Dear Dr. Kleaveland

Dr. Kleaveland offers his views on health care reform. It is not a pretty sight, but we face off in a battle of dueling public letters.

You can read his complete dissertation by using the link, but here are some lowlights.

Consumer protection in the health industry is addressed as follows:

No denial for pre-existing conditions or gender.

Guaranteed coverage to all individuals and employers and automatic renewal of coverage.

Prohibits premium variance except for reasons of area or family enrollment and sets limits on higher premiums based on age.

Prohibits cancelling of health insurance coverage except for convincing evidence of fraud.

Pious platitudes but this demonstrates how little the good doctor actually knows about the current system. Every state has provisions that allow access to health insurance on a guaranteed issue basis. Every one. Yet this fact is ignored over and over.

Setting premium limits sounds great but as has been demonstrated over and over in states that have attempted to over-regulate health insurance, the result is less competition and significantly higher premiums for almost everyone.

All states have laws that prohibit the cancellation of health insurance except for reason of fraud or non-payment of premium.

Skipping around a bit, we find the following.

Lists required covered services, including hospitalization, prescription drugs, mental health services, preventive services, maternity care, and children’s dental, vision and hearing services.

Payments for primary care services would be increased

These are admirable, but costly. But let’s look at the doctors arguments as to why “health care reform” is needed.

Medical insurance premiums have more than doubled in the past 10 years.

OK, and why is that?

Health insurance premiums are driven by the underlying cost of medical care and the benefits they are required to cover. Most of the things Dr. Kleaveland proposes are built in to the House and Senate proposals. None of the provisions will serve to lower health insurance premiums, so what is really accomplished?

Requiring health insurance companies to take on more risk (banning medical underwriting), covering more items (dental, vision, mental health parity) and compressing the premium spread will result in massive premium increases if this form of health “care” reform passes.

Look at it this way. If Washington required auto insurance carriers to cover tires, brakes and oil changes as well as all routine maintenance and repairs, would auto insurance rates come down under this kind of reform? If you paid little or nothing for maintenance and repairs, but rather used your auto insurance plan to cover these costs, do you think the underlying cost of auto repair would decrease?

If you answered “yes” you are clearly out of touch with reality.

If you answered “no” then you are beginning to understand why health care reform will do nothing to lower health insurance premiums and make coverage more affordable.

Cost of health care have risen to 16 percent of the Gross Domestic Product (GDP) and is predicted to rise to 20 percent of GDP by 2018. No country can survive or compete in the global market if they spend 20 percent of their GDP on health care.

Unless and until the cost of health care is addressed, health care reform will not do a thing to stop this type of inflationary pressure.  None of the proposals in Congress, and none of the items in Dr. Kleaveland’s letter will slow down or control the cost of health care.

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