THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Saturday, July 22, 1995 TAG: 9507210032
SECTION: FRONT PAGE: A10 EDITION: FINAL
TYPE: Editorial
LENGTH: Medium: 52 lines
Before the Clinton administration concocted its elephantine health-care-reform plan, there was general agreement that some problems of health-care delivery urgently needed fixing. In the aftermath of the Clinton debacle, however, politicians have been understandably reluctant to inch out on the same limb.
Now, Sens. Nancy Kassebaum, R-Kan., and Edward Kennedy, D-Mass., have proposed modest reforms of insurance practices that deserve a serious look. The bill has attracted bipartisan support. It contains the following.
Insurance companies could refuse coverage to people with pre-existing conditions for only 12 months. Presently, those with existing conditions can find themselves essentially uninsurable.
Portability would be assured by disallowing exclusion for pre-existing conditions in the case of those changing jobs. This addresses one of the most worrisome aspects of the present system. American free enterprise was built on social mobility as employees moved from one job to another trying to advance or took a chance and started their own businesses. Now, more and more workers feel locked into jobs, not because it is in their interest or their employers' to stay, but because they can't risk losing medical coverage.
No arbitrary cutoff of coverage would be permitted under the proposed legislation. That is, individuals or groups would be assured of the opportunity to renew coverage as long as they could pay the premiums.
Insurers may not embrace these restrictions, but the present system is topsy-turvy in subordinating doctors and patients to insurance bureaucracy. Such reforms could help redress the balance.
Ultimately, however, a way has to be found to provide adequate care for young and old, prosperous and struggling. The present system allows private insurers to cherry-pick the low-risk customers while excluding the high-risk end of the market.
But that means those with pre-existing conditions lose insurance or are locked into jobs. The elderly, the poor and the least healthy among us are dumped on a government increasingly unable and unwilling to pay for them. Insurance reform sounds good, but there is no free lunch. Forcing private insurers to shoulder some of the burden will either force increases in premiums or cuts in care and profits. It will demand much larger risk pools to dilute the cost. Or, more likely, all of the above.
The ideas contained in the Kassebaum-Kennedy bill are no panacea, but they would begin to address some glaring inequities in present health-care coverage until better solutions are devised. by CNB