A couple of thoughts - I am not sure the reinsurance idea will work either. It should in theory but I am skeptical it will in practice.
I also work in health care and many insurance policies cover diabetic testing supplies and Obama's plan of using the fed plan as a base would guarantee coverage of them. Virtually every state has an appeals process for denied benefits (some are better than others) and if people are actually being denied this coverage, they should file an appeal. The process in most states requires a letter along with denial documentation to the Department of Insurance or regulating body.
"Virtually every state has an appeals process for denied benefits (some are better than others) and if people are actually being denied this coverage, they should file an appeal."
And how many working people living on the edge of poverty have the time/will/or knowhow to go through this process?
The point is that there are recourses if people are not being provided with access to their health coverage. No system is perfect and while there are major issues with private insurance even Medicare denies claims wrongly at times which is why it also has an appeals process for people to contest those decisions. Do you think the only Medicare beneficiaries who contest decisions are wealthy?
There are ways to make people more aware of their rights such as notifications to all beneficiaries and allowing advocacy groups to have stations in social service offices, hospitals, medical clinics, etc. Just because you are poor or not knowledgeable does not mean you have to be denied access to your rights.
Have you ever read Kafka?
I think he made a far description of the way that an impersonal bureaucracy like modern (for-profit, no one ever talks about how the insurance industry was until very recently not for profit) insurance works.
It's all good and well to say that people can appeal to the Department of Insurance, but for those who need it most this makes no difference.
Many chronic diseases (in particular diabetes) are endemic in low income and minority populations where lack of access to affordable food that isn't loaded with sugar and simple carbohydrates has created an epidemic.
I'll give Obama this, this national health insurance exchange idea might make insurance more transparent, but if you have to sort through 7,000 plans it makes no difference. I think that we have to transition to a single-payer government run plan that expands off Medicare in the long term.
But in the short term I think that we should reduce the burden on consumers by forcing the standardization of insurance plans into a set of 4-5 plans that offer the exact same coverage. So that way the consumer only has to choose between 4-5 plans instead of 7,000.
The mess that is the Medicare prescripton drug benefit should serve as a cautionary tale of the dangers of allowing insurance companies to write thousands of different plans.
Back to the idea of strandardization, I'd say put it on a grading scale. Medicare or equivalent is an A-plan, and so on down to junk D and F plans that cover virtually nothing. It's intuitive. No one wants to buy grade D eggs at the grocery store, I think that will work for insurance also.
"But in the short term I think that we should reduce the burden on consumers by forcing the standardization of insurance plans into a set of 4-5 plans that offer the exact same coverage. So that way the consumer only has to choose between 4-5 plans instead of 7,000."
This makes a lot of sense. I have no problem with a single payer system - in fact it makes the most sense. However, I have worked on healthcare/health policy for 15 years and the chances of it happening are slim due to political will/new winners and losers issues. In fact, all the candidates are proposing modified versions of the Health Alliances from the Clinton plan of 1993-94. It's not perfect but it is a huge improvement over the current system.
The Clinton's were never able to create a political coallition that united large trade unions and large manufacturers like GM. I tihnk that Edwards plan can.
Already, there's talk that Cerebrus is making an offer to the UAW for workers employed at Chrysler to tranfer healthcare costs to the union in exchange for the company creating a funded VEBA. The Steelworkers just made a similiar deal with Goodyear.
So I think that Edward's plan anticipates that in the next few years, you could use his open enrollment Medicare based plan to transition union workers to public healthcare. This takes a group that traditionally has seen universal healthcare as a possiblity to get screwed (union workers took lower wages in exchange for health care, if you unload their healthcare off onto a system that they have to pay into, you're stealing from them) to something that the union is going to decide for them.
I have a strong feeling that Bonior was involved in this.
Hopefully you are right. THe piece people miss is there are a tens of millions of jobs in health care from hospitals to doctors offices to device manufacturers to pharmaceutical companies, etc. Any changes create new winners and losers in this industry. All you have to do is look at the beating Eliot Spitzer took when he tried to move state health money around to expand health insurance for children in NY to see how hard this is politically. People ignore this part pretty regularly when taking about universal coverage and it is a mistake.
