The claim is that it’s an open market, but for most working stiffs their company has the choice of carriers and they only get a very narrow choice of that company’s plans, perhaps the deductible.
Here’s a NY Times analysis Real Choice? It’s Off Limits in Health Bills
This is why Republicans are for trying to break the link between employment and health insurance. One proposal is allowing insurance to be traded across state lines to increase competition. McCain proposed removing the tax exemption for employer-provided insurance to let consumers pick their own plans. (Of course he was demagogued away with the “What, you want poor widdle Timmy to pay more for his vaccines?, etc etc.”)
This might also help increase high deductible plans, which function more like real insurance (paying for catastrophes only) and would help contain costs the free-market way.
If by “contain costs”, you mean charging more for less, you might be right. I have been on an high deductible plan for the past two years, having no other choice, and it has been an absolute disaster for my wife and myself. I work for a global financial services company, and employees have very little choice over their health insurance plans.
I never understood the rational behind that… The block to selling across state lines isn’t a Federal block, is it (else my question is very different)? So Republicans want to override every state’s legislature on the restrictions and other requirements for doing business in their state? The Republicans who chant about Constitutional authority defend this how? The Republicans who are upset about the Federal government imposing its will on states are OK with this how?
Is it general nanny-state=bad, no matter what level, so even if the people of a state chose it for themselves, nanny stating is so bad that they can’t have it? That is, using the Federal nanny to beat up the state nanny?
It may be a good idea, but it certainly points to the pure partisanship of many claims (if I’m reading this right). I wish discussions could take place without fear of it being a Republican or Democrat idea (or either one being used as a simple smear).
I’d also be interested in how this would increase competition. Right now there are a host of national insurance companies, with (I assume) state-specific plans. Are there that many state-level/local insurance companies out there that would change the market that much? Have Aetna, Blue Cross, etc. been conspiring all this time to keep their costs up?
Lack of necessity for options was the nice thing about the Canadian and Brit plans. When I needed help there they each time just fixed me up. In London I was hit by a car and spent a day in the hospital. They didn’t bother with deductions and copays, no insurance card, no check that I hadn’t lost my job since it was issued… just got me fixed up and sent me on my way.
When I lived in upstate NY, there was exactly ONE health insurer available to me (Empire BC/BS).
Hardly a choice.
If that’s their goal, they’re going about it in a funny way, by adamantly opposing everything related to a bill that has breaking that link as its primary purpose.
Republicans like to claim that they’re pro-free market, but what they really are is pro-big business. The two are not always the same, so when we see legislation which is pro-free market but anti-big business, like the health insurance bill or the cap-and-trade bill, they oppose it.
The cap-and-trade bill handed out most carbon permits for free. You call that anti big business?
The only way I can see this working is if it managed to cut insurance premiums to a fraction of what they are now. I don’t know how exactly how big a percentage of my insurance my company pays for, but I’m willing to say it’s around 60 percent. And even though what I pay is tax exempt, it still takes a pretty big chunk out of my biweekly paycheck. If my company weren’t subsidizing the cost, I would be having to do without it.
And there already seems to be quite a bit of competition within individual states. Where I live a number of national insurance companies have affiliates.
I have somewhat mixed feelings about this. On the one hand, I often wonder why insurance is tied to employment. Causes so many problems such as encouragement for employers to limit full-time employment, and expense/unavailaility of insurance to the un/underemployed.
But on the other, I really shudder when I hear suggestions that what we need is increased competition and more options for the consumer, such as interstate offerings. I am in the minority that thinks that ever increasing choice is not necessarily desireable, as it undervalues the individuals costs involved in making those choices. Hell, we are already confronted by countless choices from the supermarket to your TV and phone providers and your natural gas. I’m not convinced that the end result of these increased choices has necessarily resulted in my receiving better products/services at better prices across the board.
I am very fortunate that my employer offers a decent variety of health care HMOs and PPOs from which I can choose. But I sure don’t want more options than that.
I feel I’m not phrasing this well. Sorry.
The premise of “across state lines, just like car insurance” is a phony one. There’s also a hidden agenda or two, or three.
Yes, you can call a 1-800 number to set up your car insurance, but the policy is written to fit your state’s insurance laws. You might not get the same policy you’d get if you lived in the next state, where insurance rates must be the same for men and women, or where there’s no-fault car insurance. Some companies decide not to sell policies in a few states.
In health insurance, there are some additional tricky details. Some states require insurers to offer coverage for contraceptive drugs, IUDs, and such. Other states wouldn’t dream of doing that. If you’d like to have one policy for everyone in every state, you’d have to even out that rule. Do you make all the states cover contraception, or do you make them all cover no contraception? You can see some power groups lining up on one side or the other.
Just as a counter-point…
My husband and I have a HDCP with an HSA, and it works wonderfully for us. Do you fund an HSA for the non-catastrophic expenses?
To the OP: Yes - we have all kinds of choices, since we’re HSA/HDCP. We control *everything *to do with our healthcare. Of course, it’s not a good fit for everyone, but that’s okay. We need lots of options for healthcare, not just “single-payer” or “national insurance companies” or whatever.
It’s worse than that. The insurance companies buy a state legislature, and pass bills more or less deregulating insurance in that state. Then all insurance companies basically move there and write policies under the rules of that state. If you’ve got an insurance commissioner in your state who wants to work for the consumer, she basically has no power.
Anyone doubting this would happen should ask himself why so many companies are incorporated in Delaware.
Of course we fund an HSA. We also have a small matching contribution from my employer.
This doesn’t even cover the cost of monthly prescriptions, let alone non-catastrophic expenses.
As opposed to now, where everyone gets unlimited carbon permits for free? Yeah, it’s a start.
With health savings accounts, the problem is that a catastrophe can be composed of multiple non-catastrophic events. Typical two-income family, for instance, it’s not a catastrophe if the mother is pregnant on maternity leave, or if the father is down with the flu for a month, or if one of the kids they already have breaks a leg climbing a tree. So presumably, those are things that catastrophe insurance wouldn’t cover, since they’d be expected to come out of an HSA. But what if all three of those happen at once?
HSA plans have a maximum deductible for the family, usually like $5K. It’s per year, not per incident. So once the baby is born, ($5k hospital bill ), Joey’s broken leg is covered by insurance, and so is Dad’s flu treatment.
The same is true even if it’s very small things, like expensive prescriptions.
“unf unf unf free market SPLORT”
“Senator McCain, which do you worship more, the free market or Ronald Reagan?”
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