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'Uninsurables' Requires 6-Month Wait
Democrats' Plan to Help!!!!!In addition to a six-month wait to qualify for the health insurance program, there's a more fundamental issue -- whether $5 billion set aside for the three-year program is enough. WASHINGTON - You're afraid your cancer is back, and a health insurance company just turned you down. Under the health care bills in Congress, you could apply for coverage through a new high-risk pool that President Barack Obama promises would immediately start serving patients with pre-existing medical problems. Wait a second. Read the fine print. You may have to be uninsured for six months to qualify. "If you are a cancer patient and have cancer now, you can't wait six months to go into a plan because your condition can go from bad to death," said Stephen Finan, a policy expert with the American Cancer Society Cancer Action Network. He called the waiting period in the Senate bill "unacceptable." Advocates for people with serious health problems, as well as some insurance experts, are raising questions about one of the most important upfront benefits in the Democratic health care legislation: a high-risk pool for the medically uninsurable. Obama proposed the pool in his September health care speech to Congress. Intended to serve the most vulnerable as a temporary fail-safe, it would stay in place until 2013. That's when insurance companies would be banned from denying coverage because of medical problems. Government subsidies to make coverage more affordable for millions of uninsured would also start that year. Now, concerns are being raised about the design of the high-risk pools. In addition to the six-month wait, there's a more fundamental issue -- whether $5 billion set aside for the three-year program is enough. The money would be used to help people in poor health pay premiums. Obama credits his Republican presidential rival, Sen. John McCain of Arizona, for the risk-pools idea. But when the GOP candidate proposed it in 2008, the estimated cost was $7 billion to $10 billion a year. The six-month wait is in the health care bill the Senate Finance Committee approved last month. To qualify for the pool, patients must be turned down for coverage because of a pre-existing condition and uninsured for at least six months. "If you are somebody with cancer or a heart condition who needs immediate coverage and immediate treatment, that's not very helpful," said Karen Pollitz, a Georgetown University health policy professor. Senate Finance staffers say the restriction is meant to prevent people switching from more expensive coverage to take advantage of government assistance. But the House health care bill unveiled last week by Speaker Nancy Pelosi, D-Calif., doesn't include a waiting period. Instead, it would require insurance plans who "dump" seriously ill patients to repay the federal pool. "The House provision will provide immediate relief for people with high-risk conditions who have no alternative for coverage," said Finan. It may be easier to fix the waiting period than the financing. Both the House and the Senate Finance bills set aside $5 billion for the pools. "It doesn't seem like it's near enough money," said Douglas Holtz-Eakin, who was a top domestic policy adviser for McCain. The McCain campaign ultimately concluded it could take as much as $20 billion a year to properly run risk pools, he said. The White House says McCain's proposal was more elaborate and not directly comparable to Obama's. If the Democrats' risk pool starts running out of money, the government may have to start a waiting list, raise premiums or take other unpopular measures. Congress could be asked for a bailout. Several independent experts say concerns about the financing are valid. "It would seem that ($5 billion) is going to be small relative to the need," said Thomas Buchmueller, a University of Michigan business professor. Some 30 states now have risk pools for those who can't get health insurance on the private market, covering about 200,000 people at a cost of around $1 billion a year. "This is clearly not going to be enough money to cover everybody," said Pollitz. Insurance expert John Bertko, a visiting scholar at the Brookings Institution, said it may be possible to stretch the $5 billion, but there's a small margin for error. Bertko said his "back of the envelope" math suggests there are about 1 million uninsured Americans in poor health, or five times the number currently covered by state high-risk pools. If all of them signed up for the new federal pool, it would burn through the $5 billion in a year. However, people eligible for government benefits often fail to sign up. And if only one-third were to enroll, the budget could work. That's cutting it close. "No doubt about that," said Bertko. 15 comments from 8 users
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posted by
ApolloDawn
on Nov 5, 2009 at 07:39 AM
Good morning, Witters; if anyone thinks this case from a conservative site, it didn't: http://www.latimes.com/busi... I hate to write what must sound like a right-wing remark (because it isn't intended to be), but I was afraid they would start backpedaling on their grandiose promises. I thought we were going to get rid of the word "uninsurable." Now they're carving holes into the plan around it? "We will guarantee affordable health coverage for everyone! (Except for you, and you, and you, and all of you, and (eek) me as well?)" Whenever the word "qualify" appears, you can be pretty sure that you don't. I have written my thoughts on the issue. Apparently they are discovering what I feared - it will be impossible to put up the resources for a plan, public, private or mixed, that will be able to do all that we want it to do.
