Obama's eight protections

CJR’s Trudy Lieberman summarizes the eight protections that the President assures us will reform health insurance.

A sample:

No discrimination for preexisting conditions. That’s a good thing, and insurers have agreed to eliminate health status as a factor for granting coverage in the individual market if every American is required to carry insurance one way or another. Right now, a few states restrict preexisting conditions clauses; the Health Insurance Portability and Accountability Act (HIPAA), passed in 1996, gives people the right to buy a policy in the individual market without regard to health problems if they do so within sixty-three days of losing coverage and if they have used up all their COBRA benefits. HIPAA, though, didn’t say anything about premiums, and so insurers in most states charge higher rates to discourage people with preexisting medical needs from signing up.

What to watch for: Lobbyists inserting language that limits insurers’ risks, like the restrictions in the HIPAA law that still make it difficult for sick people to obtain coverage. President Obama has been silent on the question of age rating, which serves as a proxy for using health as a factor in charging higher rates. Older people are likely to present more health risks and cost the insurers money. “As long as they can rate people up for age, that’s a proxy for health rating,” Kofman says.

Good stuff.

Ms. Lieberman is one of those must-read columnists when it comes to health care. Complicated issues, spelled out in ways that make sense. I don’t always agree with her – but I’m always going to read her stuff.

She was on Bill Moyers Journal the other night along with Harvard’s Dr. Marcia Angell. It was one of those despair-inducing hours that illustrated the long odds against reform of the health care system.

BILL MOYERS: The President, as you were saying a moment ago, is saying to everybody who's not covered, we're going to mandate that you exercise that right. We're going to mandate that you buy some form--

MARCIA ANGELL: We're going to deliver the private insurance companies a captive market. That's right. And they love that.

BILL MOYERS: Say that again.

MARCIA ANGELL: They love that.

BILL MOYERS: The-- his policy does what? His program?

MARCIA ANGELL: Delivers to the private insurance industry a captive market.

BILL MOYERS: By the mandate.

MARCIA ANGELL: By the mandate.

BILL MOYERS: It says "Marcia Angell, you've got to--"

MARCIA ANGELL: For whatever price they want to charge. Right. And so, this will increase costs. And let me tell you what he's running into, and he'd like to be able to pull a rabbit out of the hat, but he won't be able to. If you leave this profit-oriented system in place, you can't both control costs and increase coverage. You inevitably, if you try to increase coverage, increase costs. The only answer, the only answer, and he said it at the beginning of his press conference, is a single payer system. In his first sentence, he said, that is the only way to cover everyone.

Gah.