INTELLIGENT Health Insurance Reform Using The Free Market and LIMITED Government

As a multi-state Licensed Health & Life Insurance Broker, I have been providing quality Health Insurance services for hundreds of families and Small Businesses around the country for the last 15 years. I have seen first hand how WELL our health care system works AND how well our Health Insurance system CAN work. I have seen first hand (over and over again) what happens when a Health Insurance company pays claims (by the hundreds of thousands) thereby protecting the financial future of their insureds and ensuring that they receive the very best medical treatment. Specifically by allowing them access to expensive medical procedures that they could never afford on their own. I have also helped many consumers obtain access to legitimate major medical Health Insurance coverage even if they were labeled as "uninsurable" on the open market.

That being said, I have also seen first hand where our Health Insurance system has failed. Most especially when it comes to denying applicants coverage for pre-existing conditions when they apply for Individual (non Group) Health Insurance. In fact, it is arguably this one systemic problem (over all others) that has led to the current fever pitch amongst the Democrat Majority to push their idea of health insurance "reform" on to the American public. Sadly, even though President Obama promised unprecedented Transparency during the current Health Insurance "reform" negotiations. We have seen no such thing since the process began. Thankfully both the House & Senate bills have been released for the American Public to review. One thing I can tell you after reading both bills is that neither bill is about health insurance reform. They are instead about Tyranny.

Nonetheless, we still definitely need Health Insurance reform on many levels and if Government must play a part, there are intelligent things that can be done. Here’s where they can actually help:

• Eliminate the ridiculous State imposed Mandates that PROHIBIT Health Insurers from offering coverage in EVERY SINGLE STATE! For example, Small Businesses in California have roughly 6 (yes that's six) options for Health Insurance. Yet there are 1,300 Health Insurance companies in America! States like Colorado FORCE carriers to cover "substance abuse" which DOUBLES the Health Insurance premiums in Colorado (you can now waive "substance abuse" coverage and your premium is subsequently reduced BY HALF!). This kind of State Mandate (and so many more) is what prevent the majority of Health Insurance carriers from offering their products in every State.
  
  Basic economics 101 teaches us that NOTHING increases quality and drives down prices LIKE COMPETITION! How can we increase quality and competition when we stifle it by imposing ridiculous mandates that inhibit competition from the get go? All 1,300 Health Insurance carriers should be able to offer ALL of their products in EVERY SINGLE STATE. This way if you do not like your current coverage you have 1, 299 OTHER OPTIONS. With that many options available, carriers are NATURALLY FORCED BY THE RULES OF COMPETITION AND FREE MARKET ENTERPRISE to IMPROVE not only the quality of their products but to also improve their customer service OR THE CONSUMER WILL PURCHASE their Health Insurance from 1,299 other carriers! It's as simple as that! Also, actuarial tables teach us that the more lives that are in the pool, the lower the premiums for all. How much lower could premiums be if everyone in EVERY state had 1300 carriers to choose from? How can NONE of the bills proposed in the House or the Senate not address repealing the McCarran-Ferguson-Act of 1945?
  

• Instead of bailing out GM with Billions of our blood sweat and tears and then letting them file bankruptcy 3 months later. Why not expand State Run High Risk Pools to ALL States for those who are rendered uninsurable? We already have such State Run High Risk Health Insurance pools in the majority of States. These Risk Pools will cover anyone regardless of their medical history. The problem is they are under funded so the premiums are extremely high. Instead of spending up to $2.6 TRILLION over the next decade to insure only 20 Million of the 45 Million uninsured. LEAVE the bulk of the nation's risk where the money is, namely with the insurance companies. Since the uninsured FAR outweigh the uninsurable, this would cost far less than the currently proposed $2.6 Trillion over the next 10 years.
  

• Update the outdated Health Insurance Portability laws (regarding credit for pre-existing conditions) to INCLUDE Individual Health Insurance Policies. As it stands now, HIPAA law allows an insured to move from one "Employer Sponsored Group Health Insurance Plan" to another "Employer Sponsored Group Health Insurance Plan" and receive FULL coverage for "pre-existing" conditions so long as they can prove to the new carrier that they have had 18 months of prior coverage with no lapse of more than 63 days. Millions of American Entrepreneurs have chosen to leave Corporate America and strike out on their own since these archaic laws were written in the 1980's. As the face of our work force changes so too should the laws that protect it. Most especially since these entrepreneurs shoulder the BULK of the nation's risk and PAY the bulk of the nation's tax load! Throw them a legal bone!
  

• Educate the American consumer about the primary reason for the high cost of health insurance! Namely, LOW DEDUCTIBLE, LOW CO PAY (a.k.a. Traditional) Health Insurance. NOTHING drives up the cost of Health Insurance like maintaining a low deductible, low co pay plan. Instead, offer new more intelligent option to the American Consumer like "Consumer Driven Tax Qualified Health Insurance". There simply is no more intelligent or cost effective way to insure anyone. The sad part is, these Consumer Driven Tax Qualified concepts have been around for more than a DECADE! Yet, only a small minority of the American population has even explored these intelligent (& much lower priced) Health Insurance alternatives. Those that have, are WAY AHEAD of the rest of population when it comes to managing medical risk.
  

