Two Republicans in the state legislature have an idea to make health insurance more affordable. No, it’s not health care exchanges. No, it’s not universal coverage. Instead, it’s a plan to create a “personal health premium account” for paying for health insurance. They say people could use it to pool money from employers, family members, charitable organizations, and the like. However, employers would be “under no obligation” to fund the accounts, so it would require the goodness of their hearts for money. Which begs the question: how exactly does this make insurance more affordable at all? Simple: it doesn’t.
I guess Senator Hann and Representative Gottwalt are trying to come up with solutions within the narrow bounds put forward by their leadership: no health care exchanges or anything else remotely supportive of the President’s health care bill, and no money from either employers or the government. What results, of course, is thin gruel. They say that such an account would be good for people with part-time jobs, without explaining at all how these part-time employees could afford health care without help in the form of money. When people can’t get access to health care, how often is the problem the fact that they don’t have a neat little account for bundling up contributions from employers, families, and churches?
Nothing is said about who would run and administer the accounts, nor is anything said about making these accounts available to the unbanked, who are (I’m guessing) a bit more likely to be going without health care benefits. Nothing is said about getting employers or other entities to actually put money in these accounts, say with tax deductions, although those deductions would be a terrible idea anyway. In short, this is about as textbook a case of “looking like you are doing something without doing something” as you can get.
At least attempts to get an exchange up and running in this state will actually accomplish something (and, of course, the Republican leadership in the legislature is against that). However, even an exchange, while one of those Rube Goldbergian contraptions made necessary by the realities of politics, isn’t good enough. I’ll hammer this until I die: we need to decouple health insurance from employment, and have a system of auto-enrollment for insurance paid out of taxes? Think of it as the mandatory cell phone plan: you can sign up for a cell phone from one of the major providers (one may be a government-run plan, but it is not required) where you can compare plans. If you do not actively sign up for a plan, you will be sent a basic phone at random from one of the participants, with a minimum number of features. Regardless, you will be billed through your taxes. Easy.
Sadly, we seem to be far more interested in calling women whores for using birth control than in trying to design a health care system that gets health care to everybody. Designing health care premium accounts is definitely one of those activities that is not helping us get closer to our health care goals.