The new insurance exchanges
The new insurance exchanges
Over the last few years, the constant worry for employers and families has been the same. Factories have been controlling their costs and overheads, yet finding the one uncontrollable factor the rising insurance premiums. It's been the same with families who have felt victimized. Insurers have taken their money when it suited them and then cancelled the policies whenever the risk of claims increased. At state level, budgets already under pressure were facing rising healthcare costs. These helped push more states into deficit. No matter how the media may try to paint the insurance industry as innocent, the harsh reality is it has operated without any sense it can or will be held accountable no matter how much it gouges the public. This is all set to change as the Affordable Healthcare Act of 2010 comes slowly into effect.
One of the ways in which the GOP has attacked the new law is by describing it as nationalized health care. For many, simply using words like socialist, nationalization, or communist is enough to condemn the program without having to say anything more. Except the reality is not quite as the right wing would have you believe. The essence of socialism is some degree of central control that redistributes resources to help the weaker members of society. Except, the new law decentralizes the primary responsibility to the individual states.
The law assumes that state governments are closer to their own people and so better placed to understand their needs. This means the states are responsible for setting up the new exchanges or insurance market places. Once established, you and small businesses will be able to buy your health policies. Why is this an improvement? Because the insurers will all be seen in open competition with each other in a single exchange. It's rather like this site which gives you a search across all the leading insurers in your state. Except this is not completely transparent. The current search engines can be manipulated by the insurers as they preprogram their responses. In the new exchanges, the insurers will all have to list their prices side-by-side for like-for-like policies. It will allow you to make a more realistic comparison and pick the best deal.
In this, the states have great flexibility on the design for their exchange. For example Massachusetts controls which insurers may quote their policies whereas Utah allows all insurers to quote. Your elected representatives will decide what benefits the plans must offer. They may choose to require insurers to offer benefits matching those available in employment plans or allow a more basic set of benefits. These are local decisions with your representatives accountable at the ballot box if you do not like their decisions.
Individual health insurance is something so important, it should not be left to unaccountable insurers. We all have a stake in ensuring the health insurance plans we buy offer good coverage at reasonable premium rates. If we find the insurance industry is still behaving badly, we should be able to fire the politicians who should be imposing regulation, and replace them with people who are prepared to protect us from exploitation.
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