New York Times: Health Care Law's Uneven Path to Better Insurance

[BzaDem]

"First, people will be required to buy insurance, to spread costs among the sick and the healthy. Second, insurers will be prohibited from cherry-picking only the healthiest customers, again to spread costs. Finally, the government will give subsidies to people, like McDonald’s workers, who can’t afford insurance on their own.

Germany, the Netherlands and Switzerland all use a system along these lines to cover everyone, largely through the private sector, for less money per person than this country spends.

The recent disruptions in our health insurance market are partly a result of the fact that the stool’s three legs were not built on the same timetable. Some of the insurance regulations, like the one on overhead costs, are starting to take effect. But the new markets for health insurance, known as exchanges, won’t be up and running until 2014. This timetable has its problems, and the Obama administration will probably need to grant some more temporary exemptions.

In 2014, however, the choice for McDonald’s workers will no longer be between a bad policy and no policy. Through the exchanges, they will be able to buy a real health insurance plan — one that covers cancer, heart attacks, surgeries, M.R.I.’s and hospital stays. Dr. Carroll notes that many families will end up paying less than they are now paying out of pocket and will get more access to care, too.

For insurance companies, these changes won’t be quite so positive. They will no longer be able to sell plans that devote 30 percent of revenue to salaries for their workers. They will not be allowed to compete over which company can come up with the most ingenious ways to say no to the sick. Their benefits and prices will become more public, thanks to the exchanges."

--snip--

http://www.nytimes.com/2010/10/06/business/economy/06leonhardt.html?_r=1

[leftstreet]

1. Did we take this long torturous route to Medicare? Social Security?

No, I didn't think so

[frazzled]

2. Actually, yes

The original Social Security Act was a mere shell of what we know as Social Security today. It excluded many people—largely women and agricultural workers, meaning African Americans. "Job categories that were not covered by the act included workers in agricultural labor, domestic service, government employees, and many teachers, nurses, hospital employees, librarians, and social workers. The act also denied coverage to individuals who worked intermittently." (http://en.wikipedia.org/wiki/Social_Security_(United_States). It went through many transformations and improvements over the years.

Medicare has undergone many transformations since its original passage in 1965 as well. Some details here: http://seniorjournal.com/NEWS/2000%20Files/Aug%2000/FTR-08-04-00MedCarHistry.htm

[depakid]

3. Well, if you consider expensive, high deductible, high copay insurance

that offers around 70% in actuarial value "better," then this bill's for you!

[PoliticAverse]

4. All the laws and regulations in the world are meaningless unless they are enforced. n/t