posted by
jfrancais
on Nov 5, 2009 at 07:52 AM
I want to believe that was put in there to appease the private sector faction but it's still troubling, nonetheless. it will be impossible to put up the resources for a plan, public, private or mixed, that will be able to do all that we want it to do. If we can put up a trillion dollars to find WMD then not find it and continue to fight two wars, I'm not convinced that we don't have resources. It comes down to will. Look at the dollars being thrown at the Osama Bin Laden problem. The government is spending large sums of money to kill one person but not willing to spend money to insure the health of millions? Something is wrong here. Are Democrats really about the people? Are Republicans really about values? posted by
ApolloDawn
on Nov 5, 2009 at 07:56 AM
That's a good point, Jfrancais; it does sort out what things each values more, and what they value less. In the long run, I still stand by my belief in the long-term unsustainability of a universal health plan that can meet all demand. posted by
witterpitters
on Nov 5, 2009 at 07:57 AM
How many bazzillions got spent to crash a rocket into the moon and make a big hole? How many bazzillions were dished out to failing companies/banks? Are these things more important then people? Apparently so. Why do people in prison have better health coverage then John Q Public? posted by
jfrancais
on Nov 5, 2009 at 08:01 AM
What they are proposing was never meet to meet long term unsustainability. It was meant to serve as a "last option" in hopes that it would make the market more competitive and drive down prices. None of the options being proposed are universal health care. I think market based solutions divert the morality of it all which American capitalism is good at doing. The idea of people having access to health care is not an economic policy issue to me. It's already proven what the US is willing to spend when it has the (moral?) conviction to do so. Are we willing to spend the amount of money we are spending under the phony guise of "freedom isn't free" "I support the troop" or "remember 9/11". posted by
learnem
on Nov 5, 2009 at 08:16 AM
If the Democrats' risk pool starts running out of money, the government may have to start a waiting list, raise premiums or take other unpopular measures. Congress could be asked for a bailout.
or get our taxes raised.......AGAIN posted by
siouxcityranch
on Nov 5, 2009 at 09:46 AM
I think I'm gonna *PUKE* posted by
pogo
on Nov 5, 2009 at 09:58 AM
These are all very good arguments about the pitfalls of going to a different system. But what is the alternative? Stay the course? I don't think we can. We need to start somewhere, work out the bugs and move forward - something this country has always done. posted by
adampayne
on Nov 5, 2009 at 10:56 AM
We still do not have a bill. If you think this is an outrageous capitulation of the health care reform promise, you should call, or write, your Congressman and Senators. I'm sure Rep. McCarthy and Rep. Costa will hear everyone out with great empathy since the Republican plan McCarthy has so vigorously touted these many months just got blistered by the Congressional Budget Office for spending more money and covering less people than the proposed Democrat bills, and Costa's Blue Dogs don't want to spend a nickel more to do anything. I am sure there will be other gaping cracks when the final bill is written with plenty of loopholes for the pitiful and maligned private health insurance monopoly to jump through and continue earning big dollars for large investors and top management. On the plus side the touted reform bill does away with bankrupty threat for those injured or sick, covers 96% of Americans, and strips away those old preconditions or too sick to covered routines. Maybe some of you conservatives out here have a better plan for health care coverage and containing costs. I certainly would approve moving tons of money away from defense contractors and into the health and education bucket while having the government set the prices and the compensation in many industries. It worked very well through World War II and all through the 1950s. What have you got? posted by
ApolloDawn
on Nov 6, 2009 at 06:52 AM
Adam, I always enjoy what you write, because it is always written with a good heart. Am I being included among "you conservatives?" ;) My specific problem is "meet the new cracks in the program - many of the same cracks as the old program." That's what will make people feel betrayed, when they want the cracks fixed. My plan for containing costs includes opening the accounting books and revealing what's behind the costs. I think we'll find enough padding to ship a nuclear warhead via UPS. I also foresee delegating to technicians and even consumers more medical functions that are now, by law, confined to licensed medical practitioners.
posted by
ApolloDawn
on Nov 6, 2009 at 06:54 AM
Jfrancais, "None of the options being proposed are universal health care." Not in the commonly understood sense of a government-run system. But if the objective is to get everyone covered, and I believe it is, then it has all the provisional features of universal health care. posted by
NancyII
on Nov 6, 2009 at 07:03 AM
One thing that bothers me is the pre-existing part. If a person never pays into a plan and then becomes ill with a catastrophic illness and wants insurance NOW. How can any fund sustain itself that way? Paying out what could be millions to a person who never contributed? And no, I don't know the answer, I'm asking. posted by
NancyII
on Nov 6, 2009 at 07:09 AM
By the way, I'm in an HMO and when I went to the doctor this past week I waited for 45 minutes in the waiting room and another 45 in the exam room before ever seeing the doctor. She was with me for maybe 10-15 minutes. How is universal health care going to handle the millions who don't have health care and now will be flooding the existing doctors offices? posted by
ApolloDawn
on Nov 6, 2009 at 07:11 AM
I don't like the idea of requiring people to buy coverage, but I see the reasoning behind it, meant to address just that question. I could live with it. People who contract a catastrophic illness during this transitional period would be a one-time bump in the road, most likely taken up by a public option. posted by
ApolloDawn
on Nov 6, 2009 at 07:15 AM
"She was with me for maybe 10-15 minutes. How is universal health care going to handle the millions who don't have health care and now will be flooding the existing doctors offices?" Great question. My concerns have been, for some time, the inability to meet the demands made upon a system that has been made accessible to everyone for every demand. A good place for government subsidies might be medical school tuition. Need more doctors? Facilitate entry into the profession.
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