Building A Customer-Oriented Health Insurance Exchange
http://thedianerehmshow.org/shows/2012-12-04/building-customer-oriented-health-insurance-exchange
In the shadow of negotiations over the so-called fiscal cliff, another deadline looms in Washington. States have until December fourteenth to decide whether they intend to create state-based health insurance markets. If states choose not to build their own or partner with others, then the federal government will step in. As states rush to create exchanges by 2014, they’re considering how best to develop health care comparison tools. Individuals and small businesses need ways to plan for unexpected expenses, find out which plans include their provider, and compare service quality. Diane and her guests talk about building customer-friendly health insurance exchanges.
Guests
Robert Krughoff
founder and president of Center for the Study of Services and Consumers' CHECKBOOK.
Julie Appleby
senior correspondent, Kaiser Health News.
Sonya Schwartz
program director, National Academy for State Health Policy.
William Custer
director of Center for Health Services Research at the J. Mack Robinson College of Business, Georgia State University.
Glen Shor
executive director, Massachusetts Commonwealth Health Connector.
Comments
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To those single guys in Mass who decry their $400 or 500 a month premiums, how about the retired 59 year old teacher in Indiana with mild hypertension.......her Blue Cross monthly premium is $870 while her pension after 32 years teaching and four years of other employment prior and a Masters degree is $1800? The family plan is more like 1500 if she needed it.
Remember that it is the overall COST of care that is out of control......the way the US administers the care and then charged for the care.......NOT the care itself.
As long as the insurers are running the show and bending the ear of Congress, it will continue to be the foxes ruling the chicken coop.
@HA.
Actually, this time you raise some interesting issues.
I will try to put them in some sensible sequence.
HC reimbursements based on outcomes not fee for service is one of the best ideas around. It promotes personal responsibility for both the care giver and the institution - clearly a solid conservative principle.
"Former "big blues" switched from mutual companies to the massive all profit machines they now are."
Returning insurance companies to the days of the mutuals is not a terrible idea. At least worth exploring - given that insurance companies can not compete on a level playing field.
"Those in the real health industry know that PROFITS are now tops in the minds of insurers and some corporate facility provider chains"
HOWEVER, if insurers could compete on a level playing field and operate coast to coast, you would see much lower rates and much lower HC costs. The model is not "Medicare". The model is the post office v. FedEx v. UPS. Unfortunately, the proposals of republicans to promote competition (insurers allowed to sell across state lines) and to lower costs (restrictions on lawsuits which instigate a lot of unneccesary ass-covering expense) were NEVER CONSIDERED by the President. That by the way, is what told me he was never serious about anything but 100% government-run HC and HI in this country. But I digress.
Expanding the "Medicare" model to push insurance companies out of business will drive us head-long into the mediocre. Competition not mandates drive good outcomes the most effectively.
My American son attends college in Europe and teaches English part-time to pay for some of his expenses. He has excellent health care insurance via an international health insurance company based in the USA. They provide medical insurance for Americans and other westerners living and/or working outside of their countries at least six months per year. His medical insurance costs $1400 a year including wellness visits, doctor visits, hospitalization, prescriptions, medical evacuation to a German, Swiss, or US hospital, surgery, medical tests, vision exam, acupuncture, massage therapy, counseling, and treatment of chronic illnesses. When I asked why the low cost for the very best medical insurance, the insurance agent replied 'the lower costs of medical care in Europe and other countries with private/public universal health care systems'. My son loves his health care provider. When he needed a simple elective surgery, all of the medical tests and surgery were completed within one week. When he was sick here in the US, he found it difficult to get an doctor's appt. and said 'I'm going back in a few days, I'll just go to the clinic and be seen right away'.
We are paying too much for health care in the US and it won't change until we have a single payer plan or a public option. Health care costs harm our economy. It is a pity that too many Americans are fooled into believing that our private health care system is the best. It's not. My son wondered if it's worth it to return to the US after living in Europe. Sad.
If I was in your position, I would move to Israel. Friends of mine worked there and loved their health care system.
The French, Brits, Germans, Swiss, Swedes, Norwegians, Dutch, and other Europeans may pay a higher tax rate but they receive much more from their taxes. If you combine your federal, state, local, excise taxes, fees, you're paying more and getting less. If you combine your health insurance costs, you're paying more then the Europeans and getting far less.
Looking back on my own health care over the last 60 plus years, I can say I have received some of the best and some of the worst health care that our system can possibly dish out.
While I certainly am concerned about the cost, I am far more concerned with the competency. A few bad experiences with doctors will influence your opinion about our system.
I worked in the healthcare field for 12 years before being downsized. Since my lay off, COBRA has long expired and as far as employment goes, I've been working temp, per diem and then seasonal. I then acquired a f/t position w/o benefits only to be laid off again...
In NJ Gov Chris Christie just vetoed legislation to institute the Affordable Healthcare Exchange..He reasoned NJ could not shoulder the burden of expenses and on the Jon Stewart's "Daily Show" even stated that the Federal Government could provide the information to him since they want it implemented.
Even while progressing claims and discussing benefits as a Claims processor, I 've always asked and wondered why in the US would healthcare be left to the whims of employment and political philosophy. In my small town, we saw a hospital (which survived for over 100 years) go out of business . Except for ER, Nursing School and some outpatient services, we saw the loss of jobs while the hospital claimed the main burden was non payment due to the uninsured.
I say this to say that it would be fiscally responsible to pool our healthcare. In my experience, the fastest paid claims were those processed and paid by the government, jobs could be saved as the "uninsured" are processed and can pay into some kind of system, and in state where the unemployment is 9.8% (above the national average), maybe employers would hire a little more if potention employees had their own coverage.