Friendly fire: Health care reform

Ethan:

Since the passage of the Patient Protection and Affordable Care Act in 2010, the nation has heard too much heated rhetoric on the issue of genuine health care reform and not enough facts. The first fact that should be considered in any health care reform plan is the spiraling rise in treatment costs. The source of this fundamental issue is government-run health care insurance. While government programs like Medicare and Medicaid are not actually single-payer health insurance systems, they retain some of the negative aspects of single-payer insurance. For one thing, there are no reasonable means of ensuring cost-effectiveness in treatment. Considering that there are over 70 million people presently enrolled in those programs at present time, cost-effectiveness has been removed from the treatment process for over a quarter of all Americans who have health insurance. Lack of cost-effective measures for care in this much of the health care industry has fundamentally distorted the price structure of health insurance that reinforces my original point that government is the problem here.

Sean:

Your explanation only tells half of the narrative behind rising costs. While government bureaucrats may contribute to a lack of efficiency, private insurance companies employ armies of actuaries to statistically identify the liability of patients by age, gender and physical disability. For instance, when browsing online premium quotes for brand name insurers such as United Health, Aetna and Blue Cross you'll find that premiums for a female will be $20-40 more than a male of the same age. Instead of providing collateral for personal health, insurers treat patients as a statistic to be exploited, and the market largely goes unchecked due to a lack of competition.  

I support President Obama's healthcare reform for banning such discrimination due to preexisting conditions. However, I don't think the reforms went far enough because they did not include a public option as a viable alternative for patients unsatisfied with unfair treatment from private insurers. It's sobering that in a 2010 report from the World Health Organization, the US ranked 37th in health care quality, far below the publically health insured nations of France, Italy and the UK. Obviously there is still need for improvement.

Ethan:

First of all, actuaries are not tools of discrimination. They assess the costs of different forms of goods and services. This is a vital function in effective pricing, and removing the health care industry's ability to make these assessments inhibits their rights as well as good business practices. Before you start quoting cost differences as arbitrary and unnecessary, make sure there aren't legitimate reasons for said costs differences.

As for Obamacare's mandate of coverage for preexisting conditions, this further deteriorates the general price situation. In order to pay for coverage of these new customers, insurance providers must hike costs across the board to deal with a relative minority of those that it is insuring. A more effective manner of dealing with the issue would be to create a joint program between the federal government and the several states like Medicaid that would provide for the partial subsidization of health insurance for people with preexisting conditions, that would give them health insurance at a comparable cost to the rest of society while not distorting general insurance costs for all individuals.

Sean:

I understand the business logic behind an actuary, but if someone can't discriminate against gender and physical disability in housing, education, or food/water distribution, why should such practices be condoned with health care? Furthermore, it is already illegal to pit discriminatory statistics toward race in premium price quotes. I see no reason why gender and physical disability shouldn't be protected with similar legislation.

Instead of getting the nation deeper into debt by subsiding Big Pharama with Medicare D, all levels of government should invest in programs that encourage citizens to be physically active and eat right. America shouldn't be leaving the sick, infirmed and obese behind. It should be providing a path to a healthy independence from an untrustworthy private sector and a bloated and inefficient national health program.

Ethan:

I don't want to call the private sector untrustworthy because it has been shown to be highly effective and cost-efficient in other areas of the economy, though I am glad that we share a consensus on needing to move away from the bloated and inefficient government programs toward a focus of preventative health care. As for actuaries and changes to health plans regarding race, gender and physical disabilities, the rationale is simple. Not all people are physically the same; there are general differences in body structure and personal health based on gender, race and any disabilities or preexisting conditions that a person may have. To that end, health insurance companies should be free to alter health insurance programs to better fit the need of each individual even if it means a higher cost.