The New England Journal of Medicine is doing an admirable job in working to advance the conversation about universal care among physician and healthcare audiences.
Yesterday, the NEJM.org posted an article titled The Individual Mandate — An Affordable and Fair Approach to Achieving Universal Coverage by Linda J. Blumberg, Ph.D., and John Holahan, Ph.D.
It's a worthy read with insightful commentary on insurance pools, and how our present system makes it difficult for people with health problems to obtain and maintain insurance. Further, voluntary insurance lacks incentives for efficiently managing health care costs.
The piece then goes on to argue that if it was mandated that everyone must have health insurance coverage, adverse selection (currently conducted by health insurance companies) would be eliminated and by providing care who those who need it most, better care management would result that would reduce the sky-high costs associated with acute situations in chronic conditions that have been allowed to go on without adequate treatment.
Health insurers engage in many practices that make it difficult for people with health problems to obtain and maintain their coverage; they do so for the express purpose of protecting themselves from the potentially enormous financial consequences of adverse selection. Adverse selection entails the disproportionate enrollment in insurance plans of people with higher-than-average health risk. There is a natural tendency for such selection to occur, because people prefer to pay for coverage only when they think they will need health care services. Insurance pools cannot be stable over time, nor can insurers remain financially viable, if people enroll only when their costs are expected to be high. Consequently, insurers create, and regulators permit, structured barriers against such behavior, including such policies as exclusion periods for coverage of preexisting conditions, benefit riders that permanently exclude particular types of care, higher premium rates or cost-sharing requirements for people with health problems, and outright denials of coverage.
NEJM | An Affordable and Fair Approach to Achieving Universal Coverage
The New England Journal of Medicine is doing an admirable job in working to advance the conversation about universal care among physician and healthcare audiences.
Yesterday, the NEJM.org posted an article titled The Individual Mandate — An Affordable and Fair Approach to Achieving Universal Coverage by Linda J. Blumberg, Ph.D., and John Holahan, Ph.D.
It's a worthy read with insightful commentary on insurance pools, and how our present system makes it difficult for people with health problems to obtain and maintain insurance. Further, voluntary insurance lacks incentives for efficiently managing health care costs.
The piece then goes on to argue that if it was mandated that everyone must have health insurance coverage, adverse selection (currently conducted by health insurance companies) would be eliminated and by providing care who those who need it most, better care management would result that would reduce the sky-high costs associated with acute situations in chronic conditions that have been allowed to go on without adequate treatment.