re: #173 Gray Skies

I will stick my neck out here and say that I am one of this group. I have a few years until I am Medicare eligible (not such a great deal anyway), my spouse is a sole proprietor in construction in Nevada (you know what is happening in construction here - no work), we are receiving no unemployment benefits, and we still carry high deductible individual policies that are not cheap, the premiums for which we are paying out of dwindling savings. I have watched the orchestrations (both President and Congress) in health (care? insurance?) reform over the past few months. I continue to be amazed that people who complain about insurance companies are willing to trust the government after all of the wheeling and dealing and secrecy in planning we have been exposed to. There is no free lunch, and I am not talking about just dollars here.

On principle I believe the individual mandate is unconstitutional.

A few other observations:

I also worked in the health insurance industry for years, and the CBO is correct in concluding that insurance premiums for those on individual plans will in fact increase. There is no way that insurance companies can be forced to take everyone, at the same time providing rich government mandated benefits, and not raise premiums. As part of my work, I also observed that high ER use (for non-emergency conditions) occurs as much on the part of insureds as uninsureds. The insureds far too often take their coverage for granted and have no idea of the real costs of services and how their utilization of services may affect premiums. This is borne out by studies in our own company that showed that our own employees (who paid zero for their health care plan by virtue of being an employee) had the highest utilization among all employer group plans, including State and Federal employees (which were very large groups). Any health (care? insurance?) reform needs to include measures to change behavior that seeks care for anything and everything.

I also believe, if the current system is flooded with 30 million new insureds, there will be access rationing. One of the most common complaints about my employer (which was a staff model HMO - we had our own doctors, clinics and hospitals) was that patients had to wait forever for appointments (we eventually fixed this). Impeded access is not going to go over well with insureds who at this point experience few delays in accessing care. Also having to see nurse practitioners and physician assistants, if this is how the problem is remedied. (I personally have received some good care from this level of practitioner, but those accustomed to seeing doctors will probably not like this).

I also note that the President now promises that no one will have to change their doctor under his plan. I believe that he initially promised that no one would have to change their insurance if they didn’t want to. What has changed?

Finally, I am one of those who is concerned about the deficit. I believe that the proposed legislation is going to cost far more than what is projected.

These are just a few things that I have considered. I agree that something needs to be done, but I do not like the current proposed legislation. Mainly, I do not trust federal government. I believe that reform might better be initiated incrementally at the State level.

Just a perspective from the other side.

I think it goes back to the fact that people don’t understand insurance. It is a risk management tool—not a black check with arbitrary restrictions placed upon it. We cannot legislate away the risk.

As simple as it sounds, I truly believe people either don’t understand or don’t believe the risk is REALLY REAL.