Tuesday, September 11, 2007

Universal Health Care in AK?

I just came across this article on adn.com about Hollis French sponsoring a bill that would mandate universal health care coverage in the state of Alaska.

Just based on the brief information in this article, it sounds like the idea might be similar to what was passed in Massachusetts in 2006. However, I need more details...such as what kind of coverage people are going to be mandated to have, and at what cost to themselves.

The term universal health care is being used too broadly these days (I think) to mean simply "everyone's covered" instead of "we find a way to help everyone get coverage in a reasonable way that doesn't create an economic burden on the individual."
Which, I think, was the original intent. I mean, who is going to be defined as amongst the poorest? I bet I'm not...but I sure couldn't afford a real health care plan, and either could most of the people I know.

I'm completely in favor of absolutely everyone having some sort of coverage to meet their health care needs. However, I'm not in favor of the individual being fined for failure to provide for that need when such a heavy economic cost is associated with it. The issue here is not that individuals aren't taking enough responsibility for their health care. The issue is that our health care system is set up to function as a series of corporate machines. Corporate machines rarely favor the individual unless a heavy enough demand requires it.

I'm not sure that setting up a system which fines people for not being willing or able to buy in to the bigger system is the appropriate way to apply demand based economic pressure.

I'm going to see if I can't find the wording of the bill... when I do I will post it, probably with more commentary.

My other commentary (at least on the article from adn.com) is on the suggestion that individuals be allowed to purchase insurance from other states if it is cheaper than purchasing from an instate provider.

Businesses can already do this on behalf of their employees and it often creates a larger burden than necessary. Frequently the resultant outcome is that people have an insurance carrier with a great plan and great rates...but they have to fight to have any services covered at a reasonable rate because there are no "preferred providers" in their area. All services are immediately paid at out of network rates, increasing the cost to the individual by 30% or more.

In my experience working for health care providers, it was frequent that we had a patient with an out of state carrier who had to fight to have each service covered at a reasonable rate. They would first have to pay a higher portion of the costs directly to us, and then fight for reimbursement from their insurance carrier. This happened because, not only was my physician considered to be out of network, but there were no other physicians in the state who were. The same held true for the few large medical centers/hospitals in this state. Too Frequently they were considered out of network because they weren't daughter institutions of a larger company (Kaiser Permanente, Colombia etc...)

The one exception to this seemed most frequently to be within the Blue Cross/Blue Shield system because they are already set up to share preferred providers with the local carrier.Generally because the local carrier is the one to whom the claims are submitted regardless of whether or not they are the one through whom you are covered.(For example, I used to have coverage through Blue Shield of California, but live in Anchorage, AK...so all claims on my behalf were submitted to and paid by Blue Cross of Alaska.)

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