Ellen Goodman in an April 6 letter continues to propagate the myth that pre-existing conditions are not being covered in today's health insurance.
Tom Hanthorn | Posted: Thursday, April 16, 2009 12:00 am
Ellen Goodman in an April 6 letter continues to propagate the myth that pre-existing conditions are not being covered in today's health insurance. That is simply not true in the group health found in today's employer-sponsored plans.
As long as the employee has credible coverage and a W-2, he is eligible without limitation, and after separation can be insured with COBRA.
Further, today's employee can be negligent and continue unhealthy habits, such as obesity, tobacco and unmanaged diabetes, and transfer those resulting medical costs to his employer and fellow employees with impunity. He cannot be denied treatment, and his premiums can be increased only if he fails to comply with the employer-sponsored wellness program.
The individual market is another story, where Joe the Plumber and his brethren often buy individual health insurance with limitations or exclusions for pre-existing conditions.
To neutralize that effect, Joe and family should be continuously insured and change policies only when a pre-existing condition will not have negative consequences. If Joe is careless enough to be uninsured, he does have a big challenge to insure those pre-existing conditions. In that case, he will need to use the backup plan, such as Nebraska's Comprehensive Health Insurance Pool.
Goodman somehow assumes affordability and accessibility can be simultaneous. She also forgets that health insurance in the absence of actuarial science is just a bill-paying service. October statistics from the National Association of Health Underwriters put the average cost of medical care for under 65-year-old residents above $5,000 per person per year, making a nationalized program a breathtaking cost. So what would be the approximate cost of health care without actuarial application? About $5,000 per person. Good health is not an entitlement and is earned, just as affordable insurance needs to be earned by good health and continuous insurance.
For Nebraskans, there is a guaranteed health insurance called CHIP just for those with pre-existing conditions, and it assures availability.
So Goodman is guilty of stirring up public opinion and of not knowing a valid solution. What she is asking for is equivalent to selling life insurance at the hospice clinic. So what would it cost in that setting? And what does auto insurance cost for the 16-year-old male driving a Mustang Cobra?
Health care and Senate leaders are meeting regularly and conclude that affordability and accessibility are rarely simultaneous. They are working on solutions to subsidize medical plans for those pre-existing illnesses not in the employer group setting, akin to Nebraska's CHIP.
I ask that they call them medical plans, since they will resemble bill-paying services, and show that the patient was careless enough to be uninsured. Why should the taxpayer bear the cost of that negligence?
Tom Hanthorn owns and manages an insurance agency specializing in the self-employed.