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And the Winner is... the Medical Insurance Industry

New America Media, Commentary, Elaina F. George, M.D. Posted: Sep 10, 2009

The suspense is over. For weeks we have been holding our collective breath to see if there would be real insurance reform. Now we know. President Obamas speech on health care incorporated a lot of different ideas, but what was most striking was his statement that the public option was just one of the avenues that could be traveled to achieve an expansion of insurance coverage. Besides the demotion of the public option as an important tool to reign in the all-powerful insurance companies, there was no mention of universal health care. Wasnt that the point of this whole exercise?

To be fair, there are some good points. Under the presidents proposal there will be:

Coverage for those with pre-existing conditions
A cap on out-of-pocket expenses
People can no longer be dropped from insurance companies when they get sick
No further cap on what insurance companies will pay out

It is a good start, but it doesnt go far enough. The president spoke about slowing the growth of health care expenses, but he did not discuss a reversal of the cost of health care. With the average medical insurance premium for an individual costing over $6,000 and a family almost $12,000 a year, how does this help a middle or working class family struggling to stay in their home? Will it really help them to be mandated to purchase insurance at this price or face a penalty?

For those who cannot afford to pay for insurance and dont qualify for government assistance, this will amount to a new tax that can disproportionately affect minorities who are already affected by barriers that obstruct their access to care. Currently, of the 47 million people who are uninsured, 17 million of them are people who meet the financial criteria to receive Medicaid or Medicare. They are waiting to get into these programs, but because of state budget constraints or the wait associated with a shortage of physicians who actually still take these insurances, they are effectively out in the cold. I dont see how the presidents proposal will ease this crisis.

As it stands, his proposal will ensure that insurance companies get millions more customers who have nowhere to go. Even those people who enter the "exchanges" will have to buy private insurance since the weakened version of the public-lite alternative will not come online until four years from now.

Essentially, he is asking us to trust the insurance companies to play nice. The theory appears to be that by gaining more money, perhaps they will charge people less. In a for-profit industry, I am skeptical that this will work since it has not worked to this point. The insurance companies have had free reign and they have rigged the system to maximize profits on the backs of patients and physicians. Like Wall Street, they have now been rewarded for their bad behavior.

Dr. Eleina George is president of Peachtree Ear, Nose & Throat Center in Atlanta.

Related Articles:

Why Insurance Companies Deny Health Care

The Unintended Consequences of Healthcare Reform

Will Health Care Reform Harm Ethnic Minorities?

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