Ezra Klein has no health insurance

by Nathan Empsall, Fri Aug 28, 2009 at 11:31:16 AM EDT

Here's a high-profile surprise - and it's as much a surprise to the Washington Post's Ezra Klein as it is to us. This illustrates part of what's wrong with an employer-based health insurance industry that offers little to no choice to its consumers. From Klein's blog:

I didn't know I was uninsured. Didn't have any reason to believe I was uninsured. But, for the past four months, I've been among the uninsured.

The story actually starts a decade ago, when I was a part-time tutor for Score Educational Centers, which were later consumed by Kaplan Inc., which is in turn owned by The Washington Post. Fast forward 10 years, and I'm on the phone with our benefits people setting up my health insurance. Everything seemed to work fine -- except that I didn't receive any cards or membership information. When I inquired after it, I was informed that I didn't exist in their records at all.

What seems to have happened is that my Social Security number was in the computer system from my time with Score. Since my classification was "part-time employee ineligible for benefits," the computer overrode the effort to choose my health insurer.

Tags: Ezra Klein, Health care (all tags)

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5 Comments

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Re: Ezra Klein has no health insurance

He makes a good case but draws a bad conclusion. Here's why:

He writes this:

"Under reform, the individual mandate would force people to be aware of their insurance plan. The employer mandate would force employers to make sure the paperwork was in order. Over time, the growth of the exchanges would allow you to remain with your insurer even as you changed jobs."

That's all fine and dandy, but as his example suggests he himself was not aware of his uninsured status. What happens if someone does not know? Or someone forgets, or just does not have the money to buy mandated coverage. The incrementalists out there does not say what if anything they propose that can keep costs down. Moreover if you have a weak exchange and nothing to keep the costs down, once you have a lapse in coverage what guarantee does one have that a new privately purchased insurance will not have astronomical premiums over and above paying a fine?

Right now the window of enrollment into an insurance plan in the state of NC is July (for BCBS, I am sure of that). If that window passes you are up shit-creek without a paddle. There is no safety net. The uninsured safety net should be something like medicare for all with open enrollment. But since that is not even being considered in the corridors of power, the alternative would be a public option that can keep costs down and have an open enrollment for people who find that they have no insurance and have passed the enrollment date. Without these any mandate for individual coverage is forcing people to play russian roulette with a fully loaded gun; either way you lose.

by tarheel74 2009-08-28 12:35PM | 0 recs
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Too many hypotheticals built it

It would take a good deal of work to chase down all the provisions of HR3200 that address the concerns you have about the individual mandate. But consider this:

Waxman is not a moron. Dingel is not a moron. Neither Kennedy nor Kennedy's staff were or are morons.

Don't you think they might, just possibly have your back and not have written a bill that can be so easily gamed by insurance companies?  Your questions assume things that are not actually in evidence. For example you throw in "nothing to keep the costs down". Well there are lots of things in the bill that serve to keep the costs down both directly and indirectly.

What you need to ask is whether any particular concern has been adequately addressed by the members and staff of the Tri-Committees and HELP and then delve through the bill language to check. Instead like too many you have apparently assumed that Waxman and Dingel have just thrown your ass to the wolves in the form of the insurance companies.

Title 1 Subtitle B of the Tri-Comm Bill is called Standards Guaranteeing Access to Affordable Coverage. It is not long, it starts on page 19 in the E&C version and extends through pg 25. Sec 112 covers guaranteed issue and Sec 113 rating rules. Together they should address your concern about "astronomical premiums". On my reading such premiums based on the individual circumstances you cite would not be allowed. Now if you would like to make an argument why and how these sections could be gamed then great. Nothing we need more than an argument based on substance.

But really some people on the left, particularly what I call the Single Payer Now! people tend to operate from a bill of their own imagination much as the Deathers do. A little more chapter and verse (or in this case subtitle and section) would be useful here.

by Bruce Webb 2009-08-29 04:45AM | 0 recs
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Re: Too many hypotheticals built it

HR 3200 is dead. Even the president won't support it, even though it s an excellent bill. As far as medical loss ratio goes, the existing medical loss ratio is 75%, and the bill does not propose what it proposes to keep it at that level. Finally look at MA. What happened there is in spite of guaranteed universal coverage it did not keep premiums down. Most insurance company data I have seen shows medical loss ratio at about 82% (again there is not transparency in this as the insurance lobby quashed this measure). So the entire point for me is without a public option offering low price coverage as a competitor and without strong measures to keep the price down how do you guarantee lower premiums?

by tarheel74 2009-08-29 10:25AM | 0 recs
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Re: Ezra Klein has no health insurance

It wasn't the computer that overrode. It was the business rule, decided by humans, implemented in code by people that caused that outcome. A computer is a tool use by humans.

by ThosJoseph 2009-08-28 04:50PM | 0 recs
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No one in history has ever

--been run over by a bus. Some combination of human activity and natural events must have combined to set that bus in motion and some further combination of human activity and/or natural events must have combined so as to cause the paths of the bus and the person to intersect.

Please don't blame the bus.
________
You can over think these things. The English language assigns agency to inanimate objects all the time. And I think we are all aware that computers have not quite gotten to H.A.L. levels yet.

by Bruce Webb 2009-08-29 04:54AM | 0 recs

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