• Is this another new idea for improving health reform? – ctd.

    Let me add one thing to Austin’s post from earlier.  Let’s focus on this part of the Jenkins piece:

    Under this charter, let’s permit insurers to design their policies free of ObamaCare’s mandated benefit levels and free of state regulation…

    What’s the first thing the new nationally-chartered insurers would do? Rush out cheap, high-deductible policies, allaying some of the resentment that the mandate provokes among the young, healthy and footloose affluent…

    First, these folks could buy the minimalist coverage that (for various reasons) actually makes sense for them.

    The regulations against under-insurance, weak as they may be, are some of the best aspects of the bill.  The fact that mini-med plans were going away is a good thing, not a bad one.

    Cheap plans are bad plans.  There’s no magic to this.  To a limited extent, you get what you pay for.  The reason McDonald’s plans were low price was they they offered almost nothing in the way of benefits.

    The various reasons that Jenkins glosses over in the last statement are almost always about cost.  The reason McDonald’s offers that plan is because it is cheap.  The reason most people buy cheap plans is because that’s all they can afford.

    This is one of the worst ideas I’ve seen yet.  It’s also has one of the best chances of actually happening.  Lots of regulations will be set at the state level, and there are lots of things still left to be worked out.

    • The McDonald’s plans and the other mini-meds seem bad to me but what is wrong with very high deductibles?
      I think very high deductibles should be encouraged.

    • BTW I think that calling the mini-meds health insurance should be considered fraud.

    • What evidence is available is mixed on high deductible plans. It may cause people to skip cheaper care. It may lead people to avoid care they dont need. Preferences for a high deductible plan are mostly philosophical as far as I can tell.

      On the philosophical front, it does put front and center the idea that some who are currently healthy do not want to pay into the system. They just want to join later when they think they will need care. Given how insurance works, I would think the problems this creates are obvious.


    • Well, considering the pyramiding of both delivery of service and payment processes, this might be one way to “fight costs” and the “individual mandate.” Problem is,it does NOT address the oh-so many multiples of middle men (clearinghouses, medical payment consulting firms, provider network outsourcing, contracting abuses (particularly in the area of provider rental networks and PBM kickbacks), it seems to me that this proposal to legitimize under-insurance is nothing short of stellar intellectual dishonesty and could, in many respects, be considered a fraud on the public perpetrated by the very “insurers,” provider rental agencies and yes, Wall Street (for being a key motivator for such behavior).

      Don’t get me wrong, there are providers and payors (clearinghouses) who truly strive to conduct business in the most ethical manner and with their patients’ well being first and foremost. On the other hand, we most certainly have abuses in the system that I seriously doubt the health care industry as a whole and most members of the Congress really even care about. Yet, this is, in effect, an unauthorized tax that could be put to better (more efficient) use.

      Bottom line, if we’re going to embrace under-insurance, don’t expect the price of health care to come down. It doesn’t even begin to address the multiple other issues leading up to those cost increases.