Rigging Universal Health Coverage

Devising a system of universal health coverage in Utah is a high priority for our governor (I’d say it’s second to expanding our state economy). As usual, Scott is pointing out the glaring flaws in the approach the governor is taking.

I find it more than a little disconcerting that a task force made up of people who make their money on health care are being put in charge of coming up with ideas. It should not be surprising that such a group would encourage a mandate on individuals. If we should have a mandate at all, shouldn’t it be a mandate on those who make their money on health care, perhaps a mandate that insurance companies must offer a broad array of plans, or that health care providers publish their prices (these are very preliminary ideas, just suggesting that a mandate on individuals is misguided).

I also think that the task force should include some people who are not already insured – at the very least they should spend a lot of time talking to people (insured and uninsured) to find out what kind of plans would attract more people to purchase insurance. That should be the basis of any policy decisions and, if necessary, mandates for the insurance companies.

In my experience, one of the reasons that doctors and clinics don’t want to publish their prices, is that they charge different prices depending on your insurance. They accept that when they want to charge someone $100 for a visit the insurance company will return the bill saying that they will only allow them to charge $88 for that visit and that they will pay $73 of that (leaving a $15 copay).

It seems to me that the pricing system is upside-down. Doctors should publish their prices and insurance companies that will accept that doctor will agree to pay that published price (of course allowing for the copay structure). Doctors who charge higher prices would not be accepted by as many insurance companies and insurance companies who would not pay enough to cover the costs to doctors would not be able to offer access to as many doctors. People without insurance would also be able to make informed choices on the services they use. If my experience is any guide, the option of health savings accounts combined with a high deductible policy (sometimes called catastrophic coverage) would look much more desirable to more people.