I posted this in another thread, but thought it deserved a serious discussion topic of it's own. Does anyone else work in the insurance industry, or are you involved in regulations or benefits plan design and administration? If so, would you be interested in a discussion of the speech and perhaps Healthcare Reform's anticipated impact on their own profession?
I am very interested in this topic since Healthcare Reform will likely have a great impact on my chosen profession as a Benefits Plan Manager. Please let me know what you think.
The president spent about a third of his time clearly defining the problems that face our nations healthcare system. Although he left out any strong statements concerning the role of frivolous lawsuits in that cost, he did a good job defining the other problems... nothing new there, but a good start...
He then went into a very few, poignant pieces of his 'vision' of his plan (there is currently no plan submitted, it is still in draft form).
· If you have Health Insurance now whether through Private/Medicare/ER sponsored - there will be no requirement that you change your plan. However:
o There will be strict new guidelines and regulations placed on that insurance plan by the federal government
o Insurance companies/plans will be forced to accept members with pre-existing conditions
o Insurance companies will not be allowed to drop members if they become ill (except for non-payment of premiums)
o Insurance companies cannot place lifetime or annual dollar limits on care
o There will be a federally mandated cap on maximum Out of Pocket costs to members
o Routine/preventative care will be required to be covered (mammograms/colonoscopies)
· If you have no Health Insurance now
o Affordable coverage will be made available (sounds like the intent is a catastrophic plan)
o One method would be to establish an Insurance Exchange (that will work as a risk pool similar to the way companies use group plans)
o Group Rates would be made available under Insurance Exchange
o Tax Credits would be made available to assist individuals in seeking their own insurance
· These changes would not take place for four years, so in the meantime, the government would set up and run a basic Catastrophic Plan so that people who are without coverage right now, and are currently ill, can receive care.
· There would be penalties for remaining uninsured if you can afford one of the options and you fail to do so.
· If you are a small business and your profit margins prohibit offering a plan to your employees, you will be able to file a Hardship Waiver in order to remain uninsured.
After that, the president went into more of the 'why we need the plan' speech and chastised those who cannot work together to build a reform bill that would work. He decried fear mongering and said he'd not tolerate it anymore, but that he would work with anyone who was willing to work together. He also alluded to a preference to de-regulate the insurance slightly in that companies could offer insurance plans across state lines. (Personally, I think that is a very good idea.)
He ended with a mini eulogy to Ted Kennedy and that was about it.
Not exactly a homerun, but I do think that at least he is talking about a few specifics in his plan. I found the speech helpful, and I think that the healthcare industry has a little better idea what they're working with here.
My take. Any others?