End of the Road Near for Private Health Insurance? Individual Mandate May Be Only Hope to Save It S We Wait for the Supreme a System Where Insurance All That
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THE STATE JOURNAL n FRANKFORT, KENTUCKY n A pRiL 15, 2012 n PAGE D3 Caroline PoPlin End of the road near for private health insurance? Individual mandate may be only hope to save it s we wait for the Supreme A system where insurance all that. As we learn more, and can Court to render its verdict do more, diseases which used to on health reform in June, companies can design be acute and rapidly fatal – can- An Associated Press artist rendering shows attorney Gregory G. Katsas there is an important cer, heart attacks, even HIV – have products, set prices, and speaking in front of the Supreme Court during three days of arguments on Aquestion to ponder: Does Ameri- become chronic. Instead of dy- can exceptionalism extend to choose customers, where ing, with appropriate treatment the health care law. Justices seated, from left, are Sonia Sotomayor, Stephen health care? Are we different than customers are likewise patients can live with their ill- Breyer, Clarence Thomas, Antonin Scalia, Chief Justice John Roberts and An- other advanced democracies? nesses for decades. Treatment is thony Kennedy, Ruth Bader Ginsburg, Samuel Alito and Elena Kagan. The country was jolted by the free to pick and choose, becoming ever more expensive, vigor of the conservative justices’ will give us just what we and sometimes, as with HIV or able to those who need it most, eryone is really in the same pool, attack on the Affordable Care Act, heart disease, lifelong. Moreover, and insurers drop sick patients at pays the same, gets comprehen- “Obamacare.” It is now entirely have: insured citizens chronically ill people are at risk for the first opportunity. sive benefits with limited co-pays, possible that the five-man conser- facing rising premiums for predictable, expensive complica- The individual mandate in the and the government regulates vative majority will hold the cen- tions: people with diabetes some- ACA addresses this problem by provider prices. terpiece of the law, the individual reduced coverage, growing times develop kidney failure, can- forcing the healthy in with the A system where insurance mandate, unconstitutional, along numbers lacking coverage cer may recur. sick, which means healthy cus- companies can design products, with the requirement that insur- So, much disease is now com- tomers’ premiums would likely set prices, and choose custom- ers cover high-risk customers for and care. mon, predictable and expensive. go up. ers, where customers are likewise the same price as healthy ones. In- The core competence of insur- ica now. In the last half-century, Supporters of the ACA also ex- free to pick and choose, will give deed, the court may overturn the ers is risk management: it is up to medicine has been completely pect insurers to use the market us just what we have: insured citi- whole act. them to evaluate risks, and charge to drive down health-care costs, zens facing rising premiums for Democrats are dismayed; Re- transformed. enough to cover anticipated loss- Insurance works best where by bargaining with providers. To reduced coverage, growing num- publicans are encouraged. But es, with something left over for date, insurers have had limited bers lacking coverage and care. there is a large group of people let’s consider the larger picture. themselves. success: it is hard to force prices The ACA is the last, best chance at low risk for the covered event, The ACA is America’s best shot In this country, most people are down at the only hospital in town, for Americans to receive health which is rare, limited in time and at providing universal health care healthy most of the time. Insur- or the best. On the price front, care through a private insur- cost, unpredictable as to individu- through the private insurance ers compete vigorously for healthy Medicare has done much better. ance market. Personally, I doubt market. The rest of the developed als but actuarially predictable for customers by offering low premi- Moreover, insurers have no con- it will work. But if the Supreme world has abandoned private the group. Think automobile ac- ums. Too many sick patients in trol over the real cost drivers in Court throws out the individu- health insurance in favor of sys- cidents. the pool can ruin an insurer’s day, American health care: ever more al mandate, we will have to de- tems closer to single payer, where Illness and injury were once and force it to raise premiums. expensive technology and drugs cide whether, when the chips are everyone receives comprehensive like that: you never knew who Higher premiums can drive the (which may be little better than down, we are all in this together, benefits paid for by taxes or tightly would break a leg, get pneumonia, healthy customers into the arms what is already on the market), or one’s freedom to choose to par- regulated prices. So far, these sys- or have a heart attack. The strick- of a competitor. Insurers call this physicians who flock to profitable ticipate is even more important. tems have achieved better health en individual would get surgery, or the “death spiral.” specialties. Medicare does not This decision will test the Ameri- outcomes for a fraction of what we the few medicines we had, and re- Modern medicine allows insur- control these things either, but it can character. pay. cover or die. What happened last ers to identify high-risk, high-cost could. There is a reason private health year had no bearing on what hap- customers early, and avoid them. So maybe other Western coun- Caroline Poplin, a physician and lawyer, is a insurance, which served us well pened next year. That is why, unless it is tightly reg- tries had good reason to go with a consultant to Social Security Administration for many years, is failing in Amer- Modern medicine has changed ulated, insurance is often unavail- public insurance model, where ev- and law firms. Voters need to see more of Romney’s tax returns The following editorial appeared in the nee has released two years turns dating to 2000 during curately assess candidates’ and their governing deci- of how he performed in the San Jose Mercury News on Tuesday, of tax returns, from 2010 the 2008 campaign; George values – not just what they sions. role he says would make April 10: and 2011. Last week, his W. Bush made public his re- say they believe. They show In Romney’s case, the re- him a better president than spokesman said that would turns from 1991 forward. what causes candidates turns are especially impor- Obama. As the Washington itt Romney can’t be all. “We think that’s suffi- Even some of Romney’s Re- support, how they’ve con- tant. Romney downplays Post reported last week, oth- possibly think cient,” Eric Fehrnstrom told publican rivals have called ducted their careers and his time in public office and er financial disclosure forms he can get away NBC News. on him to disclose more, where their wealth comes says his experience as head Romney must file allow him with this. Is he joking? predicting that his failure from. They also show of the private equity firm to legally hide an unusually MThe multimillionaire for- Presidential candidates to do so will give the Demo- whether candidates have Bain Capital has prepared large portion of his assets mer governor of Massachu- need to release multiple crats ammunition this fall. now, or have had in the past, him to be commander in from public scrutiny. Tax setts and presumptive Re- years of returns; President Tax returns are one of any conflicts of interest be- chief. His tax returns will returns will help fill out the publican presidential nomi- Barack Obama released re- the few ways voters can ac- tween their investments give voters a fuller vision picture. The two returns Rom- EXPANDED ney did release raised ques- BASIC CABLE www.fpb.cc 352-4372 ON TV TONIGHT Brought To You By tions that only further scru- tiny can answer. Because SUNDAY AFTERNOON APRIL 15, 2012 SUNDAY EVENING APRIL 15, 2012 Romney earns his money 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 through investments and NHL Hockey Nashville Predators at Detroit Red Wings. Western Conference Quarterfinal, game 3. From Joe Louis Arena in NHL Hockey Pittsburgh Penguins at Philadelphia Flyers. Eastern Conference Quarterfinal, game 3. 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