insurance

Health reform needs urgent treatment

In the ongoing health care debate, it's difficult to sort out fact from fiction. A lot of fear mongering and truth twisting in recent weeks have resulted in information distortion.

Has that changed Americans' core belief that health reform is necessary? I don't think so. We may disagree on details, but we hold on tenaciously to this premise: Health care coverage is vital and reform is necessary because without it everyone is at risk of physical and financial ruin.

Fact: Most working Americans who have health insurance from their employers are one job loss away from losing coverage after exhausting COBRA benefits. Those with pre-existing conditions have a better chance of finding a miraculous cure than of getting an affordable health care policy on the private market.

Fact: Many small businesses, considered the main growth engine of this country's economy, cannot afford to insure their employees. Of the 46 million uninsured Americans out there, nearly 26 million are small-business owners, their employees or their dependents, according to a recent study by the National Federation of Independent Business.

Fact: Health costs have risen at a rate much higher than inflation. In 2010 costs are projected to rise more than 10 percent, according to two independent surveys, one by The Segal Co. and another by Aon Consulting. More than 70 percent of employers are at least thinking about passing these costs along to workers in the form of higher premiums, deductibles, coinsurance or copays, according to a survey by the International Foundation of Employee Benefit Plans.

Few people say the health care situation is just fine the way it is.

The current health reform proposals on the table would require nearly all Americans to have health insurance, and they stipulate that premium costs cannot be based on how sick or well we are. But a lot of details about the plan -- such as how to subsidize the poor, who will ultimately pay for it and how the health plan will be structured -- are still up in the air.

Greasing the wheels

Money is a central focus -- health lobbying has kicked into high gear. The Center for Responsive Politics reports that the health sector is the biggest spender so far this year at $263 million-plus. That's money spent by pharmaceutical companies, hospitals, health professionals and service companies in an effort to make themselves heard in the din. In second place is the finance, insurance and real estate sector, which spent nearly $223 million so far this year. Health insurers are a big part of that group.

It must be difficult, if not impossible, to get a handle on what's best for our citizenry with so much cacophony in the Capitol.

In his illuminating book "Supercapitalism," Robert Reich explains that our democracy is compromised by lobbyists because they represent the interests of private corporations whose primary motive is to gain competitive advantage.

"Part of the task of lobbying is to provide evidence of the greater wisdom of your point of view, which often requires the work of economists, policy analysts and other data gatherers and number crunchers, as well as wordsmiths able to make almost any decision sound reasonable," Reich writes. "The predominance of these corporate-financed experts in policymaking, in effect, leads the public to assume the only issues of any importance are those that bear on the welfare of consumers and investors, rather than on the well-being of society or the planet as a whole."

advertisement

We can hope and pray that our senators and representatives place the concerns of their constituents above this corporate largesse. Better yet, we can contact them and demand that they do.

What's wrong with the way things are?

But change is not something to be feared. Those concerned about health reform should take a moment to assess how things work right now. Let's look at the modus operandi of insurance companies and talk to someone who has spent the bulk of her 25-year career facilitating payments from health insurers to providers and patients. Kathryn Thompson works in Minnesota, which is "one of the very best states when it comes to providing coverage for almost all of its citizens and has some of the very best health care plans found anywhere in the U.S.," she says.

During most of her career, Thompson, director of operations at Apple Valley Medical Center, in Apple Valley, Minn., worked in physician and facility reimbursement, revenue cycling and collections. Her job was to make sure that health care providers were being reimbursed at the proper rates and that patients' questions about their health care bills were answered.

Show Bankrate's community sharing policy

Connect with us