Health Care: Mandate Conundrum

The private heath care system in the United States is far from perfect-covering some, under-covering others and leaving millions to fend for themselves. Perhaps the biggest challenge in dealing with the looming health care crisis is how to make our way out of a fragmented system and into a system of universal coverage.

An answer offered by Republicans and Democrats alike is mandating the purchase of private insurance. Former Republican presidential candidate Mitt Romney helped usher in the era of mandates when he was governor of Massachusetts. Senators Barak Obama and Hillary Clinton are both advocating mandates, albeit in different formats.

But, can private insurance mandates really help achieve meaningful, universal health care?

Mandate proponents say that to control the rising cost of insurance, we must get healthy people to join large purchasing pools with sick people. The theory being that healthy people pay premiums without taping into the system as often as sick folks.

It all makes sense on a spreadsheet, but when you bring actual people into the equation, it becomes much more difficult.

The problem with mandating the purchase of private insurance comes down to one word: trust. The public simply does not have faith in insurance companies. Bankrupcies, denial of care to those who ostensibly have insurance coverage and a 65% rise in premium costs since 2000 have seen to that.

One way insurance companies can begin to rebuild trust is by being more transparent. Disclosing broker commissions on health care plans, revealing a cost history of various premiums and revealing what portion of a premium goes to direct medial expenses would be a good start.


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