My Health Care Solution.

No new taxes or government involvement in the health care insurance provider process.

Problem:

Reasonable people know they need health care insurance. Many simply can’t afford it.

Currently insurance providers are hand picking those they will insure. These are the least risk, healthiest folks in the population. How are they doing it? With premiums, by adjusting premiums for every individual they can effectively eliminate those they will not profit from. At the same time, eliminating so many from coverage results in higher premiums for those who are covered. The insurance industry has become no more that a premium collector from a select group instead of being an insurance provider. Don’t believe it? If you have individual insurance vs group insurance and are unfortunate enough to make a major claim, when your new term comes up for renewal, watch how fast they either don’t renew, or price your premium so high you just walk away. Sure you can get a new policy but it will be priced to reflect your history, and that pre-exiting condition, excluded for at least 12 months. They will however be happy to accept your monthly premium payment, if you can afford it.

High premiums are the major obstacle to obtaining decent or any health care coverage at all. So how do we solve this problem and not affect the profit of the insurance providers?

Solution:

I see what may be the only reasonable solution. One I may be able to support: regulation.

For the most part I oppose regulation; however, I see it working positively in the public utilities arena. People are offered a utility product which like health insurance we all need, electric, gas. The price is regulated here by the PSC (Public Service Commission).

They set the rate or maximum rate that can be charged. If the utility company needs to raise rates do to costs or expansion they must present their case to the PSC for approval before doing so. The PSC works to adjust rates, if necessary, that benefit both the public and the utility company. Utility companies are profitable under this system/ process.

The country would be divided into regions, Southeast, Northeast etc.

Any company providing health insurance in a region would be required to provide a basic health care coverage plan (Standard for the entire country) to anyone in that region.

The national standard would be developed by a national group composed of an insurance commissioner from each region. Premiums would be determined by the regional Insurance commission. Regional commissions would be made up of the state insurance commissioners from each state within that region.

Premiums would be set by region based on overall risk in that region.

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Reasonable and customary charges would be set by region, similar to what is done now.

Maintenance of Profit and Coverage:

I see an increase, or at the least, the same profit for insurance companies by increasing their customer base thus spreading the risk across a region (think group coverage).

Supplement participating companies with current alcohol/ tobacco taxes collected regionally. Make these taxes fluid, easily shared with other regions if needed.

Further reduce risk with a customer deposit, similar to utilities now, with a maximum cap.

Well that’s my general idea. It seems reasonable to me and I think it would work with little federal government involvement, which means little federal control.