• I would say weed out the 12 million Illegals (that we know about) who are sucking our Medicaid system dry...but as Congressman Joe Wilson so aptly stated, Obama CLEARLY wants to "provide a PATH TO CITIZENSHIP for the 10 to 12 million Illegals in our country". Once they're legal, he can then cover them ALL on our tax dollar! So YES his plan IS to cover Illegals, he'll just make em legal first! Think they're not sucking our Medicaid system dry? Just visit California or Illinois. Good old “Blago” enrolled thousands of Illegals in to our Medicaid system, thereby running the program in the ground & leaving our Illinois Medicaid system approx. $1.5 BILLION behind in payment of claims to physicians who have been providing “free” care to all illegals who were lucky enough to flock to the State of Illinois to insure themselves for “free”. In fact, according to the U.S. Census Bureau 10 to 12 Million of the Uninsured in America are illegal aliens. Who comprise the rest? Find out here.
  

• TORT REFORM! This is one area of reform that is rarely spoken of by the Liberal left. Medical malpractice liability forces providers into practicing defensive medicine. In other words, it causes medical practitioners to order multiple expensive (and often times unnecessary) tests and procedures "in defense of" potential lawsuits, JUST IN CASE they miss something in a patient's case. All for fear of being sued for ridiculous amounts in a malpractice lawsuit. Limiting liability lawsuit awards to reasonable amounts will deter those who seek the "big pay day" by filing frivolous lawsuits against medical practitioner.
  

• Establish a Federal oversight committee to regulate and hold accountable physicians who make medical mistakes. What’s one of the biggest reasons why health care is so expensive? Hint: It’s not “rich CEO’s” and “outdated medical records transfer processes.” It’s Medical Mistakes! Here’s the real facts you won’t find in the media outlets:

1994: Five years after a groundbreaking Institute of Medicine report focused attention on medical errors in hospitals, Americans say that they do not believe that the nation’s quality of care has improved. In fact, 1 out of 3 patients states that they have experienced a serious medical error http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.534

1995: A Study published in the Journal of American Medical Association (JAMA) found that only two percent of medication errors that occurred during the medication administration process were intercepted.
a. More people die from medication errors than from work place injuries
b. Medication errors account for approximately one out of 131 outpatient deaths and one out of 854 inpatient deaths.

1999: Institute of Medicine (IOM) releases its first report on healthcare quality and medical errors. http://www.iom.edu/?id=12735 The Study finds in part that:

a. Medical errors are responsible for injury in as many as 1 out of every 25 hospital patients.
b. Between 44,000 and 98,000 Americans die each year from preventable medical errors in hospitals alone.
c. The deaths from preventable medical mistakes are equivalent to the number of people who would die if a jumbo jet crashed EACH AND EVERY DAY OF THE YEAR, and all its passengers died!
d. Medical errors cause more deaths than motor vehicle accidents, breast cancer or AIDS…..and this study is TEN YEARS OLD and STILL no Federal oversight committee! Oh wait! It gets worse!

2002: A Study issued by the United States Pharmacopeia (USP) concluded that more than 200,000 medication errors occurred during 2002

2004: CDC reports that 90,000 patient deaths occur each year due to patients contracting hospital acquired infections. http://www.cdc.gov/ncidod/dhqp/pdf/nnis/2004NNISreport.pdf
a. Many hospital acquired infections are caused by health care workers who fail to wash their hands in between patients.

2006: Studies assessing the state of hospital patient safety conclude that current progress is slow, results in general are at best modest, and the gap between the best possible care and actual care remains large. http://www.healthgrades.com/media/dms/pdf/PatientSafetyInAmericanHospitalsStudy2006.pdf

More Facts:

Preventable medical errors result in extended hospital stays, expensive treatment for chronic medical conditions and astronomical medical costs that are associated with treating debilitating life-long illnesses. Some experts state that these costs may be in the range of $150-200 Billion dollars per year. Gee, where else could we spend that money??? Quick reminder:

ALL of the aforementioned happened under the nose of our Federal Government. And we want them to regulate Health Care?? Let’s not save ALL of our anger for the “greedy” insurance companies and “over paid” doctors and CEO’s. Let’s focus our Anger on our GOVERNMENT who has allowed this systemic problem to continue over three administrations!

Ask yourself, why does the health care industry basically regulate and report on itself? Why is certification and accreditation voluntary? Why don’t we have a Federal agency that acts like the FAA and investigate medical mistakes, just like airline accidents or near misses? Why do only some states have mandatory reporting requirements of medical errors? All Good Questions that need to be answered before we hand over our very health freedoms to the same Government to “regulate”.

In summary, REAL healthcare reform can be accomplished through consumer education, weeding out abuse of existing Federal entitlement programs (via a legitimate needs assessment) and increased funding and expansion of existing State sponsored Risk Pools so that people who are declined for insurance have an affordable option to continue coverage if declined on the individual major medical market. Following these few simple steps will go a long way towards not only maintaining our current health care system, but also towards keeping the bulk of our nations risk where it belongs, namely with the private health insurance industry. In light of the recent multi Trillion Dollar "Bail Outs" and many other failing corporations coming to the table with their hats in their hands (and their private jets on the tarmac) the last thing our government should do is start cutting more blind "bail out" checks in an effort to "reform" the U.S. health care system.

But hey what do I know? The video below sure makes Government sound wonderful! I mean just look at their track record!

By the way, unlike the lies told by many. Conservative Republicans DO HAVE a plan to reform our nation's health insurance system. It is called the "Empowering Patient's First Act" or HR3400.