Reform Proposal 4

One of the main tenets of the Obama-Biden plan for health care reform is to “Make Health Insurance Work for People and Businesses -- Not Just Insurance and Drug Companies (whitehouse.gov).” Our groups’ beliefs are also in line with these goals. As we have previously stated, many Americans are without health insurance, to the tune of 46 million people. With the nature of our health care system today, no concerned human being can agree that our current for-profit system is ethical with all the uninsured that need care in the United States. Health care costs are rising, yet “Managed care plans earn higher margins today than they ever have before, and operate at lower medical loss ratios than at any time in their history (Carl McDonald, Verden Report).” We feel that this system is not one that is conducive to providing Americans’ with the best health care possible. From 2003 to 2007, the costs of premiums fell as an overall percentage point. This correlated with health insurers spending less on health care. In the last couple of years though, premiums are raising again while insurance companies are continuing to spend less on health care. What this means is that the cost of health care is getting shifted from the companies to the enrollees.

“Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by 2008. The average employee contribution to company-provided health insurance has increased more than 143% since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115% during the same period (Verden Report, 2007).” These are yet more stats that drive home the point that health care costs are getting out of control, and reform needs to happen to control said costs. What is truly disheartening about these stats is the fact that the money doesn’t make its way back to the enrollee. “Contrary to claims about making health care more affordable for all, the money is simply going to Managed Care Organizations bottom lines as profit (Verden Report, 2007).” We believe that Managed Care Organizations should operate with the consumer foremost in their minds, not the companies’ bottom line. It would be in the best interest of the consumer/enrollee if laws were passed that ban cost shifting whenever said company is in the black (aka making money).

One reform that can really help to control consumer/enrollee cost would be to require insurance companies and managed care organizations to “cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums (whitehouse.gov).” Unexpected costs place too large of a burden on the consumer. Laws such as the following can go a long way to keeping prices at a stable level, because no consumer should have to worry about unexpected health care costs destroying their financial stability. Consumers currently have to sign up for a contract to receive health insurance. Because the nature of a contract is a long-term one, insurance companies and managed care organizations should be beholden to offering a fair, stable rate for the coverage that they provide. Shifting costs to consumers while companies profits goes against everything health care should be in a country like ours.