[Mb-civic] EDITORIAL 'Ownership' Isn't the Cure LATimes

[Michael Butler]

http://www.latimes.com/news/opinion/editorials/la-ed-health4sep04.story

EDITORIAL

'Ownership' Isn't the Cure

 September 4, 2004

 After 27 years of work, Dave Parker lost his job at a small electronics
sales firm in Orange in October 2001. A 1986 federal law called COBRA,
requiring insurers to continue offering employer-based coverage to employees
who have lost their jobs, kept Parker's insurer from dropping him. But that
didn't stop the insurer from "customizing" his policy to address his heart
condition ‹ a personal touch that boosted his premiums by 39%. Later, his
premiums soared further, and this year his insurer doubled his co-payments
and raised his premiums by an additional 16%.

 Welcome to President Bush's ideal of "added choice" in healthcare.

 Buzzwords like "flexibility" and "ownership" might sound empowering when
read off a teleprompter, as they were frequently during this week's
Republican convention. When discussed behind the scenes by health insurers,
however, they are read as code words for giving insurers more leeway to
"cherry-pick" ‹ offering bargain-rate coverage to those who need it the
least (such as healthy children) while pricing care beyond the reach of many
who need it the most.

 Bush's "ownership society" ideal for healthcare is embodied in the health
savings account. These let a family of four put aside up to $5,150 in
tax-free savings that can be used to purchase health insurance on the open
market. That will be small comfort to low- and middle-income families
because the premiums for such family policies ran more than $9,000 in the
group market last year, and would be even pricier if purchased by an
individual family.

 Another danger is that many healthy and wealthy people will flee group
plans in favor of health savings accounts, leaving the older, more
comprehensive health insurers stuck with a growing proportion of poor and
sick members. Insurers that aren't driven out of business would be forced to
raise costs. 

 Not all "ownership society" healthcare ideas are bad. One of the most
radical ‹ requiring all U.S. residents, some with government help, to buy
health insurance, much as drivers are required to buy auto insurance now ‹
has gained converts not only from the predictable places like the
conservative Heritage Foundation but from centrist think tanks like the New
America Foundation. The proposal deserves to be at least discussed by both
presidential candidates.

 Most of the healthcare ownership ideas the president has proposed so far,
however, are fundamentally unfair. It's an issue both parties will have to
address more seriously before the country's near-terminal healthcare system
goes flat-line. 


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