The problem with the health care industry isn't too much regulation, it's not enough. I am not for nationalized health care. However, the excesses, manipulations, and control that insurance companies have over a provider's ability to treat their patients is not only a major problem procedural wise, but a huge problem cost wise. Some things that need to be regulated to fix the health care system are:
Tort reform
Health care decisions placed in the provider's hands, not the insurance company's
Simple, universal form/payment systems
Elimination of pre-existing condition limitation when switching insurance
I'm sure there are other issues that need regulation. Unfortunately, I only see a half hearted effort on the Obama administration to address these complicated issues. Seems like he's going for the quick fix to gain points with the public.
I'll go over some of these things again, as I have done a few times.
I agree that there needs to be more regulation in the healthcare system, not less, but only in some areas. But the focus needs to be in the relationship between the provider and insurer, because this is a two way street. Yes, insurance providers do have people looking at treatments and rejecting payment of those treatments to the provider, based on what they believe to be treatments that are unecessary. While its true that these people do not see the patient, the treatment is reviewed by a liscenced medical professional. The insurers pay good money to these people. In the case of an RN, he/she could make well more than they could working at a hospital. However, providers are more willing to do "more tests" for insured patients, than they will for uninsured patients. Because the insurance companies have the deep pockets. This back and forth fight between health insurer, and provider over what is necessary, is a HUGE part of the problem IMO. This is an area that needs regulation. However, it is my opinion that the regulation needs to come from the states and not the federal government. Insurance laws are written by state legislatures and are overseen and enforced by a commisioner of insurance in each state. Devising a national regulatory system would infringe on the ability for states to retain control over the health care providers and insurers under their rule.
The payment situation is absurd, and its because of the back and forth struggle between insurer and provider. I received a bill for $350 almost a year after my son was born, from my wifes anethesia. I called to find out why I was getting a bill for $350 dollars, since we hadn't been to the hospital for nearly a year. Supposedly there was a dispute between the two that had to be settled before they could bill us. Now thats not a huge bill in this case, but its an inconvience for sure.
If we were to remove the stipulation that pre-existing conditions have to be covered, then insurers will have to be allowed to charge additional premium because of pre-existing conditions. Insurance by definition is the transfer of risk. The greater the risk they assume, the greater the premium they charge. Thats the insurance market in a nutshell. The reason they do not cover pre-existing conditions, is because they are trying to keep the premiums lower. Anybody who seeks to reform this, had better be careful because if they try to be noble and force insurers to cover pre-existing, and deny them the ability to charge for it, will seriously screw everything up and insurance companies would either collapse(more unemployment for you to deal with Mr. President) or they would find a way to increase premium in an "unrelated" way, to cover costs.
Also I remember reading on Obama's website during the campaign season, that he would essentially remove the cap on insurance policies. I do not know if he still seeks that, but that would be a disaster of epic proportions. As I said before, insurance is a transfer of risk. If we tell insurance companies they must take on an infinite amount of risk, what do you think that will do to premiums? ALL insurance policies, regardless of what kind of insurance it is, has a policy limit. The higher the limit, the higher the premium. Insurance companies have deep pockets, but not that deep.
