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Health Insurance Industry Offers Conditional Support To Accepting All Customers

There's still more good news this morning suggesting that health care reform is creeping closer to reality:

The health insurance industry said Wednesday that it would support a health care overhaul requiring insurers to accept all customers, regardless of illness or disability. But in return, the industry said, Congress should require all Americans to have coverage.

The proposals, put forward by the insurers' two main trade associations, have the potential to reshape and advance the debate over universal health insurance just as President-elect Barack Obama prepares to take office.

In separate actions, the two trade groups, America's Health Insurance Plans and the Blue Cross and Blue Shield Association, announced their support for guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage.

As Steve Benen says, this is important news given the industry's role in killing Hillarycare, and suggests more political momentum for reform heading into 2009.

One other interesting dynamic at play that has reform advocates cheery is that a wide variety of the other interest groups that also moved to sink Hillarycare want reform to succeed this time, for a whole bunch of different reasons.

Late Update: More must-reading on the issue from Ezra Klein and Jonathan Cohn.


44 Comments

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But in return, the industry said, Congress should require all Americans to have coverage.
Hmmm...would this "all Americans" part be an attempt at a poison pill? Something that they know wouldn't be possible.
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I don't think so. The quid pro quo on making insurance mandatory benefits them by:

1) Increasing their customer base; and

2) Ensuring that they have healthy clients as well as sick ones (if insurance isn't mandatory, young healthy people might not purchase it) which will keep premiums down and profits up.

What I think this is REALLY all about is the insurance companies trying to gain bargaining leverage to kill a Medicare for all option in health care reform legislation. What they really don't want to have to do is compete with a federal government plan that has lower administrative costs and more consumer-friendly policies. That, I think, will ultimately be the biggest battle in health care reform and the insurance industry is dead set against it.

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"Something that they know wouldn't be possible."
Uh...that's the Democrat's plan...isn't it? Heath insurance for everyone? Whether they want it or not...

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The only people *required* to have coverage under Obama's plan are children. Otherwise, you can keep your current coverage, or opt into the same coverage federal employees have.

Somewhat different than your characterization. From you, this is disappointing, but not surprising.

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The way you just explained it..."everyone" needs medical insurance. That's what I said the plan was. Some people actually choose not to have coverage. They are young, healthy and prefer to pay out of pocket for rare usage of a doctor than monthly premiums that are more expensive.

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Uh...that's the Democrat's plan...isn't it? Heath insurance for everyone?
If the insurance companies are pushing for all to have coverage one would assume they mean for all to have medical insurance. Not even Obama's plan allows for guaranteed 100% coverage of "all Americans", rather that insurance is more affordable and available and that small companies (those who currently don't offer coverage because of expense) are given incentives to do so.
Whether they want it or not... And who exactly are those that wouldn't want medical coverage again? Talk about strawmen.
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It's cheaper for a lot of people. I go to the doctor every 5 years for a physical. I buy Nyquil at Publix if I'm sick. Why would I pay $200 a week for insurance I never use? (For the record I have Tri-care because I'm retired military until medicare kicks in, but I don't use it...eventually I'm sure it will be more frequent, but if I were 25 again...)

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Well, for those people who aren't ex-military and have no insurance, they could suffer catastrophic injuries, have to go to a hospital, and run up enormous bills they can't pay. In the end, of course, somebody pays. It would be better for those people to be covered.

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In the end, of course, somebody pays.

Actually, in the end we ALL pay.....higher property taxes to support city or county hospitals, higher rates from hospitals and doctors for those who self-pay, higher insurance rates for those of us with insurance. It's just a ridiculous system at this point.

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I understand the reasoning, the question is what's fair? Is it fair to force someone to get insurance on the chance that they may need it someday? I pay workman's comp insurance...have for years...never used it. I've paid unemployment insurance since I was 16, never used it...how much does the government get to mandate about what I should pay to protect myself?

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There will never be a health care system that is "fair" for all people all the time. The goal is the one that helps the most people and makes the most economic sense for the country, businesses, and individuals.

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First off, you pay unemployment insurance? Really? Taken out of your check and everything? In most states it's paid by the employer.

Look, I understand your point, but unless we as a society are willing to say to people "Buy in or your on your own" and then sit back and refuse to treat people when they become catastrophically ill or injured unless they can pay, then it won't work.

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I am with you one this one SFC. We pay so much into insurance and never use it or use it so infrequently that one never gets their moneys worth.

Since we don't get our money back if we leave an insurance company, we inherently pay for any American's pre-existing condition. It is interesting how they play us against each other, but this should be very simple. Insurance is the greatest waste to a healthy American that we should be able to share that benefit with those less fortunate. Simply said, I am not using mine so you can. Let us share the responsibility thru accounting for all healthy American's to off set the needs of the American's in need.

