Entries Tagged 'Health Insurance' ↓

Let’s leave the politics of healthcare reform to one side and focus on a proposal to change the law to allow free market competition between insurers in different states. A policy consistently mentioned by the Republican party is to break the state monopolies in the insurance market. Since the 1800′s, the individual states have claimed the sole right to regulate the sale of insurance within their own borders. Each state has asserted the right to license insurance companies and to set the terms on which they can conduct business. This has led to a patchwork of different sets of regulations with each state creating unique laws. In turn, this forces an insurance company to set up separate subsidiaries to trade in each state. No licensed company can sell a policy to someone who has a residence in another state. There was a brief moment in 1944 when a decision of the Supreme Court allowed the possibility of federal supervision. But the lawmakers in Washington immediately changed the law to retain state control. Why is this a bad thing? The national insurance companies have divided up the states between them and choose not to compete against each other. This keeps the number of insurance companies in each state artificially low and, because there is no real competition, premium rates are higher than they should be for weak policy terms. Continue reading →

In case you have the possibility to opt for employer-sponsored group health plan there’s a really important decision to be taken. Most employers, especially big companies or small businesses within purchasing pools, offer their workers a wide range of plan types, which typically include both HMO and PPO health plans. Being the most popular of all plan types, these two have distinct features, and understanding the difference between them is really important for having adequate insurance coverage for you and your entire family. So let’s take a closer look at each to have better knowledge of pros and cons they deliver.

HMOs

Health Maintenance Organization (HMO) is an alliance of medical workers and facilities (doctors and hospitals) that have a contract with the insurance company for providing their services for a fixed price.

HMOs are generally regarded as having many rules and restrictions for their users. The person having an HMO plan is required to choose a single physician who will be responsible for all your healthcare matters. The primary physician should be a member of the HMO network, which means if your current doctor doesn’t make part of the association then you will have to find another one who does. In case you have to visit a specific specialist, you will first have to visit your primary doctor for a referral, otherwise you won’t get the care you need.

The definite benefit of an HMO plan is its price. It is much cheaper than any other health insurance plan type, having lower rates, premiums and typically free co-payments. This is a very attractive option, however you have to keep in mind that first of all there’s not much flexibility involved with HMOs, and doctors participating in them will usually have more visitors because they have to make up the low cost of the plan by servicing more people and get profit from that. Continue reading →

Watching politics is a fascinating way to pass the time. People always find new ways to repackage the same basic debates in ever different forms. The media float above the fray, supposedly with a dispassionate eye. The code of the professional journalist preserves a neutral position, identifying the key facts and giving both sides of the debate a fair hearing. Unfortunately, the arrival of Fox News and the rise of the Right Wing Jocks has produced an opinion-based approach to reporting the news. This is not simply skewing the coverage. It is actually introducing new levels of venom into the debate itself, raising the profile of news reporters and commentators as demagogues, and personalising the attacks made on government. No other issue has raised the heat of passion in the debate as the proposal to reform the provision of healthcare in the US. Many on the right of the political spectrum see these proposals as a direct attack on their individual liberties and as promoting big government. They approve the rise of activism that has seen groups around the US protesting in the Town Hall Meetings run during the summer and in the so-called Tea Party protests which focus on the rise of big government and the redistribution of wealth through alleged socialist measures.

As a momentary aside, let us make a politically incorrect observation of fact. The membership of the Republican Party is, with the exception of the tokens like Michael Steele, mainly a party of white people. Similarly, the vast majority of the protesters in the events organized in 2009 are white. It is just a coincidence that the primary focus of their anger is Barack Obama. That said, the key measure in the reform package is some change to the current system of insurance. The supporters of reform argue in favor of mandatory insurance. As it is, a significant percentage of the young and healthy do not buy insurance. Continue reading →