Monday, March 29, 2010

Well, Waddaya Know

Oh, those poor insurance companies. They're painted as the villains in the health care debate, when in fact they're just companies with employees trying to provide health care coverage during a time of explosive medical costs. They're trying, really, really trying, but those damned doctors and hospitals are gouging us all.

That's the lament of Patrick Johnston, president of the California Assn. of Health Plans, an organization that lobbies state lawmakers and works with regulators on behalf of California health plans in an opinion piece appearing in today's Los Angeles Times. He maintains that the country has settled on the "wrong whipping boy" when the real villains are health care providers and healthy people who have dropped their insurance coverage because they are unemployed or underemployed.

And we should listen to him because?

Working in the healthcare system, however, I have more insight than many into what is causing those premiums to rise.

He then proceeds to point out that insurance company profits aren't growing nearly as much as other profit driven companies. How sad for the insurance companies. I'd shed a tear or two, but I just can't summon them, especially after reading this article in the NY Times.

It seems that insurance companies believe that the new law doesn't really require them to issue policies which cover children with pre-existing conditions in 2010, which is what the framers of the law intended. Their reading of the law is that such a requirement doesn't kick in until 2014.

The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.

To insurance companies, the language of the law is not so clear.

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.

William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”

Nice, eh?

The ink isn't dry on the new law, and already the insurance companies are finding wriggle room, their lawyers gearing up for the challenge. That's one way to ensure profits over the next several years, which is, after all, the whole point of free market capitalism.

Tell me again who the real villains are, Mr. Johnson.

And then, members of Congress, tell me again why a single payer system was never even considered.

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