My Tall Ideas

This of course is the topic that is on everyone’s lips lately.  Comments are either good or bad.  I think most of the talk that you hear of course is the complaints about the new Health Care bill.  I don’t want to talk about whether this new bill is good or bad or if it is going to work.  I haven’t read all the in and outs and wouldn’t be able to give a fair assessment.   I just want to take a moment to just discuss the one comment I hear the most and that I think is just plain stupid.  That comment would be, “I don’t want to pay for everyone else’s health care too.”

 This comment obviously comes from people who have no idea how health care and insurance currently works.  I work in customer service for a big name health insurance provider currently and guess what…You pay for others’ healthcare and insurance right now!  So this comment is totally ridiculous.  Let me break it down a little bit and give a brief description of how you pay for others’ healthcare and insurance currently.

 First of all everyone who has insurance is put into groups.  If you get your insurance through your employer, your group is the people employed with that company who have coverage under that policy.  If you have a policy just directly enrolled with the insurance company and not through an employer you are put into a group of people who have the same type of policy and are getting their insurance directly through the insurance company as well.  These groups are what determine the rates for the most part.  If people in your group use the insurance a lot and you never use it, you are paying for their healthcare.  When your rates go up, some of that can be due to claims from your group exceeding the money that was pooled by the previous year’s premiums.  They can also go up in the expectation, based on previous claims, that future claims will exceed the pooled money from premiums.  This is how insurance works.  This is how you are able to afford coverage because everyone pools their money together to cover everyone in that group from possible health problems.  If you didn’t do that your premiums would be much, much more outrageous because you would have to have money pooled up in order to cover the worst. 

 The second way you pay for others’ healthcare is for the people who don’t have insurance.  These people still have medical problems and still have to go to the doctor or hospital when they do.  A lot of hospitals and doctors will write off bills for people with low income.  Some people will just not pay their bills at all and leave the hospital or doctor on the hook for all of it.  They may get sued but they still don’t have to money to pay for it if they do.  All of this makes the doctors and hospitals charge more and more every year for healthcare, because they are losing money treating patients who can’t pay for it.  That means that your health insurance has to take more money out of your pool each year to pay for services because of this price increase.  This then requires that more money be put back into your pool to make up for it.  Thus, it results in higher premiums for everyone.

So you see we are all paying for everyone else’s healthcare already.  Most people just don’t understand that.  The best way to get premiums and healthcare costs lower is to get everyone insured somehow.  Not sure how to get that done but that is what needs to happen.

Tags: bill, costs, doctor, group, health, healthcare, healthcare bill, healthcare reform, hospital, insurance, insured, medical, money, obama, obamacare, pool, premium, providers, reform