I bet you there are more of us who consider ourselves "healthy" and don't effectively exercise our healthcare to its fullest. I can say that I am one of them. I have always had health insurance but never felt as if I got my money's worth. I would rather feel like I am helping someone instead of wasting my money and allowing these insurance companies rob me blind.

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A CHANCE you will need it someday? No. It's not a chance, it's a certainty. You WILL need it someday. And when you do, your premiums will not cover the costs. That's the idea of insurance - pooled risk. People who don't use it help pay for those who do because eventually we all will use it.

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Unless, of course, he drops dead suddenly, after living a perfectly healthy life.

The insurance companies' premise is that if they are forced to cover all pre-existing conditions for new customers, irresponsible people like SFCWallace (I kid) will go without insurance until they get really sick with an expensive illness, which does happen to most people at some point in their lives. Then all of a sudden they will demand insurance that fully covers their condition.

That's not really health insurance; that's just getting someone to pay for your healthcare. Likewise, once SFCWallace is cured of his horrible disease, there is nothing to stop him from dropping his insurance.

I think--evil though they are--the insurance companies have a point. There has to be some incentive for healthy people to plan ahead and pay for insurance while they are healthy. If you can just add and drop it at any time with no penalty, there is no point to having health insurance unless you are currently sick.

Since the insurance companies were one of the main lobbies that prevented universal healthcare before (and since this version doesn't really affect doctor salaries), Hillary's mandate might make it back into the healthcare plan with little resistance.

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(For the record I have Tri-care because I'm retired military until medicare kicks in, but I don't use it...
You're making my point -- you have medical insurance (and a government one at that). Those younger folks that you mention already have a low-premium, high-deductible insurance today -- that doesn't change.
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Very interesting.

I can't imagine HCI really thinks that this particular President will look for a coverage mandate. But they also realize what's coming.

My take: They're trying to get in the game now by taking a much different tack than they did against Hillarycare.

Even if this is a Trojan horse from HCI, it's still good news. It's the first time either of those organizations have ever talked about accepting all customers. Another sign that change in this area is really coming. :-)

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In other words, they know the jig is up. They want to position themselves to get the best deal they can. They know Obama has a mandate on this.

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...the same 53% mandate GHW Bush had back in 88...?

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I didn't say a general mandate, I said a mandate on this issue. What major issue/issues did Bush run on in '88 that he made a point of repeatedly saying absolutely HAD to be accomplished? I can't recall any offhand, unless you count no new taxes.

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Mandates are a very bad idea. They want the public option of the health care reform plan to be limited so they can shunt off the sick, elderly, and disabled onto the public option.

It's a terrible plan. Obama campaigned against Hillary's plan because it included mandates.

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Don't sweat that. That's just HCI posturing. They know the clock is about to strike midnight on their profiteering, and are hoping to pull a Lieberman.

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***Breaking News****

Henry Waxman defeated Dingel in the fight for house chairman

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That's EXCELLENT NEWS FOR THE EARTH!!!!!!!!

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WOO-HOO! Go Henry! (God, I'm such a Geek.)

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...based on your picture I always thought you were Greek...not Geek.

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Oops, didn't see you posted it already.

Such good news.

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Regardless of whether mandates are a good or bad thing in a possible health care plan, this is NOT necessarily a good thing. The health care industry is demanding mandates--everyone gets covered so that they don't have to pay the costs of those who choose not to be covered, get sick, and then seek coverage--yet refusing to go along with controlling costs. That is, they still seek to charge those with diagnosed illnesses exorbitant, impossible rates, which pretty much is a killer to any solid health care plan.

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Well, I may be missing something, but why should the health insurance industry offer coverage to someone who had the choice to be covered, refused, and then chooses to join in only after they get sick? I'm no fan of the health insurance industry, but it's a no brainer for them. In addition, if they were willing to do that, then what would be the incentive for ANYONE to buy insurance up until the time they got sick?

See Jonze's post below.

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Wouldn't that be a part of the cost of doing business. So that aspect would be paid for already from the thrashing we already get for nothing.

No mandate is needed for me to put gas in my car but to use it, I have to pay for gas. We deal with costs that we can't control every day and adjust our behavior accordially. Its time for use to demand and adjusted, too.

Insurance companies be damned. If people didn't have to worry about access to healthcare maybe we would be able to address the preventative side of the argument and no only will force the poor insurance companies to do what they went into business to do.

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Waxman beats out Dingell to chair House Energy and Commerce Committee:

http://thinkprogress.org/2008/11/20/waxman-energy-commerce/

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That's a big win for Obama, IMO. Getting a major overhaul of our Energy Policy seems alot more likely now.

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It's big for more than that.

One of the little-discussed reasons that many of Clinton's initiatives failed was that he didn't have great relations with Congress, especially the House. So, despite the Dem majorities in 1993-4, Clinton didn't have the personal support to help get things passed.

