Getting Serious About Health Care Reform

I'm not a health insurance reform expert. Almost no one on earth is. That doesn't mean we can't talk about it. And I think that any discussion of insurance reform has to begin with the problems we are currently facing, because we can't find solutions to problems we only understand vaguely.

The biggest problem, of course, is that costs are increasing at an unsustainable rate. Premiums are rising at four times the rate of inflation and wages. National health expenditures are rising faster than GDP. Over the past ten years, premiums have more than doubled for the average family. Employers increasingly cannot afford adequate coverage, and the individual market for families is incredibly expensive.

There is also the problem of cherrypicking. The primary goal of the insurance companies is to make money. That is the nature of business in general. To maximize profits they only insure the healthiest people and they avoid paying for procedures, treatments, and medicine as much as is humanly possible. This means that those that need insurance most are least likely to get it, and those that have insurance are likely to be fought tooth and nail for using it. There are countless stories that illustrate this point.

There are nearly 50 million uninsured Americans, including nearly 10 million uninsured children.

So what we've got is a system that does not work. After decades of minimal regulation we are on the cusp of a system failure that would have serious consequences. Does this sound familiar? The difference between the insurance industry and the banking industry is that we allowed the banking system to basically fail, millions of people lost billions of dollars and retirement savings before we stepped in and put some serious regulation on the books. We simply cannot afford to let that happen in the insurance industry where more than just money is at stake.

From what I can glean from interwebs (and here are some articles I really like on more liberal side of things), Democratic health care reform has two main goals. The first is industry regulation. Here is where we address many of the problems that have slowly matriculated in the current system. Some examples are that insurance companies would not be able to deny consumers based on their medical history. Insurance companies would be required to set premiums based on community rating rather than experience rating. Under community rating, everyone would pay the same premiums, regardless of medical history, age, etc. Under experience rating, the current rating system, premiums are based on those and other factors. These reforms would create a much larger risk pool which would make health insurance affordable for many for whom it is not now.

The second part of health care reform seems to be a reform of the market itself. This is where the public option comes in. For all the new regulations that are being proposed, no one doubts that the incredibly rich and powerful and resourceful insurance industry will find ways to continue their current practices. Ambiguous language in the bill, bullying those without the means to fight back, delaying procedures for as long as possible, and the like are all ways that they can game the system. Regulation will be necessary and helpful, but it won't take us all the way. What's more, individual plans and small group plans will still cost more than large group plans because the administrative costs are higher and the risk is spread over a smaller group.

So a public option would combat those problems. It would provide a safety net for those that can't afford private insurance. It might resemble public/private choices like parcel service or education where there is a niche for both government run options and private options. If there were only ever private colleges and universities and suddenly the government decided to provide lower cost, competitive colleges and universities, would conservatives being calling it socialism? I kind of think they would. But no one is calling the current system socialist.

I don't think the public option for health insurance is all that different. The government subsidizes and runs education at all levels because we have deemed that education is so important that it should be provided to every citizen. In fact, education up to 12th grade is absolutely free for every citizen. Why is it so different for us, as Americans, to then say that adequate health care is so fundamentally important that we are going to make sure that every American has access to it? That is going to mean a market where there is competition between the government and private industry, but we are okay with that because it means that everyone has the peace of mind knowing that they have the means to deal with the sicknesses and injuries that their families will face.

I have said it before and I say it again now, this is a moral issue. I want to live in a nation where we make sure everyone, regardless of socio-economic situation, or any other factor, has access to adequate health care. Certainly it is better for our economy to have a more healthy, physically and mentally, workforce. But it is also good for our souls.

We are told again and again in the scriptures and through prophets to care for the sick and needy, the orphans and widows. In our modern world, health care is an essential part of that admonition. There is no way for us to individually make sure that the poor have health care, we have to do it as a group. I'm not saying that you have to support a public option to be a good Mormon or to keep the commandment to care for the poor, but it is a legitimate way to do so where no other viable option has been presented.