Insurance Capital Can’t Figure Out Health Insurance

 

Here's a quick rundown of what it means to have "good insurance."

Like many middle-aged people, I have health problems and need to see a specialist from time to time. The "good" side of my insurance is that these visits are covered.

But it's not that easy, because nothing is ever that easy.

Having insurance and seeing a specialist means that you need your GP's prior approval, even if you've never met one. What that really means is that someone in the office has to check the box on the electronic form. It's not even necessary in advance. Pre-approval can be retrofitted. All it takes is someone checking a box at some point.

Sometimes this step is overlooked and a visit to a specialist is billed. The news that I owe my provider money arrives somewhere in a blizzard of communications reaching my family of four, each receiving some level of care. The point is to stop paying attention. But if someone forgets to check the box, I get billed and if I forget the bill it goes to the collector which happened twice in the last year. All of a sudden I have to explain to the chatbot that I'm not in debt for $495 and the clinic knows I'm not in debt, but it takes all sorts of interactions to fix the problem. and long phone calls.

As you say, good insurance. Many find themselves in a much more precarious position. I can't help but believe that we can do better. For example, can we create insurance that covers people's health needs without prioritizing the interests of private companies? used by Americans. The problem is that you must be over 65 or below a certain income limit. Everyone else is out of luck. Americans are big fans of the government's plans, despite threats from the insurance industry. Try telling older people that you're taking up Medicare and see what reactions they get. You will be labeled a radical. No, it doesn't make sense.

Connecticut has struggled in recent years for what it calls public health insurance options. This is different from Medicare-style single payment insurance, but instead works in competition with traditional health insurance, at least possible. In theory, it eliminates the profit-generating aspect, so it offers better coverage at a lower price point (along with a $1 million CEO salary). This is not a new idea. Other states have enacted such plans, and the public option was discussed at length in the Obamacare debate (thanks Joe Lieberman) before it was finally shelved. In a state where the Democratic majority and many lawmakers support the public option, this should be a ripe area for a Connecticut version.

It Didn't Happen.

Some places are known for exciting industries like aerospace and microchips. Danbury is wearing a hat. Unfortunately, Hartford is known as the insurance capital of America. The companies that gave the city its title aren't as dominant as they used to be, but they still have influence over key policies that affect business.

Over the past few years, these companies have, first quietly, then openly, threatened to rethink their Connecticut home if they chose the public option. Many Democrats supported the plan, but the governor, along with Republicans, opposed the idea. The Democrats could have passed the bill anyway and tried to override his veto, but they weren't ready for this fight...and it died.

It's Not That It Can't Be Reproduced.

As it happens, he, one of the bill's strongest supporters, and the man who drafted it at last year's session, is now a nationally elected official with a newfound significance. Recently elected State Comptroller Sean Scanlon is fighting for better health insurance but taking a pragmatic approach.

Scanlon is not pushing any publishing options this year. He was in the front row of last year's debacle, so he doesn't want the plan to fail again.That doesn't mean the need is gone, he said in a recent interview.

In his new position, Scanlon relinquished the power to submit bills to the General Assembly, but he had a greater voice in shaping the direction of state policy. As an auditor, he drives changes in the government's pension policy and reduces health care costs. However, it may take some time before the publish options appear again.

Concerns about politics were always exaggerated. A private insurer takes care of the logistics so you're never left behind. Cost is an issue, but keeping people healthy and insured seems like a worthy goal of spending public money. We are lucky to have someone like Scanlon in the state who understands this problem. However, his tenure is the same as that of Ned Lamont. It's hard to see the future of public options with this governor in office. I mean, we're all losing.  

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