Health insurance companies need reform

Editorial Board

“We need to generate better value in this country,” said Denis A. Cortese, CEO at the Mayo Clinic, speaking on health care reform.

We’re of the opinion that the Patient Protection and Affordable Care Act — Obamacare, for those of you who just dozed off — was a great idea consigned to political quagmire from the get-go. It makes us sad. The health care cost per-person in the United States is double that of most industrialized nations. If you’d like perspective on that statement, we’ve been ranked 37th by the World Health Organization — below Cuba, but above Slovenia. 

Why does health care cost so much? Are doctors and nurses overpaid? Hardly. Are pharmaceutical companies to blame? Maybe, but the research and development that goes into new drugs and vaccines isn’t exactly cheap. The real problem is that health care is an extremely lucrative business.

Unfortunately, certain facets of health care turn a hefty profit. And many health care and insurance providers will cash in on this in the worst ways.

Two concepts need to be understood: pre-existing condition and rescission.

That first term is pretty self-explanatory, even for politically correct rhetoric.

However, rescission is less well known. This isn’t the economic recession we’re talking about — it’s a business practice. By definition, it’s the act of rescinding, the canceling of a contract between two parties, returning to a state as if said contract had never been made to begin with.

Up until Obamacare, rescission was an all-too-common practice. If you’d failed to disclose an aforementioned pre-existing condition, insurance companies could, and did, retroactively cancel your policy. It didn’t matter if patients had paid thousands of dollars into their current policies, were in the throes of chemotherapy, or were victims of catastrophic injury. People lost their insurance on technicalities.

Why? Simple: Health insurance is a business. Businesses are designed to turn profits. Keeping you healthy — and paying — is definitely in the interests of the company, but picking up the slack after your deductible is a business expense. Some companies saw the practice as an opportunity to cut their losses. A recent congressional report showed that three insurance companies combined to save $300 million over five years with 22,000 rescissions of medical coverage.

A major part of the Patient Protection and Affordable Care Act is rectifying this problem, ensuring that companies will insure those with pre-existing conditions and will not drop people when they need health care the most.

As a temporary transition solution while new regulations are put in place, the act calls for a government Pre-Existing Condition Insurance plan. This is intended to be active for only a few years while Washington goes through the usual dog-and-pony-show getting the rest of the act set up.

This system is, in fact, already in place, and has been since the summer.

States have received money to insure people with pre-existing conditions. California has so far received enough for 20,000 people while states like Wisconsin have room for about 3,000 people, and these plans will cost about the same as an insurance plan for someone with no pre-existing condition.

While the system has yet to gain widespread use — most states have had barely one-tenth of their allotted capacity sign up — this is an excellent first step toward some much needed health care reform.