- Some 30 million without health insurance
- Denial of coverage for pre-existing conditions/canceling coverage after illness
- Increasing costs of health care and medical insurance
Many (maybe most?) of those 30 million elect not to carry health insurance because they feel they don't need it. They're typically single 20-somethings who generally enroll once they get a little older (and wiser) or when they decide to marry. In any event, 30 million represents just 10% of the US population...hardly the stuff of crises. Nevertheless, there are millions without insurance due to their employment situation. They might be unemployed or working for a company with no employee health insurance.
Much of this can be solved by a nationwide plan administered jointly by the nation's health insurers and funded in part by taxpayers and the insurance industry. The catch is that participation in the plan would be limited to those who can prove they have no other option. Funded at $4000 for each of the 30 million uninsured, the price tag comes to $120 billion a year. The participating insurance companies would cover the administrative overhead.
This brings us to the problem of pre-existing conditions, which is much less of a problem than most think. Under employers' "open enrollment" periods, employees can enroll in a plan without proof of insurability. Only when an insurer can prove that a condition existed and was previously diagnosed and the individual wasn't previously enrolled in a plan do insurers ever attempt to deny coverage. These cases are actually pretty rare and could be handled on a case-by-case basis. For the self-employed, require the insurers to establish a nationwide plan for them and administer it as if it were an employer plan. The risk pool would be more than large enough to offset the risks of insuring those with pre-existing conditions. As for insurers who cancel someone's coverage after they're diagnosed with a serious illness, that's simple: make the practice illegal.
Finally, if health care costs are spiraling, it might help to actually examine the reasons why and address some of them. Legal exposure is one reason costs keep going up, and tort reform would certainly help mitigate the problem. A recent Congressional Budget Office report estimates that tort reform would save $54 billion over the next decade. While that doesn't address the entirety of the problem, it's not exactly a drop in the bucket. I'm not opposed to wealth distribution if it means taking $5.4 billion a year from trial attorneys and putting it back into people's pockets. And, for crying out loud, allow people to shop across state lines for insurance. Let insurance companies compete with each other on a broader scale.
Am I over-simplifying? Maybe. Well, almost certainly. But you get the picture. We have shortcomings in our health care system that actually have nothing to do with the delivery system itself but with how people pay for it. What we don't have is a health care crisis. Congress should address those issues with sensible legislation and not a behemoth of a bill that will make all Americans indentured servants to a government-run health care complex.