Obama clearly doesn't have that problem. One of his very recent WH appointments was Phil Schiliro, who was a longtime Waxman aide. With Pelosi wielding the Speaker's gavel, and Waxman bringing his green bent to this high-profile committee, the path should be much smoother now.

I'm not predicting success or failure for the initiatives Obama will try to push through. But it'll certainly help a great deal to limit the food fights about them.

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The insurance industry is only stating common sense here. If they're forced to cover anybody without it being mandated that everybody HAS to have coverage, then it simply wouldn't work. Here's why - Say I'm a healthy guy and figure I don't need coverage, all of a sudden I find out I have a survivable cancer but know it would ruin me financially so I go get health coverage (that under Obama cannot be refused for pre-existing condition), I pay my premiums like everybody else and luckily I survive and am cleared, at which time I promptly cancel my coverage. So I just have to pay my premiums, the insurance company has to pay hundreds of thousands of dollars in health care costs, and then when healthy I cancel.

It would bankrupt the industry.

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That sounds fair.

Individual first. There will always be someone out there that wants to take your money. And so what if it does go bankrupt, it doesn't change anything for you are the people who can't get coverage today anyway because of pre-existing conditions.

Anyway, I bet they are free market folks. Don't feel sorry for those who are more fortunate than ones self. They just have to adjust their business model for the new scam. Trust me, they will never go away.

example: railroads built this country, then big oil and now the phone companies. The first phone lines were run along rail lines, think about it. Guess what these people are into next, sure money like healthcare and insurance.

I say lay today's business model to waste and make them build something for the 21st Century American.

WHAT DID WE FIGHT FOR IN 2008? THIS IS OUR TIME!!! TAKE IT AND STOP THINKING ABOUT HOW TO MAKE IT EASY FOR THEM!

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Mandatory purchase of private insurance is literally nothing short of a massive welfare program for the health insurance industry.

Let's also not forget, as part of this discussion, that the primary function of an insurance company is not "providing coverage" so much as it is the generation of investment capital. Their portfolios are getting dinged along with everyone else's and they want to make it up by dinging us all for more money.

Danger, danger Will Robinson...

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Too funny. As pointed out above the criminal health "insurance" industry sees that the gig is up. Hopefully, health insurance carriers will be going the way of the dinosaur. F*ck em. They won't be needed and merely are another layer of unnecessary bureaucracy and skimming taxpayer dollars to line their pockets. AMF.

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This is not Obama's plan, but it was Hillary's. I would say don't trust them. If they are offering then there's a catch, maybe they will offer you your current plan at its true price instead of the gauging that they are giving us today for 2 trips to the doctor a year and you come out of the pocket for any subsequent visits.

Health care today is like buying a car without an engine. We do have a car but we have to pay big time to make it work.

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As noted above, I think this is really a preventive strike against a Medicare-for-all public health insurance plan option. That's what the insurance industry doesn't want because a government-run plan will beat them on price, with much lower administrative costs, and on policies because the focus will be on consumers rather than shareholders and profits. With this, they can say, "here, we more than met you halfway, we can cover everyone ourselves, just keep government out of it."

I think having a public health care option is essential to any health care reform legislation being effective, but this battle is what the insurance industry is saving its powder for.

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When the insurance industry likes a health care insurance plan, grab your wallets and hang on.

Private insurance currently keeps over 30% of every insurance premium dollar, less than 70% goes to providers. In big "inefficient" government programs, Medicare needs only 2% for administration and the Veteran's Administration just 4%.

Why the HUGE difference? A bunch goes to excessive salaries, profits and "retained reserves". But even more goes to all the bureaucracy and paperwork to screen out people who might cost a lot. That's people with pre-existing conditions, or family histories of disease or genetic risks. In other words, people who might actually get really sick and need insurance. The insurance companies will cover you if they think you won't need it.

The system is fatally flawed. Private insurance companies' main goal, of course, is to make a profit for their investors. Since they don't have to cover everybody, they can pick and choose whom to accept, and can also charge different rates to people based on their risk. That creates a perverse incentive for each company, acting in their own interest, to avoid covering people who may need it the most, leaving those who are caught without a big company plan and get seriously ill to go bankrupt and then their health care costs fall on all taxpayers.

Two of the negative consequences that drive up the cost of the system are: First, the taxpayers are effectively subsidizing the profits of the insurance companies, who get to cherry pick the low risk high profit people to cover and leave the rest to government (all of us). Secondly, each company creates a myriad of rules and paperwork to screen people out or to fight expensive bills, which makes life a nightmare for doctors and hospitals who have to deal with literally thousands of different plans and their rules and paperwork.

