We have numerous small businesses in this country that are struggling to afford health care for their employees and millions of citizens who have no insurance for sickness or accidents. The rates for the insured keep going up in order to pay for those without insurance getting treated in emergency rooms for free. Not only are premiums being raised for those who are covered, but the cost of treatment is higher for the uninsured since they probably let their problems go until a real emergency forces them to do something about it.
One provision of the Affordable Care Act (labeled Obamacare by opponents) envisions creating exchanges in 2014 to make it easier for uninsured citizens to get coverage. However, states do not need to wait that long. Right now, states can create exchanges alone or band with neighboring states. As of mid-June, many states have legislation pending to set up the needed exchanges. Pennsylvania is currently working on House Bill 627. Six states -- Illinois, Mississippi, Maine, Montana, Utah and Wyoming -- are ahead of Pennsylvania and have established plans to meet the new requirements for 2014.
Under the new system, if insurers wish to be included in the exchanges, they will have to follow the rules. Plans must be "in the interest" of the buyers, and in many states, insurers must justify rate increases and prices. A standard format for options and costs must be presented so that buyers can efficiently compare their options. Creating more competition will hopefully lower prices and make affordable health care available to more people.
Another area where progress and savings are possible is electronic health records. Up to $45 billion has been budgeted for incentives to doctors and hospitals to digitize patient records. These short-term incentives will lead to long-term savings through greater efficiency.
Money will be also saved as Medicare Advantage plans are fazed out. There are widespread reports of abuse and deceptive marketing by agents trying to enroll seniors into Medicare Advantage plans. The National Committee to Preserve Social Security says that overpaying private companies to provide service that could easily be provided by traditional Medicare at a lesser cost undermines Medicare and increases the Part B premium for all beneficiaries. Money spent on these plans ends up in the pockets of investors and shareholders while patients are denied access to services that would be covered by traditional Medicare.
Rather than wait until the Affordable Care Act provisions take effect, states should get ahead of the game and make these sensible reforms now.
