Reforming health care (Part V): Adjust insurance involvement

During the recent presidential campaign, one voice had a particularly ironic ring to it: John McCain, the GOP’s Chosen One, claimed "market forces" would solve the problem, ignoring the fact that "market forces" caused the mess in the first place. This man who’s received government-administered care all his life warned of the terrible consequences of allowing bureaucrats to control health care. With no worries about his own access to health care, McCain wants insurance company execs to continue denying care to people who need it while receiving fat bonuses for performing that odious task.

Market forces, indeed!

In the long run, the goal must be universal single-payer coverage. But as much as we want to kick those evil insurance companies out of the health-care picture, it won’t happen overnight. In the first place, it’s just not wise to tell an entire industry to simply fold up its tents and go away quietly. Such a move would create so much chaos that even the recent banking/auto scare would seem like an economic boom in comparison.

Instead, Congress should pass reforms that squeeze so much profit out of insurance involvement that companies voluntarily drop out of that part of the business. That would give them time to adjust their business models and move personnel to other departments, minimizing any resulting layoffs. Insurance businesses have a lot of irons in many different fires (pun definitely intended). They’ll find other ways to use the resources they now focus on the medical industry.

At the same time, Congress must establish a comprehensive government plan that is cheaper than private insurance. Such a policy would be so seductive that people will abandon insurance companies, hastening their decision to bail. You see, millions of people still believe private insurance is superior to government-administered care. That misconception is based on the fact that Medicare has so many holes that force beneficiaries to buy supplemental insurance to cover the gaps that were manufactured by meddling insurance lobbyists in the first place. Talk about a vicious circle!

It’ll take time to lure all those people away from tradition. But when that finally happens, for-profit medical insurance will be history--at last!

Besides the army of lobbyists and lawyers whose sole purpose is to prevent solutions to the health-care crisis, a series of anti-reform commercials is scaring people by citing rare problems from the U.K. But for every single occurrence elsewhere, there are thousands of cases of neglect resulting from bad policies on the part of U.S. insurance companies:

Insurance companies deny coverage of diagnostic tests, often leading to avoidable patient deaths.
Insurance companies deny coverage of medication and treatments, forcing patients to "just live with the pain."
Insurance companies deny effective treatments, calling them "experimental," often leading to avoidable deaths from treatable conditions.
Insurance companies require preapproval in emergency situations, hindering timely care and sometimes leading to avoidable deaths.
Then there are new-employee waiting periods and that infamous pre-existing condition clause. You know: when insurance companies deny medical care to people because they need medical care.
These and other policies are the reason Congress must set strong guidelines for insurance reform, including:

Abolish all waiting periods for coverage and restrictions on pre-existing conditions.
Patients can choose their own doctors and receive care at any accredited medical institution.
Insurance must pay for all preventive care, including regular physicals, vaccines, and diagnostic tests.
Insurance must pay for all necessary medical care, including pain medication and treatments.
All prescription medications must be covered, with no formularies allowed. Only equivalent generic brands can be substituted for a brand-name drug.
Insurance must fully cover so-called "mental" or "psychological" care, with no temporal or monetary limitations attached.
When a person becomes temporarily unemployed, their health insurance premiums would be paid by a government subsidy until they return to work.
If Congress can establish a truly effective government insurance program, in spite of all those lobbyists, then it won’t be too long before every American will be standing in line to get that superior single-payer coverage from Uncle Sam. It not only can happen, it must happen!