That's why the private insurance companies keep so much of the premium dollar to themselves. But all this extra work to create rules and screen people out doesn't add value to society as a whole. Each company doing this individually in their own way, when combined results in a huge morass of rules and paperwork which actually wastes an incredible amount of money (not to mention our time and emotional stress). I'm all for private business when it makes sense and improves society but not when the system perversely rewards companies for adding complexity and cost but not value to the whole.

The solution is to create one set of rules for payments that covers everybody all the time. Doctors, hospitals and other providers would still be private, there would just be one insurance payment system - a single payer system. Many independent economic studies have shown it would save so much that everybody in the country would be covered and we'd have money left over.

Just imagine - your coverage wouldn't be dependent on your job, or your negotiations with an employer. You'd keep your health insurance even if you lost a job or had to close your business due to your illness. Your child would still have health coverage when he or she leaves school. Doctors and other providers could focus on taking care of you, not billing. You wouldn't have to put off going to the doctor or dentist until the pain got so bad (and the condition much harder to treat). A single payer insurance system would know you'd be with them for your lifetime, so would be able to focus on long term savings and preventative care.

Single Payer - The best for you, the best for the economy

For more information:
www.pnhp.org/facts/single_payer_resources.php

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Before everyone gets too excited, notice that the insurance company said they'd cover everyone, but they didn't say at what price. You have diabetes? Sure, we'll cover you. And your premium will be...wait, let me get another truckload of zeros...

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I'm so glad you mentioned this! The insurance companies will just price sick people out of the market. That's what they do here in Texas already, if you have a pre-existing condition they send you to the Risk Pool where your rates are double. For me it was better than nothing, but I had cancer and no choice. When you look around the world (ie.Europe) they don't have the added stress of worrying about paying for health care, drugs, nursing home care. Americans lose their savings, homes, sanity. 1/2 of U.S. bankruptcies are due to illness. This happens even when you have health insurance. (One of my cancer drugs cost $8100 a dose, I needed it 8 times!) We must go to single-payer and get the profits out of health care. It is not right to profit off of peoples misery!

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What fascinates me here is that the health insurance industry is talking about this as if it's some sort of negotiation. Okay, they say, you can pass your little laws, but only if we get to make demands in return.

Uh, no. That isn't how it works.

Global mandates/Romneycare is a terrible idea and hopefully this terrible idea won't manage to re-infect the Democratic health care plan. I would like to think Hillary Clinton lost for a reason.

Okay, here's a question-- Daschle wrote a book about health care earlier this year, before the primaries really got going, right? What's his position on mandates?

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This seems to be a pretty good discussion here, I just see one thing missing. Hidden and not so hidden costs of Corporate Health Care.

Lobbyists: It’s is their job to be a constant influence in the ear of your representative in Congress. Their goal is to influence politics that favor(profit) the insurance industry. This is an expense that contributes to high insurance costs.

PR: This is also referred to by many as “propaganda”. Like the lobbyist, the goal here is to influence politics for the benefit of the insurance industry. This too contributes to the high costs of insurance. The current campaign is pushing for a “mandate” on the premise that it is the “uninsured” who are mostly to fault for high price of insurance.

Political contributions: Again, the goal is to influence our political system for the benefit of the insurance industry. Beyond simply contributing the the high costs of insurance we pay, political contributions and lobbyists compete against the peoples interests in Congress.

Lawyers: Any time a claim is paid, it cuts into the insurance company’s profit. Lawyers, expensive as they are, help keep profits up by denying any claim they can. One example from Sicko cited an “undisclosed Yeast infection” as the reason for denying payment for care and canceling coverage. If you didn’t watch Sicko because you were told it was “anti-American” propaganda… refer back to PR expenses. Lawyers contribute to poor service and individual financial burdens from unpaid medical bills.

Screener: This is the individual that will decide whether or not you will be profitable to insure. Disclosing all of you medical history may prevent you from acquiring coverage, failing to do so may result in unpaid medical bills. Refer back to Lawyer expenses.

Advertisement: This is the main battle ground of competition between the many insurance companies. As expensive as advertising may be, it is imperative for any corporation to be profitable. Spending lots of money in this area also ensures favor with broadcasters for an additional boost in PR assistance. This is just another cost that is passed on to the consumer contributing to the high price of insurance.

CEO: These individuals make more than any government employee or elected official. His or her goal is to keep profits as high as possible, buy jets and take long vacations.

Some of these expenses may be an exaggeration, or not, the short list is by no means complete. And NO I didn’t point out all the faults in every other nation like those opposed to National Health Care would have liked me to.

I support HR 676. I am opposed to being threatened with loss of choices, long lines and rationing, by any politician in a position to prove what a terrible job they are capable of if we ditch their corporate buddies. Understand that these people are not providing us with an honest warning, they are not fear-mongering, they are threatening us.

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