The New Landscape of Health Insurance: Reform?

It has been a few weeks, and we have seen lots and lots of new ideas, perhaps rhetoric about the new system that will be employed in the U.S. for health insurance. The Obama Administration continues to be front and center with its ideas, and they circle around many of their original plans. The government wants desperately to offer a public option to both the uninsured population, which hovers over 40 million Americans, and anyone else in the market, whether with or without coverge. Obama continues to tell employers and employees covered by group plans that they can keep their plan if they so chose, but would like to increase competition through the public option. Many defenders of private insurance point to the ineffective Medicaid and Medicare plans currently in force in the U.S. These plans just like private insurance have not kept costs in line, and get steady push-back especially from private physicians and hospitals.

Regardless of political opinion, many things about reform are front and center - controlling treatable illnesses and conditions such as obesity, smoking, a Asthma, with wellness and prevention. These conditions alone account for plenty of the spending in the current system, and are coupled with the fact that electronic medical records are not the norm in 2009. As such many tests are duplicated along with multiple visits and procedures that could be eliminated if records were more coordinated. Approximately 30% of the spending in the U.S. is attributed to this waste alone.

The private insurers are going to need to budge if the wish to remain in business and many point to the medical underwriting around pre-existing conditions. Private insurers urge a mandate for every American to be required to have coverage similar to car insurance, in order to bring more healthy Americans in to the system to offset the claims that would be incurred by sick members. In general that is the problem, private insurers can have more "lax" underwriting and in fact offer more affordable coverage if these massive insurance pools have a better mix of healthy and sick members. Perhaps that is where we will find ourselves after all, with a private system augmented with Congress enacting stronger legislation around mandates for coverage, some for of government subsidy for coverage (for certain income levels etc...) and perhaps a revamped Medicare system to pick up some of the costs for the very low income population currently uninsured. Regardless one thing must be done, all Americans should be required to have health insurance, though our reformed system must offer a suite of affordable products, and places through which one can secure it.

One thing is for sure as mentioned recently on Good Morning America by Michelle Obama, and that is the debate is strong, and reform will be no easy task. Years of out-of-date legislation that governs the current private system, and Medicare/Medicaid as well, needs to be brought up to speed with 2009. After all, we have not had any major reform for years and years.