Cadillac Plans: Since When is Good Coverage a Luxury? [View All]

[Blue State Blues]

Cadillacading this article in the New York Times, and I was struck by the references to a “Cadillac tax” on "gold-plated insurance plans."

The plans referred to as "Cadillac plans" are typically plans that have low or no deductibles, low or no co-payments, and they require less in out-of-pocket costs for those fortunate enough to have them. In short, they provide good coverage.

Strange, isn't it, that we would think of good coverage as a luxury. Coverage that encourages preventative care and actually pays the costs of illness, that's a luxury now.

Isn't access to health care the reason we purchase health insurance in the first place? Isn't that what it is for?

According to the article,

Most economists’ favorite idea for slowing the growth of health care spending was ending the income tax exemption for employer-paid health insurance to make lower-cost plans more attractive.

So let me get this straight, their brilliant idea for lowering health care spending was shift more people onto lower-cost plans? Lower-cost, for-profit health insurance plans with higher deductibles, higher co-payments, and higher out-of-pocket costs?

But you know, the reason these plans cost less, is that they're worth less. And, at the extreme end of the scale, they are practically worthless.

The best idea for slowing the growth of health care spending was to shift more of the costs onto the patient?

Which, I guess makes a certain amount of sense. If you have to pay more of the cost of going to the doctor, you'll be less likely to go to the doctor. Money saved, right?

Except that it's wrong. If you put off preventative care, if you don't catch something early when it's treatable, if you don't effectively monitor and manage a chronic condition ... we know how this ends.

The problem with low-cost plans, as implemented in our for-profit health insurance industry, is the plans are designed to shift more of the burden for paying for health care onto those who can least afford to pay.

If you can't afford to buy good insurance, you can't afford to have bad insurance. The goal isn't to make sure everyone in the country has an insurance card, it's to give everyone access to health care. Bad insurance takes money in premiums without providing health care.

Good coverage isn't a luxury, it's a necessity.

But as long as we are stuck in a predatory system of profit-driven insurance companies, good coverage that is also affordable coverage will be an impossibility.