Republican presidential candidates have called for a greater reliance upon the individual health insurance market. But many of these same candidates have had cancer and wouldn't have been able to get individual coverage under their own health reform plans at the time of their treatment.
Ricardo Alonso-Zaldivar had a great story in the Los Angeles Times recently.
Ricardo points out that Rudy Giuliani has had prostate cancer, John McCain melanoma, and Fred Thompson has had lymphoma.
All have called for a more robust individual health insurance market. But that market today relies upon medical underwriting--people who have had cancer will have great difficulty finding an insurance company to underwrite them. As the Times reports, "Cancer survivors -- even if they have been free of disease for several years -- are routinely denied health insurance when they try to purchase it as individuals."
If coverage is offered, it often comes with restrictions on the disease the person suffered with or high premiums.
Even after being treatment free for five years it's hard to get coverage. Ricardo cited a survey of 22 insurance companies Karen Pollitz did at Georgetown University about a hypothetical breast cancer survivor who was five years out from a successful treatment. "Eleven companies said they would deny coverage, and six said they would issue a policy at standard rates. One company said it would charge double the usual premium. Another said it would issue a policy but exclude future cancer treatment. Three insurers did not respond."
Romney goes even further than the other Republicans by calling for less regulation in the state-based individual health insurance market then we have today.
Employer plans generally cover all new employees--albeit with as much as a one-year pre-existing condition provision if the new employee did not have prior coverage. However, all of the Republicans provide tax incentives that would move coverage away from the employer model and onto the individual model.
No one should be able to wait to approach an insurance company until they are sick and expect to get coverage--they should have bought it in the first place. But when individual coverage costs thousands of dollars a year, many can't afford to get it. Some people lose their jobs and their coverage.
Lots of people are out there without health insurance coverage and it has nothing to do with personal irresponsibility.
Today's COBRA might help--an 18 month extension for a worker who has left their employer so long as they can afford the full cost of their employer's plan--which averaged $12,000 a year for family coverage in 2007.
A reformed health insurance system based upon an individual insurance model can work. However, the Republican candidates have not closed the loop on how they would make it affordable for people to buy coverage in the first place or how they would overcome medical underwriting and age-rating that are now at the core of this business model.
Good thing these guys didn't get laid off, lose their coverage, and have to go find individual coverage under their own health reform plans!
You can access my review of each of the candidates' health plans in the column to the right.
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