Innovating on health insurance front.As post-State of the Union Washington gears up for an all-consuming ideological smackdown on Social Security, those concerned about bigger national problems--such as spiraling health care costs and the 45 million uninsured--will need to look elsewhere for progress. One bright spot in this dispiriting dis·pir·it tr.v. dis·pir·it·ed, dis·pir·it·ing, dis·pir·its To lower in or deprive of spirit; dishearten. See Synonyms at discourage. [di(s)- + spirit.] Adj. landscape came the other day when a coalition of 60 big companies (including IBM (International Business Machines Corporation, Armonk, NY, www.ibm.com) The world's largest computer company. IBM's product lines include the S/390 mainframes (zSeries), AS/400 midrange business systems (iSeries), RS/6000 workstations and servers (pSeries), Intel-based servers (xSeries) , GE and Sears) announced an innovative plan that may reach as many as 3 million of the uninsured. Their new program is called "National Health Access," and it's meant to offer workers and their dependents who don't have access to employer-subsidized group health insurance today a way to buy better coverage than they could get in the individual market. The plan will create a new insurance pool comprised mostly of part-time workers who are generally not eligible for benefits at these companies, contractors who do business with these firms, and the firms' pre-Medicare retirees (as well as the families of all these folks). The existence of a decent-sized pool allows an insurer--in this case UnitedHealth Group UnitedHealth Group Incorporated NYSE: UNH is a managed health care company. It is the parent of United Healthcare, one of the largest health insurers in the U.S. It was created in 1977, as UnitedHealthCare Corporation (it renamed itself in 1998), but traces its origin to a , which has developed the insurance products for the coalition--to offer more comprehensive plans at a lower cost than these people would otherwise be able to get on their own. The most attractive feature of the new plan is that there will be no "medical underwriting medical underwriting Managed care The process of determining the medical needs of an individual or group before providing coverage. See Health insurance. "--the fancy name for the process by which insurers shun Shun In Chinese mythology, one of the three legendary emperors, along with Yao and Da Yu, of the golden age of antiquity (c. 23rd century BC), singled out by Confucius as models of integrity and virtue. individuals who seem to pose undue medical risks (or charge these individuals sky-high premiums that they often can't afford). Eligible workers will be able to choose from among sixtiers of coverage with different prices and levels of benefits. Andy Slavitt, the UnitedHealth executive in charge of the new plans, told me these tiers were developed after extensive market-research as to what uninsured people (especially with lower incomes) actually valued and could afford. This isn't a charitable endeavor, to be sure. Slavitt says it's hoped that the pool being created will let UnitedHealth realize normal group-coverage profit margins despite the risk of guaranteeing coverage to all comers all who come, or offer, to take part in a matter, especially in a contest or controversy. - Bp. Stillingfleet. See also: Comer . If they can pull it off, this ambition is significant. Ordinarily the individual market is the most profitable for insurers--precisely because insurers tend to reject (or charge huge premiums to) less healthy folks who actually need insurance. If the economics of this new pooling model can work for both insurer and insurees, it might lead more companies to join this coalition, which in turn would stabilize the costs and risks for insurers even more. The result could be a virtuous cycle that broadens the ranks of uninsured Americans who would not be subject to the individual market's awful bias against less healthy people--while also stretching their health care dollars as they piggyback piggyback 1. A broker trading in his or her personal account after trading in the same security for a customer. The broker may believe the customer has access to privileged information that will cause the transaction to be profitable. 2. on the group's purchasing power Purchasing Power 1. The value of a currency expressed in terms of the amount of goods or services that one unit of money can buy. Purchasing power is important because, all else being equal, inflation decreases the amount of goods or services you'd be able to purchase. 2. . To be sure, it's still a sophisticated patch on a broken system. A cynic cyn·ic n. 1. A person who believes all people are motivated by selfishness. 2. A person whose outlook is scornfully and often habitually negative. 3. might say that under the guise of a beneficent be·nef·i·cent adj. 1. Characterized by or performing acts of kindness or charity. 2. Producing benefit; beneficial. [Probably from beneficenceon the model of such pairs as step, these employers hope to pre-emptively shift full responsibility for the costs of coverage to these part-time workers and others. Maybe they reckon the halo of such "good innovations" will fend off government attempts to force employers to bear more of the costs of covering such folks themselves. Still, in an imperfect world, many people will find this patch to be a lifeline. It's also a genuine effort to design socially beneficial new insurance products for the uninsured, as opposed to the kind of "cherry-picking" through which some insurers tailor new insurance products to, say, healthy twentysomething men--creating big profit centers while essentially telling the country that the broader insurance system's pooling challenges are somebody else's problem. So three cheers for private-sector innovation. With Washington determined to ignore health care in the near term, the companies behind National Health Access deserve praise for an effort that's not only good for their P.R., but may offer insights and options for the rest of the country as well. Matt Miller, senior fellow at the Center for American Progress The Center for American Progress is a progressive American political policy research and advocacy organization. Its website describes it as "...a nonpartisan research and educational institute dedicated to promoting a strong, just and free America that ensures opportunity for all. , is the author of "The Two Percent Solution: Fixing America's Problems in Ways Liberals and Conservatives Can Love." |
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