RE: [Winona] It's the Insurance Companies

[Rich PFlughoeft]

I've been asked who should pay for health insurance if it's not the employer. Dwayne and Phil both are convinced it should be a government run single payer system. Their arguments are convincing to me. I would support such a system. However, I'm not convinced that you can bring such a system to reality. In my opinion, Americans (for good or bad) are loath to put the federal government in charge of aspects of their day to day life. Imagine for a moment, you call the IRS for a health insurance question. I know it's not a fair analogy, but it is the way some people think (again, this is my opinion).   While I'm breaking the rule that says you should never write a letter like this late at night (I'm never as clever and witty as I think I am) I'm going to give it a shot.   Assuming Dwayne and Phil are unsuccessful at bringing about a move to a national health care system I would propose the following: 1) Think only in terms of the State of Minnesota 2) Think in terms of making Insurance Companies play by rules that would 'mimic the rules we would use in a single payer system'.   What does this mean?   Well, besides the evil profit motive of insurance companies (sarcasm intended since I'm sensitive to the word profit being equated with evil) there are a few things that strike me as reasonable reasons that health insurance premiums vary significantly from person to person or business to business.   1) Pools and Cherry Picking: If you're a small employer with one or two employees with significant health issues, your premiums are going to be different from employers who have huge numbers of employees and 'on average' aren't as high a risk factor. Throw in the fact that self-insured people who have little in the way of 'health issues' are able to get insurance much more easily (or less expensively) than an individual who is seeking insurance but has a history of health problems.    2) Many healthy people are not in the insurance pools. I would suspect this happens because of two primary reasons.    2a) I'm young and healthy and I have better things to spend my money on.                                  -or-    2b) I'm wealthy enough that I don't need insurance.     How would I 'regulate' insurance companies to deal with this? 1) First and foremost, I would eliminate the issue of 'which pool are you in'?. If I was King for a day and could decree only one absolute law, it would be that insurance companies had to look at Minnesota as one and only one pool. If you are a resident of Minnesota, you are a member of that pool. Add to that the requirement that you could NOT be denied insurance because of a pre-existing condition. If you live in Minnesota, you can get insurance and it doesn't matter where you work or what your health history is.   2)This is going to be the part that will kill my plan but, .... treat health insurance in the same way we treat auto insurance. If you have an auto, you are required by law to have insurance. In my opinion, if you have a 'body and you're alive' you should be required to have health insurance. This will keep all the people that think they can stay out of the equation while they are young and healthy (or wealthy enough to avoid insurance) from diluting the pool of healthy individuals.     Please note that neither of the above points preclude insurance being provided by your employer. While I'd rather not pretend that it makes sense for me to be an integral part of the health care system, at least level the playing field.   Oh, if it isn't already obvious, the state of Minnesota would have to play a role in providing the health insurance premiums for those who could not afford them. And, the state of Minnesota may have to address the 'Minimum Wage Laws' if we expect people to buy their own insurance. Of coarse, if people would prefer, we can continue to require businesses to provide this benefit. I'm expecting then that the day will come where I'll be required to buy my employees their groceries.   So much for my late night dissertations. Good night all.   Rich Pflughoeft