Friday, July 24, 2009

Questions For Conservatives

So, a few questions for conservatives out there:

--If you want a private marketplace for insurance plans (without a public plan or government subsidies), how are the working poor and minimum-wage workers supposed to buy insurance?

--If you do not want required minimum level of benefits (set by an expert panel or some other agency), how could you ensure that the offered plans will provide the necessary benefits?

--Assuming plans offer needed care and the money is somehow available, how will patients be able to choose a plan that will meet THEIR needs? Medicare Part D created a large problem in terms of choosing the right plan—and that was for a single health insurance benefit. How are patients supposed to choose among the dozens of benefits (preventive care coverage, medication coverage, etc) without help? And who will help them? The for-profit insurance companies?

--How would this address the issues of budget and cost overruns for the current government plans (Medicare/Medicaid)? Even if we assume that an envisioned private insurance market would work, it seems we are still privatizing profits while socializing risk—just as Wall Street and the financial markets have done, much to all of our distress.

--What sorts of incentives or changes would be considered to minimize unnecessary expenses? Would the relative effectiveness research being proposed by the current administration still be promoted? Or will the options of continuing expensive treatments or interventions that have not been proven to be better than less expensive choices be left alone to continue without change?

I would think these challenges would be daunting to anyone addressing health care reform, but I guess I just do not see any way that the private-only market plan addresses this. Tax cuts/credits are nice, but how much will this really help a minimum-wage employee? Will this somehow provide enough money to purchase an insurance plan that really could promote health?

I just don’t see it.

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