Risky Business

Lowering Health Costs for the Self-Employed

By Matthew Bandyk

Posted: June 19, 2008

Looks as if I might have spoken too soon about the bipartisan possibilities of allowing health insurance to be purchased across state lines. While Barack Obama does approvingly write in The Audacity of Hope of letting consumers buy health insurance beyond just what's offered in their states, his plan would do this with strings attached.

Obama would allow the national sale of only private insurance plans that go through his "National Health Insurance Exchange." That means that the insurance plans would have to accept federal government controls on what to cover and how much to charge.

In contrast, John McCain says he would allow the nationwide sale of private health insurance without that kind of government oversight, similar to the bill that Rep. John Shadegg, an Arizona Republican, has introduced. While there have been Democratic cosponsors of that bill in the past, the fact that McCain is taking up that proposal now probably means bipartisan action is unlikely for the foreseeable future.

While both plans accept the basic premise that state-based, highly regulated insurance markets are helping to jack up healthcare costs in the individual market that is critical for the self-employed, the difference between them is in just how much regulation we should accept.

It's an important question for entrepreneurs. Many of them are self-employed and can get health insurance only on the individual market, not the group market through which many Americans get coverage via their employer. My hunch is that entrepreneurs would prefer the plan that would allow the most diversity of competing options. After all, entrepreneurs love competition.

But a National Health Insurance Exchange means less competition. As Paul Edattel, healthcare policy analyst for Shadegg, explained to me, "if you undercut private insurers and place price controls on them, government is going to become the biggest insurance company in the country."

One case for Obama's plan, on the other hand, is that we need federal standards on what an ideal health insurance plan would look like in order to deal with lack of consumer knowledge about healthcare.

tired of everthing to do with healthcare

Thanks for that tip Mike. I didnt even know that I could buy medications from overseas. That would be a huge saving for me. I wonder why more people arent aware of it. Is it pretty easy to set up?

My current health plan seems to cover very little. So i have to do my due diligence every time i do anything related to any type of practitioner. Who needs a surprise $500 bill? I try to use http://smarthealthbuyer.com to research prices on medical and dental procedures to make sure that i get a fair price for everything and to give me peace of mind that i'm not totally being screwed by my doctor and dentist.

Pamela of LA @ Sep 05, 2008 19:02:16 PM

Cut My Prescription Drug Costs

Self-employed and with lousy prescription drug coverage, I have found foreign pharmacies are my perfect solution for 50 to 80 percent savings on my medications. I shop at International Drug Mart and other licensed pharmacies and get my cheap drugs in the mail. I have talked to several retired doctors who also buy from foreign pharmacies. Can't find a better testimonial than a doctor.

Mike of IL @ Jun 23, 2008 10:42:22 AM

Ignorance is Bliss to Many

I sell health insurance. I work with many dozens each year. Of those, very few can tell me much about thier plan except thier co-pay. Most are surprised to even find out they have additional OOP cost, like a deductible. Those have a group insurance plan know far less than those that have bought individual coverage.

Based upon this experience, I reasonably assume that most people have become comfortable "not knowing". As thier premiums creep or jump up, they might become motivated to shop health coverage. Many do not, I see families paying well over $1,000 for coverage per month that could have thier own policy for a few hundered dollars. The premium saving would more than fund thier deductible. Given this, I would say most of the insured are what I call "classically and mathmatically way over insured". The percentage of people paying too much for coverage far outpaces the 4 or 5% that do not have any coverage. Being over insured is a far bigger problem than those who are not covered. This financial strain is what is hurting health coverage and making it an issue.

Becareful what you wish for. The goverment, especially our Federal goverment does not currently run any current health programs that have financial solvency for much more than the current decade. Medicare will soon be out of money.

Also some common-sense needs to be considered when looking at govermental control of health coverage. First, health care is different than health coverage and that health insurance is still another thing. Often these three terms are all thrown into the same discussion and mistakenly used to replace one antoher. Next, more govermental mandates on what health insurance companies must cover has a documented history of only adding cost and more goverment to regulate the mandates. Third, in the United States, nearly all of our care givers and doctors are not goverment employees. Many of them do not want to be either and might consider closing thier offices if they have more red tape to deal with.

It is silly to put the responsibility for reforming the healthcare and insurance market on the goverment as a viable solution. The goverment will by its very nature make it cost more. The real solution is for each adult to take a little personal responsibility to control thier assess thier needs, control thier cost and shop thier market for the best overall coverage value. Everyone would be far better served by find a trusted health insurance agent to advise them that to put hier trust into goverment health care or the goverment health insurance exchance.

As an agent, I do not fear goverment coverage will end my career. I currently sell supplemental plan to Medicare. Ask around, eveyone you know who is on Medicare has either a supplement or Advantage plan because it is not full health coverage. If we went to national health care, my market would only grow.

We all need to fix it by becoming a little smarter...

MN Health Insurance Agent of MN @ Jun 23, 2008 10:18:48 AM

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Risky Business

Risky Business

Matt Bandyk, a reporter for U.S. News, explores capitalism from where it all begins, with the entrepreneur, whose risk taking and experimentation provide the roots from which the rest of the economy grows. As much courage as it takes to create one's own business, even the entrepreneur needs some help, and this blog will look at news, trends, and practical advice for starting and running a small business.

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