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Prescription for confusion

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The Tampa Tribune

Published: November 10, 2009

A main feature of the health bill the House passed Saturday is a requirement that everyone have medical insurance by 2013 or else pay a penalty.

The consequences of this historic change are hard to predict, but our guess is that insurance rates will go up and the average level of care will decline. That unpleasant result will lead either to a repeal of reform or to an even greater level of government intervention.

The bill, brimming with good intentions, will help low-income workers and the unemployed afford insurance. It does stop short of nationalizing health care, that is, it does not put everyone under Medicare.

But, assuming the Senate passes a similar version, every detail of health care will become a political issue. That makes the future for doctors, patients and insurance companies unpredictable. For one thing, the fight over whether to cover abortions with tax-subsidized insurance will never be settled.

The House plan includes a government-run insurance option, which would work like Medicare. An attempt would be made to keep costs low by negotiating lower payments to doctors, clinics and hospitals.

The rules of what constitutes acceptable coverage will be set at the federal level. Consumers will be paying for features they don't need and should expect their insurance costs to continue an upward trend. Private insurers will try to find ways to cut corners and will pressure doctors to see more patients each day. Such changes won't improve the overall quality of care.

One of the hardest parts of the bill to understand is the requirement that insurers not discriminate against the sick. They can't charge more to new customers with costly illnesses. That rule gives healthy citizens an incentive to opt out and instead pay a fine of 2.5 percent of their income.

Last year, the average cost of private insurance for an individual was nearly $5,000. If you're uninsured and earn $40,000, your penalty for being uninsured would only be $1,000. You could wait until you get sick or hurt, then buy insurance, which by law you must be offered at the standard rate. When you get out of the hospital, you could drop the coverage until you get sick again.

Large employers would be required to provide health insurance, which would minimize the ranks of the uninsured but cut into corporate profits. Companies with 10 or fewer employees would get tax credits to help cover the insurance costs. That threshold would seem to discourage a company from adding an eleventh employee.

Business leaders have complained that the higher costs of insurance, and higher taxes for some, will kill jobs.

This bill is clearly not what Florida wants. Its delegation voted 17-8 against, mostly along party lines.

It is a partisan product built on an unstable foundation. The best that can be said for it is that it represents the beginning of reform. But the nation needs something far different than what the House produced last weekend.

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