a self-employed person does, even if the premium is the same. Individuals shopping around for the best deal would result in lower premiums. I wonder how often an employer shops around for the best deal. I'd say that more often than not, they just pick something without trying to get the most coverage for the least amount of money. Therefore, premiums remain high.
Individuals would be able to choose the plan that is right for them. Not all health plans are created equal, and different ones are better for different situations. A relatively healthy family would do fine on a high-deductible, catastrophe-only plan with super cheap premiums. But a family with chronic health issues would need something different, say, a plan with higher premiums that has a $10 copay for office visits and prescriptions. Neither plan is "better." They are simply different. But they are better for the different families. If an employer chooses one over the other, one of the families will not have its needs met insurance-wise. But if they were able to shop around on an individual basis (like car insurance!), they would have the freedom to choose the plan that is best for them.
They would not be paying for the risk factors of their coworkers. Under the current system, when an employer is purchasing a health insurance policy for its workers, it is quoted a premium based on the age, risk factors, etc. of its employees at the time. If a company has young, healthy employees, its premium for the same plan from the same health insurance provider will be cheaper than the premium quoted a company full of older, sicker employees. And consequently, a young, healthy worker at the company full of old folks will pay more than he would if he worked at the company full of young folks. Removing health insurance as a "job benefit" would enable a person to pay a premium based on HIS/HER risk factors only, not some person he/she works with.
If someone stops working for a particular company, he can keep his insurance. There won't be any more of this 30-day waiting period garbage after a person starts working for a company, which typically means new insurance. No more COBRA, which is a DRAMATIC increase in the price of premiums from the employee's point of view, since now the employer is not contributing anything to the premium.
To quote Paula in one of the conversations I've been having:
Everyone gets that money in their paycheck and then shop for health insurance just like they would car insurance. Buy what meets your need. Shop around - I bet prices would start coming down, hospitals and doctors would need to be competitive - and by that I mean in price and service. Think about it - your employer may be paying $1,500 a month for gold-plated coverage for your family - and if you are like most people, you don't get sick that often. Wouldn't you rather find a plan that costs, say, $700 a month and pocket that other $800 after taxes - every month?
The amount that you did pay in premiums would, of course, be tax-deductible - just like it is for employers.
YES YES YES. No longer would there be this huge discrepancy between what an employee pays for health insurance and what a self-employed person pays for health insurance. They would now be on a level playing field. They would both now be paying for their premiums themselves. Employers, no longer being in the health insurance business, would be able to pay their employees what they were formerly paying the health insurance companies. Self-employed people would no longer be punished for not being employed by someone else.
Do I think this will "cure" the health care crisis in America? Probably not. But I do think it would help a lot, WITHOUT resorting to the federal government getting into the health care business.
It appears that Mike Huckabee has been thinking the same sort of thing. 
I knew I liked him. LOL.
Where did you get the idea that people cannot buy their own insurance? You can buy private health insurance whenever you want–you don’t need to be self-employed. We used MILICO (I think that’s its name) about 12 years ago. Premiums were $150/month back then, nowadays it should be higher.
If you want to buy your own insurance, http://www.ehealthinsurance.com/ is just *one* place online to compare companies.
And if you prefer to talk to an agent in person, our small town has two different insurance agencies that give quotes on health insurance, so cities *must* have at least a dozen agencies competing for your business.
Years and years ago employers began offering health insurance as a way to attract workers. At first the company paid the entire premium, so it was a great incentive. As premiums rose, the companies began to share the cost with workers. If the workers had just turned down this “benefit” and kept their private insurance, they wouldn’t have become dependent on their jobs for insurance and wouldn’t now feel trapped.
I think workers have forgotten that they don’t *need* their employer in order to have health insurance. I remember an episode of CSI in which a worker stages a robbery because her boss will not schedule her enough hours to qualify for benefits. Huh? I yelled at the tv, “If insurance is so important, just buy your own!” The money that she would have spent on company-chosen insurance could have been spent on private insurance.
Private insurance is not taken from the paycheck before the worker sees it, so it appears to be hugely expensive. But as you said, you have control as to premium and deductible and co-pay, so private is definitely better.
Link | September 22nd, 2007 at 4:33 pm
I never said that a person *cannot* purchase a private policy. I simply said that job-based health insurance needs to be done away with so that there isn’t such a huge difference in premiums (for the worker) between a private policy and an employer-based policy.
I too had a private policy 10-13 years ago. I think the name was Golden Key or something like that????
So I know they exist…but IMO they need to be the rule, not the exception.
Link | September 22nd, 2007 at 5:06 pm
Barbara wrote,
who cares about health care…LOVE the new fall look *giggle*
Link | October 3rd, 2007 at 2:33 pm
Tracy wrote,
I looked into health insurance through State Farm (our car and rentinal insurance co.) when Dh was working contract, but it was *expensive* for a family so we didn’t do it. Getting it now through Dh’s work is still cheaper for us the way it’s set up now, BUT I would LOVE to have the money back in our pocket to pick my own with benefits we want/need. IF the medical insurance co. had to compete like any other business (they do now, but not quite the same way) they’d be shaping up pretty quick. It free up the employers so they can use that money another way (more raises and bonuses or even vacation days or something?) and give the employee more choices on where they get it and what kind they get.
Link | October 4th, 2007 at 10:39 pm