I am a big fan …

I am a big fan of the insurance industry. Ask anyone I know. I place dealing with insurance companies right up there with having a root canal sans Novocaine or gas on my “favorite things to do” list.

To put my affection in perspective, I like to refer to interesting facts.  For instance, according to “Dying for Coverage,” the latest report by Families USA, 72 Americans die each day, 500 Americans die every week and approximately 2,175 Americans die each month, due to lack of health insurance. You guessed it, that means that 26,000+ people are dying in the U.S. each year due primarily to no access to medical care.  Something tells me that this number is probably a conservative estimate.

As the nation and White House await the Supreme Court’s decision on President Obama’s health care law, I wonder what the few folks making this mighty decision are thinking. Are they secretly pleased that they don’t have to worry about their insurance since they receive the most generous plan on the planet (for life, by the way)?  Or are they overcome by a strong sense of obligation to make the right decision, empathetic to the plight of the average American and the daunting cost of health coverage?  Do they step outside themselves to consider what it must feel like to watch a child die from a flu simply because their middle-class parents could not afford to insure the family?

I suspect they do know, and to some degree they care…in a sort of “I read about it” and “saw the pictures in Time Magazine” sort of way.  Busily applying the letter of the law to each clause and addendum, I am sure their ruling will be well within the lines to avoid any sort of challenge down the road.  The impact of that ruling is massive and will touch every level of business and person in the U.S. in terms of costs, quality of life, longevity, productivity and dignity.

The tragic irony of our situation is that even the lucky Americans who receive health insurance under an employer plan will be forced to pay an average of $20,000 for a family of four (U.S. average) in 2012.  If the median household income (2006-2010) in the U.S. is $51,914 – as the U.S. Census Bureau reports – then Americans are in fact in serious trouble when it comes to the cost of health coverage and access to care in this country.  If you want to eat on a regular basis AND see a doctor, you will need to make a choice.

So here is what I am hoping and praying that the Supreme Court ruling states (of course their language will be exceedingly legal compared to mine):

1. We like the elimination of “pre-existing conditions” clause and we are going to keep that because it evens the playing field for all Americans and will immediately end discrimination against those who really need coverage and those who really, really need coverage. By the way, let’s kick this into effect on January 1, 2013.

2. Interstate laws governing insurance competition are out. In fact, anything that blocks a consumer or company from obtaining affordable health insurance from wherever they want to buy it from is out the window. Again, we want to open up competition and place everyone on an even playing field.  Start date: January 1, 2013.  Let the games begin.

3. The rest of this law is confusing and doesn’t make much sense so we are going to give it back to a designated panel of physicians and patients who have endured the worse of the system (i.e. survivors of cancer and other life-threatening diseases, returning military injured in the act of duty, Veterans, poor seniors, America’s working poor, etc.) to make sense of it and come back to us with their recommendations, complaints and solutions. Once they do, we will give insurance companies 6 months to make this happen while charging an affordable amount (based on household income stats, economic growth and performance, and other data).  From now on, when times are tough insurance companies will make less, not more.  This is what I like to call my Economic Sliding Scale model.

4. Finally, we are kind of tired of companies that hike up their rates well beyond the national average cost-of-living increase or the amount of growth in the economy. So, from now on they won’t and can’t.  We asked the insurance folks to behave and they have shown they cannot, so now we will dictate that they are limited to a designated increase per person or per company annually. No excuses.  Find a way to be efficient and work within this structure in a truly competitive environment.

5. You cannot force everyone to have insurance or be insured by the government. Are you kidding? You guys can’t even deliver my mail. But we can create a low-cost, low-level insurance product that would be required for children and people with histories of health challenges so that they have access to basic care and services. I’m talking 20,000,000 to 40,000,000 Americans paying $20 monthly per child.  Do the math.  That’s a lot of flu shots, birth control, blood pressure readings, mammograms, shots and stitches.

This is what I would call ‘a good start.’  Take out the confusing, costly, daunting crap that’s sending the system into a tail spin and leave in the good stuff that creates an open market scenario for consumers and businesses alike. Give the power back to the consumer and let us decide where, when and how we want to be cared for – and by whom.

There is no easy answer to this mess.  I certainly don’t envy those chosen nine people about to make a decision that will impact a nation.  But I do hope that they discard their nine robes for a moment to reflect on what this decision means for all of us. I hope they remember what it’s like to be an average American with average problems and average resources.  That would really be something.






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