OK on Love and War, but What's Fair With Health Insurance?
09 01 08 - 11:48
Betsy McCaughey's op-ed "The Truth about Mandatory Health Insurance," (Jan. 4) missed the mark on a number of key principles of the Healthy Americans Act, the bipartisan bill we are cosponsoring, and about the current debate on health reform.
The Healthy Americans Act would not "require everyone not on Medicaid" to buy health insurance. To the contrary, our bipartisan legislation would modernize Medicaid by empowering America's poor to purchase their health care with private sector choices just like members of Congress.
Ms. McCaughey claims that mandatory health insurance would make everyone pay the same price. This is not the case. Health insurance premiums currently vary by geography and health plan and this would continue. In fact, price competition among health plans is one of the core principles of our bill. Plus, our legislation explicitly provides that those who engage in healthy behaviors like quitting smoking, lowering blood pressure or cholesterol, or enrolling their children in wellness programs would be eligible for discounts on their health insurance. Under our approach, those who improve their health would pay less, whether they are young, old, or in between.
Ms. McCaughey favorably cites the fact that a 55-year old man in New Hampshire would pay health premiums that are three or four times higher than a 25-year old man. However, the price disparity can be much higher in some states under the current system. For example, one study found that a healthy 62-year old man could pay up to six times the price paid by a healthy 24-year old woman in some markets. Furthermore, at present, many people are denied coverage altogether based on their health status. While our bill would not allow this type of price gouging or discrimination, we do provide the option for individuals to choose health savings accounts for their coverage. Those who elect this option and end up not needing or using many health services can build up balances in their accounts tax free until such time as they need the money to pay for health care. And if they are fortunate to live a long, healthy life, the funds they accumulate can be used to help pay for their retirement.
Finally, Ms. McCaughey claims the growing number of uninsured Americans is largely due to immigration or the decision by those who can afford coverage not to buy it. According to studies by the Kaiser Family Foundation and the Commonwealth Fund, the increase in the numbers of uninsured Americans has more to do with the decline in employer-sponsored health insurance and the fact that health insurance is becoming too expensive for many workers, families or individuals to afford. The Healthy Americans Act would tackle these problems by giving individuals private sector choices for health care not tied to their employment, fixing the tax code to eliminate inefficient subsidies for health care, and providing sliding scale subsidies to ensure health care is affordable and accessible for all Americans.
Sen. Ron Wyden (D., Ore.)
Sen. Bob Bennett (R., Utah)
Washington
The most important issue is the oligopoly of government subsidized insurance companies and hospitals and a total lack of free market influence.
Few politicians will address the issue that health care cost is rapidly approaching 20% of gross domestic product and that the taxpayer is footing two thirds of the bill. To the average taxpayer, every 12% increase in premiums eats up 4% of any wage/salary increase.
Proposed, and previous, mandates by federal and state governments have fostered a dysfunctional system that requires major reform, not tinkering at the margin or additional mandates.
William J. Catlett
Chester, N.J.
I agree that healthy adults aged 18-34 shouldn't be required to overpay for preventative or routine health care, which are predictably personal expenses both with respect to financial significance and timing. Risk pooling (sharing costs) as a hedge against individual unpredictable expenses underlies all functioning insurance systems. Purchasing "insurance" for predictable budgetable health care expenses is not insurance as much as it is pre-paid health care.
Derek Goldin
Greensboro, N.C.
Of course mandatory health insurance is a wealth transfer from young to old. So what? In the first place, any insurance covering any form of risk is a wealth transfer from one to another segment of the population.
The pricing policies of the health insurers do not reflect the most fundamental principle of insurance: that the risk should be borne by the largest population subject to the same risk against which the insurance protects. In the case of health insurance, to give the healthier young the benefit of lower rates makes no sense. The population at risk includes everyone. The mandatory health insurance requirements being proposed have at least one virtue: forcing the young to protect their own long-term interests in spite of themselves.
Nathan Edmonson
Dunwoody, Ga.