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Health Care: Real Reform Requires Everyone to Pitch In

Editor’s note: In this piece from Greg Scandlen we see that the young, who in the polls, most support health care reform are also the ones that must participate in paying the cost. This cannot be paid for by only ‘the rich’ and by reducing the profits of insurance companies.

Community Rating?
Writing in USA Today, Julie Appleby describes one of the least discussed issues of the current debate, the restrictions on risk-based rating of premiums. Everyone seems to just blithely accept that some version of community rating is a good thing and inevitable. Neither is true.
She writes, “For years, insurers have charged older customers far more than younger ones, in part because of older residents’ higher use of medical services. Now, as Congress wrestles with a health care overhaul aimed at covering the majority of the 46 million uninsured, that discrepancy is one area targeted for change.” She says the change could have a profound effect on tens of millions of people who are currently insured throughout the country.
The article says, “Average medical spending per person among 18- to 44-year-olds was $2,079 in 2006, the latest data available from the federal Agency for Healthcare Research and Quality. Spending for 45- to 64-year-olds was $4,866, about 2.3 times more.” But, “There’s a much greater ratio depending on how you cut the data,” says Robert Zirkelbach, spokesman for America’s Health Insurance Plans. “If you break it into quartiles, there would be a 5-to-1 gap.”
Karen Pollitz, project director at Georgetown University’s Health Policy Institute. Is quoted as calling this ratio “obscene” and a “tax on getting old.”
But the core problem of the uninsured is not with older people, it is with younger people. The article says,” At the heart of the debate is how to get younger people – currently the group least likely to have insurance – to buy coverage.” It adds, “All the proposals in Congress would require almost everyone to carry insurance and impose a financial penalty on those who do not. Still, young people won’t enroll if prices are set too high, warns James Gelfand, senior manager of health policy for the U.S. Chamber of Commerce. “Young and invincible people don’t want any insurance, much less a gold-plated (plan),” which is how they may view policies if a 2-1 ratio makes them expensive or the plans include benefits they don’t want, he says.
Marian Mulkey, a senior program officer at the California Health Care Foundation, is quoted as saying a two-to-one ratio would cause premiums to double for young people in California while cutting them by half for older people. “If you have someone in their 20s struggling to pay for a policy that costs $80 a month, and it goes up to $150, what would you have to do with subsidies or penalties to get them to buy it?” she asks. “Conversely, (for people in their 50s or 60s) if you could bring premiums down to $600, maybe they’re in a much better position to keep the policy. This is the challenge.”
The on-line version of this story generated over 1,000 comments.
USA Today


September 4, 2009 - Posted by | healthcare | ,

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