Sunday, July 26, 2009

Saturday night

Had long talk with friend in Canada tonight.

Good editorial in The New York Times explaining the whole healthcare plan. See here. Right now I'm covered by a group plan at work but see may co-pays rising (as insurance companies' profits are rising) and am now having to pay a percentage of procedures (20% of the colonoscopy/ gastroscopy) -- didn't have to pay that last time. (Somebody at work just recently had the same procedure in a hospital -- I had mine at an ambulatory center -- and had to pay $1,000 out of pocket.) I also have very high monthly drugs costs. If I were to become unemployed, I'd be in a real fix. That's a constant source of worry (people in Canada and Europe, e.g., don't have to worry about this, and they have better healthcare than we do*). So what's in the new plan for me?

WHAT IF I HAVE GOOD GROUP COVERAGE? The main gain for these people is greater security. If they got laid off or chose to leave their jobs, they would no longer be faced with the exorbitant costs of individually bought insurance but could buy new policies through the insurance exchanges at affordable rates.

President Obama has also pledged that if you like your current insurance you can keep it.

Right now employers are free to change or even drop your coverage at any time. Under likely reforms, they would remain free to do so, provided they paid a penalty to help offset the cost for their workers who would then buy coverage through an exchange. Under the House reform bill, all employers would eventually be allowed to enroll their workers in insurance exchanges that would offer an array of policies to choose from, including a public plan whose premiums would almost certainly be lower than those of competing private plans.

Some employers might well conclude that it is a better deal — for them or for you — to subsidize your coverage on the exchange rather than in your current plan. If so, you might end up with better or cheaper coverage. You would probably also have a wider choice of plans, since most employers offer only one or two options.

There's also this:

The House bill, for example, would require that all new policies sold on or off the exchanges must offer yet-to-be-determined “essential benefits.” It would prohibit those policies from excluding or charging higher rates to people with pre-existing conditions and would bar the companies from rescinding policies after people come down with a serious illness. [Emphasis added.]

Also, see Paul Krugman here ("Why markets can’t cure healthcare").

*"In fact, a study last year by an influential health policy research group, the Commonwealth Fund, found that the United States had the most expensive health care in the world, yet was in last place among industrialized countries in preventing deaths through timely and effective medical care." [New York Times]

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