Official Health Care Reform Position from Peeler Insurance

Over the last month I have fielded hundreds of inquires regarding the Health Care Reform package blasting through Congress, taking valuable time away from addressing other important matters related to our clients. I do understand the concern and hopefully this ordeal will be over soon so we can get back to the task at hand, providing Texans with quality health insurance. I have decided, after much thought to reveal our position on the reform effort. I know this position may offend some of our client base and have been reluctant to post this position for that very reason but in light of the temperament or virtually every consumer I have spoke with I now think this is the right move.

First, I do support reform, just not in the sense that we are seeing now. I feel the current proposals snaking through Congress and the position of the President would devastate the health care delivery system for both seniors and under age citizens.

I do support proposals for guaranteed issue. I can’t tell you the number of times in my 16 years in the Texas health insurance business that I have had to confront a crying person on the phone because I told them they are uninsurable. This really bothers me. I feel so miserable when I tell them that due to some health condition they will have no coverage. Yes, I know there is a risk pool in Texas, but have you ever explored the rates. They are absurd. Yes, the rich can afford it, but not the average family. So, either we lower the cost of the risk pool by some additional form of subsidy so uninsurable Texans can get coverage, or we adopt a guaranteed issues mandate.

Another matter that needs to be addressed is the pre-existing condition clause. Texas law on most individual policies states that if you have prior coverage in force and have not had a lapse of 63 days that pre-existing conditions will be covered, providing the condition was listed o the application and no written exclusion rider for the condition was placed on the policy. What we need to adopt is a process tat says no pre-existing conditions limitations, period, providing a consumer of Texas health insurance has existing coverage in place and has not had a lapse of greater than 63 days. This will eliminate the ability of consumers to just go without coverage up until such time as a major illness occurs. It’s not fair to the insurance companies for them to be forced to pay massive medical claims when someone has not paid into the system.

Now, I am sure this next position will upset a few. We should require all Americans to have minimum coverage requirement enforced by financial penalty if they fail to do so. It’s only fair if you are going to require guaranteed issues and no pre-existing conditions.

We don't need a "market place" as so many politicians have pitched. Just get a good broker and you already have a market place. We quote over 1100 plans, bet the market place doesn’t offer that many options. A market place will do nothing but allow the federal government to impose burdensome mandates and restrictions on coverage options. Think of it this way, in order to participate in the exchange, which let's assume gets heave backing from the federal government (like the postal service does in advertising dollars) you must offer all kind of restrictions on coverage that many Texans don't want or need. Just let the private market delivery system work. That is one area that I think is dong fine. Let brokers broker.

Stop all the talk about cutting Medicare. You will destroy seniors like my mom and dad with these stupid Medicare cuts. My parents participate in the Medicare Advantage program that is under assault by Obama. With these cuts seniors WILL loose their current plan and be forced into higher priced options. Don't execute healthcare reform on the backs of seniors; however they are an easy target. Why? Because most seniors don’t vote for democrats. Traditionally that sector has leaned more towards the conservative candidates. Medicare reimbursement payments already are about one third less than private insurance which is the reason so many medical providers will not accept Medicare patients.

Ok, now the biggie. The Federal Public Option. Simply put this is your classic government push into a single payer system. Mark my words. How so you might ask? Obama says it’s just another avenue to provide competition. That’s a lie in my opinion and the reason is simple economics, companies can't compete when your competitor controls the rules of the game. All of the proposals for the government option are structured around the plan working like Medicare with reduced rates paid to medical providers. With Medicare the politicians set the fee schedule for services rendered by your doctor. These fees are substantially lower, I repeat, substantially lower than the fees doctors and hospitals charge private insurance companies. In most cases the reduced fees hover around twenty to forty percent lower than traditional private insurance. If the government option plan works on that fee schedule they will have less money going out than private insurance companies and therefore their premiums would be less, simply due to the plan being in a position to control spending. Private insurance companies do not have the luxury of controlling what they pay for procedures with the assistance of laws, they are forced to negotiate with the medical provider and every single time that fee will be higher. At the end of the day, since the government plan will be cheaper private insurance companies will vanish, I say within 5 years. Then you have a single payer system with all the pitfalls that come with it like rationing, long waiting periods for procedures and denied services. Folks, I think I know a little about this as my wife is a citizen of a European Union country, she tells me the horror stories of how her mom struggled to get care for a blood pressure problem a few months ago.

With Medicare some studies show that one third to half of all doctors refuse Medicare patients, WHY? The answer is simple, if you were a doctor would you choose to see patients with Medicare and the rate control forced upon usage of the plan or private insurance that pays the medical claim at a much inflated rate. If I was a doctor I would choose the latter.

Again, I support health care reform with provisions like guaranteed issues, no pre-existing conditions and mandated coverage but stand completely opposed to any public government option plan, market exchanges or non profit cooperatives as these features are just the beginning of the single payer system.

Lastly, as I have wrote about in prior syndicated articles, the cure to health care is controlling cost and the only sure fire way to accomplish this is to limit the amount doctors and other medical providers charge for services across the board, not just for Medicare. Simple economics control the expenditures and you have more money, money that can go towards lowering monthly premiums therefore making Texas health insurance affordable for all Texans. If the government wishes to set billing amounts for not only the public government option but for private insurance equally then bring the government option on, it will have no chance of success because private businesses always perform better than government bureaucrats.

Charles F. Peeler
Owner, Peeler Insurance

www.PeelerInsurance.com