Do you have health insurance? Do you need health insurance? Does a pre-existing condition prevent you from getting insurance? Can you afford health insurance? These are questions facing many Americans each and every day.
You may have seen the TV ads where doctors say that people who need their services are not coming to see them because they have no insurance. Nice ad. It’s sponsored by the American Medical Association as part of its campaign “Voice for the Uninsured.” The website is full of what they call “Real People, Real Stories.”
In this interview with Dr. Joseph Heyman discusses the issue of the uninsured in America. Dr. Heyman believes that now is the time to solve this problem. Unlike the Clinton effort in 1994, solving the problem is now the focus of a wide variety of business and political interests and the chances of everyone coming together to a successful resolution is better than ever.
The AMA proposal to expand health insurance coverage and choice is based on three pillars:
1. Subsidies for those who most need financial assistance obtaining health insurance.
This assistance could take the form of tax credits or vouchers, should be more generous at lower income levels, and should be earmarked for health insurance coverage. It is important to note that the government already gives people financial assistance to buy private health insurance—well over $125 billion each year—with an employee income tax break on job-based insurance that is hidden from public view. This tax break gives more assistance to those in higher tax brackets, and gives no assistance to those without employee health benefits. Shifting some or all of this assistance to tax credits or vouchers for lower-income people would reduce the number of uninsured and improve fairness in the health care system.
2. Choice for individuals and families in what health plan to join.
Today people are effectively locked into the health plans their employers offer, often just one or two plans, which are subject to change from year to year. A change in employment typically means a change in insurance coverage. In contrast, under the AMA plan, people could use tax credits or vouchers to help pay for premiums of any available insurance, whether offered through a job, another arrangement or the open market. As with job-based insurance today, health plans would still have to meet federal guidelines for covered benefits, but people would have greater say in what types of benefits and plan features they value. Coupled with individual choice, tax credits benefit recipients directly, and everyone indirectly, by stimulating the market for health insurance. If enough people have enough purchasing power—and enough say over how that purchasing power is used—insurers will be compelled to offer better, more affordable coverage options.
3. Fair rules of the game that include protections for high-risk patients and greater individual responsibility.
For markets to function properly, it is important to establish fair ground rules. A proliferation of state and federal health insurance market regulations has made it more difficult and expensive for insurers to do business in many markets. The AMA proposes streamlined, more uniform health insurance market regulations. Regulations should permit market experimentation to find the most attractive combinations of plan benefits, cost-sharing and premiums. It is also important that market regulations reward, not penalize, insurers for taking all types of patients. People should have a guarantee that they will not lose coverage or be singled out for premium hikes due to changes in health status. Market regulations intended to protect people who have high health risks typically have backfired, sometimes disastrously, by driving up premiums for younger, healthier people and leading them to drop coverage.
To help high-risk people obtain coverage without paying astronomical premiums, additional targeted government subsidies are needed for high-risk people that would allow insurers to keep premiums down in the regular market. Individuals also need to be encouraged to play fairly by taking responsibility for obtaining health insurance without waiting until illness strikes or medical attention is needed. People who are uninsured despite being able to afford coverage should face tax implications.
Everyone needs to write their Congressman and Senators and tell this to fix this thing!!