Joe Armendariz: Many Uninsured Could ‘Self-Insure’ for Routine Health Procedures

http://www.noozhawk.com/noozhawk/article/091009_joe_armendariz_many_uninsured_could_self-insure/

By Joe Armendariz

Consumer-driven programs already exist. So why is the government getting in the way?

According to a Census Bureau report, “Income, Poverty and Health Insurance Coverage in the United States: 2008,” released last week, there were 46.3 million uninsured Americans in 2008, up from 45.6 million in 2007 — an increase of less than 1 percent.

The nearby chart illustrates the fact that 9 million uninsured Americans are living in households earning $75,000 per year or more. About 8 million Americans who went without health insurance in 2008 earned between $50,000 and $75,000. If we combine the two groups, the percentage of uninsured Americans earning more than $50,000 in 2008 was roughly 38 percent.

Question: With $50,000 or more in household income, wouldn’t many or most of those 38 percent be without health insurance voluntarily? As a recovering health insurance professional who spent 20 years in the business, I will tell you the answer is unequivocally yes. It isn’t because the price for health insurance is too expensive, assuming the person is reasonably healthy, it is always because they have better things to spend their after-tax income on.

A few clicks over at ehealthinsurance.com, for example, resulted in me quickly finding 94 plans starting at $92 per month for a male nonsmoker in his 40s. A male nonsmoker in his 50s has 99 plans from which to choose, starting at $132 per month. A male nonsmoker in his 30s has 94 plans from which to choose, starting at $59 per month, and a male nonsmoker in his 20s ... well, he has 94 plans starting at $47 per month. This is significantly less than a typical premium cable package.

I realize there are variations in insurance premiums based on other factors, including geography. But even if you add a 20 percent load to each of those premiums to account for smokers and then another 15 percent load to allow for changes in geography, you are still well within what a person earning $50,000 per year or more should be able to afford.

Another caveat is that all of these plans are available in California only ... but if we were to change the law and allow health insurance to be bought and sold across state lines, the number of insurance options would increase dramatically. This is an essential reform of the health insurance market, and yet it is absent from all of the plans currently under serious consideration by Congress and the Obama administration.

In addition to ehealthinsurance.com, there are other exciting developments in the health-care industry that are making health care more affordable for the average American family, and yet they are completely ignored by the politicians. For example, today there are more than 1,200 (and growing daily) health-care clinics around the country operating inside retail stores. These include Walgreens, Target, Costco, CVS and Walmart. Many of these retail health clinics are staffed by full-time nurse practitioners, do not require their customers to have medical insurance policies to receive treatment, and they do not require an appointment to be treated. These are quintessential examples of consumer-driven health care.

Other consumer-driven programs can be found and accessed online. For example, the following Web sites are also changing the way people purchase health care in the United States and should be looked at as a model for how to expand access, lower costs and improve quality. They include HealthMarkets.com, MedEncentive.com, Planethospital.com, MedRetreat.com, SimpleCare.com, CashDoctor.com, Doctor on Call, TelaDoc.com, MinuteClinic.com, HealthDialog.com, HealthGrades.com and Subimo.com. And there are several others.

These cutting-edge programs represent the real future of American health care. The bad news is President Barack Obama and Congress are stuck in the 1960s, where every idea and solution is expected to originate from Washington, D.C. Apparently, the entrepreneurial, patient-centered health-care service providers listed above didn’t get the memo. But they are moving forward nonetheless and that is great news for not only America’s families but it’s great news for America’s uninsured, because help really is on the way. Indeed, help is already here if the bureaucrats, lawyers and politicians would just get out of the way.

The bottom line: The future of American health care will transcend partisan politics and the predictable efforts by lawyers to control the outcome of any health-care reform. This is true because at the end of the day it is first and foremost about consumer-driven health-care markets, and more choices and competition for that first dollar of care. This is the exact opposite of a third-party system that has failed so totally.

The myriad of high-tech innovations in our health-care system as well as the unconventional points of service for preventive/routine and emergency care are already empowering individuals, small businesses, families and communities. This is due to decentralized “regional markets” more than any so-called top-down command-and-control reform legislation contrived by the Republicans and Democrats on Capitol Hill. But, then, none of us should be surprised that the politicians always move slower than the gales of creative destruction.

— Joe Armendariz is a Carpinteria city councilman and co-founder of Armendariz Partners, a public affairs consulting firm.

http://www.noozhawk.com/noozhawk/article/091009_joe_armendariz_many_uninsured_could_self-insure/