Here's a startling report: A PriceWaterhouseCoopers study says that the current health-care reform legislation would increase a family's insurance bill by $1,700 a year in 2013 compared with not enacting the legislation. By 2019, the increase could jump to $4,000 a year more than the current status quo.
Weren't we trying to lower health-care costs?
Admittedly, the study was commissioned by America's Health Insurance Plans, the trade group that lobbies for health insurers like UnitedHealth Group (NYSE: UNH ) , CIGNA (NYSE: CI ) , Aetna (NYSE: AET ) , and Humana (NYSE: HUM ) , so take the numbers for whatever they're worth. It is clear, however, that there's one provision in the bill that would most certainly increase the cost of insurance by itself: requiring health insurers to cover pre-existing conditions.
Despite the fact that insuring something that's already occurring is an oxymoron, I think the idea of mandated coverage for pre-existing conditions has a lot of merit. It essentially breaks the tie between health insurance and employer, because employees with high blood pressure or diabetes, for instance, would finally have the option of getting coverage on their own at a reasonable rate. They would be free to move to another company that might not offer immediate health insurance coverage or even start their own business. It would increase entrepreneurism, helping the next Google (Nasdaq: GOOG ) , Intuitive Surgical (Nasdaq: ISRG ) , or Dendreon (Nasdaq: DNDN ) attract employees until the company was able to offer health insurance on its own.
But that freedom comes at a cost. Requiring health insurers to cover everyone will flood the insurance pool with people who are already sick, and those costs will have to be shared by everyone. The only way to lower the cost is to get healthy people into the system, too, by mandating health insurance.
A repulsive tax on the poor
The idea of requiring everyone to carry health insurance isn't that farfetched. States require motorists to carry auto insurance, for instance. But there's the question of how to make it a requirement. It's not like you need a license to live.
The easiest way to get everyone insured is to put a monetary penalty on those who don't have coverage. Essentially, give people a choice to pay for health insurance or pay a tax -- or lose a tax break, it's all the same.
The problem, of course, is that the people who are going to end up paying the tax are the ones who can't afford health insurance in the first place. That's not exactly "death-panel" material, but the counterintuitive nature of how to deal with getting the healthy covered doesn't sit well with many people.
To make it more palatable, lawmakers lowered the penalty originally proposed by Max Baucus, but that creates a whole new problem.
I'd gladly pay you Wednesday for a hamburger today
Without a high penalty for not having health insurance, the system is too easy to game. People could simply fail to carry insurance until they got sick, get coverage to pay for their illness, and drop the coverage later on. In Massachusetts, where the state requires citizens to have health insurance, there's some evidence that this is happening.
Using this strategy, people would still risk getting a life-threatening illness that needed immediate attention, but that's no different than the system we have now, where the uninsured are still taken care of in an emergency. And, when they can't pay their bills, the hospital eats the costs and passes them on to insured patients in the form of higher medical costs to the tune of about $1,000 a year, according to the president.
The Senate Finance Committee bill, in its current form, would extend coverage to 29 million people, but still leave about 25 million Americans without coverage. That's a good start, but far from a complete reform that many people were expecting, and it may come at a steep cost to those of us who already have insurance.
What do you think? Is this just a last-ditch effort by health insurers to keep the status quo, or are we setting up a system that's worse than the one we have now? Have an idea for getting us off the pathway of escalating health-care costs? Share in the comments below.