I joined my husband in the health insurance industry in 2001, when my husband was looking for an assistant. Before that, I was a technical analyst at Oracle Corporation. The career in employee benefits administration, and later consulting, fell into my lap, providing me with a flexible schedule and the ability to spend more time with my children. When I was starting out, my job involved spreadsheeting lots and lots of quotes for small businesses. Later, I began helping individuals who had no access to employer coverage choose a personal health insurance plan, and today, I spend most of my time managing the group benefits of many small employers. Year after year, I watched as the government’s legislatve intervention resulted in ever-increasing premiums that drastically outpaced the inflation of other goods and services. Some of these included:
- Modified community rating
- Mandatory benefits
- The removal of tobacco status as a means to adjust health insurance premiums
- The removal of gender discrimination from rate filings
- Mental Health Parity-forbidding insurers from offering plans without mental health coverage or plans with fewer mental health benefits than physical health benefits
- Laws forbidding insurers from “up-rating” or “excluding” certain pre-existing conditions, which had the negative consequence of insurers just denying a policy altogether rather than just charging a higher premium to adjust for the added risk or offering a policy with condition specific exclusions. (personal health insurance market only)
- Laws forbidding insurers from offering policies without maternity coverage in the personal health insurance market.
- And then finally…The [un] Affordable Care Act
On the surface, it would seem as if all of these “consumer protections” were absolutely necessary, however, for the vast majority of people, being able to choose plans that suited their needs allowed for more affordable options not available in today’s market. Rarely was I ever unable to place an individual with a suitable plan, even people with pre-existing conditions. In fact, I can’t think of a single time that I was unable to place someone with a plan that could meet their needs. Of course, pre-ACA, my state was one of the many that offered high-risk pool coverage, so in the rare event that someone had allowed themselves to have a lapse in coverage and also had a pre-existing condition that resulted in either an unacceptable offer of coverage or a coverage declination, Cover Colorado was there.
Fast forward to 2018. We are now at a point where consumers can no longer bear the cost of ever increasing health insurance premiums, which has basically been the result of the removal of all risk from the purchase of health insurance, turning health “insurance” into nothing more than pre-paid healthcare. The population is polarized over whether we should try to retain some semblance of a private healthcare system or throw our hands up and beg the government to save us. When I try to speak about the history of health insurance with those who favor government paid health insurance, I’m often met with cynicism and down right heated anger. How DARE I, a SELF-SERVING HEALTH INSURANCE BROKER, contribute to the problems associated with our “for profit” healthcare system! Something needs to be done, and it needs to be done now.
But the way I see it, we can either go the way of “every other developed country” and suffer all of the unintended consequences that will surely follow, or we can do things the American way, which involves reflecting upon the mistakes of our past, and reversing them. When I ask that we reflect upon the mistakes of our past, I mean we REALLY need to look back at the history of events that date all the way back to the Great Depression. Generations have passed, and we’ve lost sight of some of the changes that led to rampant healthcare inflation, and thus health insurance inflation, in the first place. I could paraphrase the details, but these historical events have been recollected in great detail by the writings of three of my favorite healthcare history experts:
We’ve got some serious decisions to make, and as an American, it’s your duty to study our history, learn from our mistakes, and fix them. There’s no easy way out. America is in a unique position to do something that no other country has ever tried. The healthcare financing revolution has begun. How can we do it better than any other country?