Increase Insurance Portability

Allow Individuals to Purchase Private Insurance with Pre-Tax Dollars

Currently, employers pay for employee health insurance with pre-tax dollars—dollars as counted before state and federal taxes are taken away. Individuals purchasing private insurance are required to with post-tax dollars.

This makes it far more expensive for individuals to purchase private insurance. The result? If someone does not receive insurance as a work related benefit, our healthcare system creates more of a financial burden to purchase private health insurance.

Letting individuals purchase health insurance with pre-tax dollars will:

• Make health insurance far more affordable for individuals.
• Encourage individuals to shop for the insurance policy the best meets their needs.
• Increase portability when individuals change jobs.

Lack of Consumer Options Means Lack of Provider Accountability

Medicare, Medicaid, and employer-based coverage remove the patient feedback that drives innovation. If a patient on Medicare or Medicaid is unhappy about the coverage offered, he or she has no other choice. A patient with employer-based coverage? He or she must change jobs to find another carrier. Under the current system neither the government nor the insurance company is directly accountable to the patient.

Example #1:

Medicare changed the guidelines for in-patient rehabilitation a few years ago. Previously, orthopedic patients such as those having knee replacement qualified for in-patient rehabilitation. Now, many of these patients no longer “meet government criteria” for in-patient rehabilitation unless enough patients with diagnosis such as strokes were recently admitted. These means how you are treated depends on who your rehab physician admitted before he or she saw you.

A rehab unit in Atlanta was fined approximately $2.5 million because Medicare felt the rehab unit did not following these rules closely enough. This is government-rationed healthcare simply to save money. Again, whoever pays holds power.

Example #2:

A gentleman treated in our hospital needed rehabilitation after suffering a stroke. When asked for approval, his insurance company denied the service without reviewing the chart. Only after my partner and hospital social worker spent 45 minutes on hold waiting for the insurance company’s medical director was the appropriate care approved.

Why did this happen? Insurance companies are paid by employers, not patients. To gain the contract they must provide competitive rates. To cut costs they limit access to care. Shifting the payer source from insurance companies to the federal government does nothing to solve this problem.