EDITORIALS
Insurers back reform
With industry’s support, change seems imminent on health insurance
It looks like health insurance is about to get its due in America, an international laggard among developed nations in providing its citizens access to quality health care. Even the insurance companies are pushing it. The country may not catch up to the Canadians or the British — whose nationalized systems have their own problems — but if the tea leaves are correct, something significant is likely to occur in the coming months. It is long past due.
Sens. Edward Kennedy, D-Mass., and Max Baucus, D-Mont., have already prepared separate plans to reform the American health care system. Former Sen. Tom Daschle, President-elect Barack Obama’s nominee for secretary of Health and Human Services, has correctly observed that insurance reform is inextricably bound up in the task of reviving the national economy.
Of course, it’s not too surprising that Democrats would favor insurance reform; the subject has long been on their agenda. But corporate America — a predictably conservative block — is restless for change, as well, as the soaring costs of health insurance bloat the cost of doing business.
What is especially encouraging, though, is that insurers, themselves, are joining the effort this time instead of trying to sabotage it. That’s what they did 15 years ago when the Clinton administration tried to change the American system of health care coverage. The administration made its own mistakes in developing and presenting the plan, but the industry’s “Harry and Louise” television ad campaign became the effective focus of opposition.
Not this time. The major group representing health insurers announced a proposal last week for covering all Americans, regardless of pre-existing conditions. In exchange, the insurers say all Americans must be required to have health insurance and, potentially more troublingly, that their coverage be portable among states, regardless of any state laws mandating minimum coverage standards. The insurers’ proposal says nothing about affordability of the coverage they would provide.
It’s fair to suspect that the insurers have merely seen the writing on the wall. With a Democratic president-elect and an overwhelmingly Democratic Congress-in-waiting, they have little chance of killing this reform effort, and so, are trying to shape it to their best advantage. If so, fair enough; they have legitimate concerns. But they can’t be the tail that wags this dog.
Mandatory coverage may be difficult to achieve, as Massachusetts has discovered with its own plan. Still, it’s an approach that may be necessary and is certainly worth exploring.
More worrisome is the insistence on overriding state minimum coverage laws. In one regard, that may be acceptable, since a federal law should be accompanied by federal minimums. But what would be left out? Mental health care? Obstetric care? Cancer screenings? It would benefit us little to have universal coverage that doesn’t cover enough.
Other questions also will need to be answered, and not just on the role of insurers. For example, how much emphasis would be placed on preventive medicine? How much would — or should — individuals be held accountable for their own unhealthy habits, from smoking to not exercising?
Questions are answerable, though. What is notable is that a critical mass of influential players believe the system that leaves too many Americans — some 47 million of them — without health care finally needs to be fixed.
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