Wednesday, May 10, 2006

Requisite for "Free Market" Insurance

Everyone blathers about the need for Free Market insurance and how, given the choice, consumers will drive the market to decide.

Well, just like consumers who couldn't pick which cereal was less likely to fill them full of 'X' without nutrition labels on the box, today's health care insurance consumers can't tell a HMO from a Homo.

Quick! If you were to suffer a myocardial infarction, would your insurance cover it? What if you were admitted to a non-plan emergency room? How about drugs? Would you be getting generic or brand-name? Get snappy! You're dying here!

That's right. Unless your name ends in "M.D.", you likely won't know what a mycardial infarction is, let alone know whether your insurance will cover it, until you or someone you love has one.

And just like Froot Loops (TM)(R)(PatentPending) at minimum this country needs "labeling" for insurance.

In short, an independent agency needs to create a finite-entry list of Health Care Levels ( Say, '10' for example). Each higher Health Care Level being a superset of the one below.

For example, if you're single, 21 and a non-smoker, you probably won't see the need to pay for Health Care Level 9, which includes all governmentally-approved health treatments, including organ transplants. Unless you have a family history of cancer and would like to make sure you're covered if you are diagnosed with osteosarcoma, (covered in HCL8) you'd be just as happy to pass less for Health Care Level 4.

As a consumer, you could fill out a form, send it to various health insurance agencies and receive a list of HCLs and prices for your age/risk group.

Heck, independent consumer's agencies could even publish statistics comparing HCLx care between hospitals and/or insurance providers.

Costs would be cut down because there'd be less bickering about what is or is not covered. If you get colitis and you've paid for a HCL that covers colitis, you're covered. Period.

Now the sticky part is getting together an industry-wide and *independent* panel to yearly re-evaluate what services are and are not covered in each level. Liars and thieves of every stripe would focus on warping HCLs to line their pockets. A big problem, methinks, but not unsurmountable.

Note that there would be no service that is not covered ( Oh, you wanted your bedpan emptied? I'm sorry, ma'am, that's not covered under any HCL), nor would any higher HCL fail to cover things that are not covered in the lower HCLs (Yes, sir. We know you paid more for HCL5, but cancer drugs and cancer treatment are not both covered in HCL5. You can only have one or the other.)

HCLs would not be the panacea of our health care problems, but it would tend to give consumers two things:

- the ability to more easily compare plans
- protection from getting shafted by perpetual contract changes.

Note that several times I said, "insurance" and not "health insurance". That's because other insurances would also stand to benefit from similar plans. Imagine property insurance levels, PILs. You pay $x for water damage, you get paid from water damage. Not, "Oh, sorry sir. Your property was damaged by wind-driven rain, not gravity-driven rain".

Doesn't hurt to dream.

No comments: