WFS Home › The Futurist › 2011 Issues of The Futurist › March-April 2011, Vol. 45, No. 2 ›

Health Insurance in America After the Reform

Subject(s):

By Jay Herson and David Pearce Snyder

If for-profit health insurers find that business is too unprofitable under the new law, where will Americans find affordable coverage? One solution may rise from the nonprofit sector led by credit unions, which have already demonstrated an ability to keep up with for-profit banks.

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Comments

Health Insurance in America After the Reform

Submitted by 1612526 on Sun, 10/30/2011 - 7:00pm.

I think this makes a very interesting point. I wonder if an examination of the need for health insurance at all might be in a discussion. An old surgeon whom i once worked with (he graduated from Mayo in 1948)told me insurance was the worst thing to ever happen to "healthcare". I think the same is beginning to be seen in Veterinary medicine..people buy insurance are taken out of direct responsibility for payment therefore are willing to have more extravagant procedures..can be charged more etc... etc... I am only 46 and have practiced as a RN for 23 years but i know we had a healthcare system prior to the invention of health insurance..just a question..

We hear a lot about added

Submitted by Anonymous (not verified) on Thu, 06/28/2012 - 11:51am.
We hear a lot about added costs of redundant testing for liability purposes; even without that it is very expensive to treat for cancer, heart disease, HIV, etc...most people could not afford it without health insurance. Costs may have been much lower back in the day but you wouldn't have all of today's treatment options and would expect a much shorter lifespan.

Irony of Healthcare Insurance

Submitted by 1570326 on Thu, 06/28/2012 - 5:50pm.
The Irony of the US model is that without an alternative public system, costs keep rising exponentially. Australia's model is one to look at. The 'Universal coverage' approach was attacked and pilloried by the conservative side of politics when the our first medicare idea was introduced back in the early 70's. Although the model has had some tweaking, today it's pretty consistent with the one that was first covered. The health insurance side of the coin for private coverage means that people in Australia have two choices - a public system where in they'll always get seen, but for elective surgery (where the patient chooses to have it) they'll be on a waiting list for availability of a surgical team. The delays in having elective surgery are a result of non elective surgery coming first (emergency procedures). The Australian's have, arguably, the best medical system in the world bar none. In the Private system the patient will pay heavily for non urgent procedures (appearances at triage of a private hospital) but they face almost no delays in having their elective surgery done when they need to. There's still some costs associated but usually no more than a 15% contribution of the overall costs. However, as has been mentioned, recently a conservative Government created an incentive for people with Private Health Insurance to 'use it' by taxing higher income earners a levy of they did not have Private Health Insurance. A good idea though the unexpected side effect was that people with health insurance now think 'well if I have to have it, I might as well use it!' which has led to an increase in waiting times as people elect to have more non essential surgeries done. The lagging effect however is now starting to emerge. People who have had interventions earlier on in their lives are by and large more healthy than might have been expected at an equivalent age. This is what Aubrey De Gray might suggest we should be doing anyway to alleviate the 'ageing problem'. Of course this then raises another issue. Boomers, being the first (and only true 'me' generation) were promised a pension for life. They've not squirreled away anything for their old age expecting the Government to fund their longevity. And now, they're living longer which means they're running out of cash. In terms of alternatives, the recent story about the quality of some of the Indian not for profit public hospitals shows that a much higher throughput of patients, at significantly lower cost is possible. Importantly the research in heart patients also shows that patients in these hospitals do significantly better than their counterparts in the US, despite presenting with much higher heart challenges from the outset. So Private without public = ever increasing charges as the for-profit motive squeezes every penny. And the Irony of keeping that model without an alternative is that the Government ends up paying anyway as the poor health outcomes lead to social issues with increase costs in other parts of the system - crime, diseases, absenteeism, lower worker productivity, skills shortages, lower education levels and more.