When I began looking into the idea of a health insurance exchange, my first thought was, "Why aren't we already doing this?" Some places are. Three years ago Massachusetts instituted its "Connector," which functions in a similar fashion to the exchange I discuss tonight, and the Federal Employee Health Benefits Program has been around since 1960.
But otherwise, most of the insurance market operates like the "wild, wild west," as Linda Blumberg of the Urban Institute put it. It's almost impossible to compare plans because many private insurers won't tell you exactly what is included in a plan until you've signed up. Before I sign up for a plan, I want to know what the premiums and co-pays are, but I also want to know what the lifetime maximum coverage is and what specific drugs are covered. Right now, that isn't easy to do. An exchange would simplify that process and would also spread risk and broaden coverage.
How the exchange functions may depend on whether or not the government decides to offer a "public plan" to compete with the private sector. That's probably the most controversial topic right now in the entire health care debate. Some analysts I spoke with doubt an exchange would offer many low cost plans without a public plan to compete with. But others said a public plan could drive private insurers out of business.
So what do you think? Have you had luck comparing health care plans, or would an exchange help? What do you think about throwing a public plan into the mix?
Comments
Most workers with employer-sponsored health coverage are required to share the costs of their health insurance premiums and benefits with their employers. In 2005, over three-quarters of workers contributed toward their monthly premiums (91% for family coverage, 79% for single coverage), and higher percentages of workers contributed to cost sharing for office visits (95%), and tiered cost sharing for prescription drugs (89%). Lower percentages faced plan deductibles (56%), separate hospital cost sharing (52%), and separate deductibles for prescription drugs (10%).
The percentage of covered workers with a plan deductible is calculated for workers with single coverage. For PPO and POS plans, deductibles are for in-network services.
To Whom It May Concern:
I want a public funded, single payer health care
system run by the government. If that is not possible, then we must have a public health care system so successfully run that those opting for coverage through private insurance companies will want to become part of the public health care system.
My concern is that private insurance companies will buy enough politicians and water down the public health plan so that only the old, the ill, and the uninsurables will be covered. This will doom it to insolvency like Medicare.
Insurance companies should be taken out of the basic health insurance business. However, there may be room for them for “Cadillac policies” offering services beyond the basic public plan.
I am encouraging President Obama to use his executive privilege to ensure that Rangel and Waxman get Conyer's HR 676 on the floor because I want formal Congressional hearings on single payer health care.
Current access to our so-called health care system is largely controlled by the self-serving insurance companies and their policies are killing Americans. Prisoners and people crossing our borders illegally have health care in America that is denied to law abiding American citizens.
I am encouraging President Obama NOT to mandate that every American must buy insurance. I know people who are paying between 8,000 and 12,000 a year for insurance policies having a 5,000 to 10,000 deductible. Others barely scrape together enough money to make rent or mortgage payments. 62% of bankruptcies are due to medical costs which exceeded the coverage of the insured. Many Americans can NOT afford health insurance at all. This is NOT health care. It is a tragedy.
Congress needs to get the insurance companies off of our backs. They have been sucking the life out of the public for decades. It is way past time to fix the mess politicians have permitted.
Suzanne W. Jenkins
Christian,
That's really interesting. Did you get your plan through the Connector, or did you go out on your own? Were there any plans available for the price you were paying in Illinois? I'd be curious to hear your experience.
I recently moved to Massachusetts from Illinois, and was shocked by how much more expensive healthcare insurance is for my family under MA's mandatory program. I typically choose a high deductible, highly flexible plan that allows me to select my doctors. In Illinois, this cost me $475 a month for coverage for my wife and our child. Here in MA, the cost for an equivalent plan is almost $800 a month!
If this is what we have to look forward to under a government mandated plan, I want none of it. Despite the high fees, I've also heard that MA's plan is way overbudget - I have absolutely no faith that the federal government can do this any better. Ironic then that Ted Kennedy of MA is sponsoring the bill.
At the very least, if this bill goes through, I want the freedom to opt out without having to pay the added taxes. I much prefer to take my chances with private care and coverage (as in IL) where at least my complaints will be heard with a profit incentive to fix what is wrong.