Among all the different models for alternate coverage that we have, from the VA to Kaiser to PPO's, there are several that would work as national policy if we ever decide to go there. That time might have arrived.
Massachusetts is offering us a "heads up" as their noble experiment makes an attempt at universal health care. Poor people get free coverage. Those who would otherwise be uninsured are mandated to have coverage that costs roughly 8 percent of their incomes. Anyone not signing up has to pay a tax instead. The idea is to avoid allowing people with no insurance to become a burden for the rest of us as their costs of "free" coverage get absorbed by higher premiums for everyone else. Those with coverage through their jobs remain unaffected.
The point is that no uninsurable person is left behind. The system may or may not be a better mousetrap, but at least its transparency will allow us to effectively weigh its merits.
Here's what happens when secrecy prevails: Just last week, Andrew Cuomo, attorney general of the state of New York, won a judgment in behalf of the state's college students whose health policies issued through their schools had shortchanged them on benefit payments. Any costs deemed to be higher than "usual and customary" were not covered by the health plans. The students were billed for 100 percent of the excess --- or in some cases, the doctors just had to eat the extra cost.
Who determined what was "usual and customary?" It was the same company, United Health, that was notorious a few years ago for paying its CEO $1.4 billion (that's not a misprint.) Apparently, most health insurance companies across the country have been using computer modeling supplied by a subsidiary of United Health to determine what was usual and customary for services in a given area. The model proved to be at least partly fiction and heavily slanted in favor of the insurance companies. Having had success in behalf of the students, Cuomo is now aiming his guns to see what he can accomplish for adults.
Anyone with a life-threatening illness can tell us what a nightmare it can be to sort through bills and get reimbursed correctly. Questioning a bill can often get a nonchalant offer to just write some of it off. What about the people too confused or cowed to complain? Like those students.