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eridani

Profile Information

Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 02:52 AM
Number of posts: 51,907

About Me

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity

Journal Archives

How European countries regulate private insurance

http://www.pnhp.org/print/news/2012/december/itís-not-profit-that-is-destroying-our-health-itís-the-private-insurance-business


Many Europeans use private health insurance companies, a few of them for-profit. These Europeans enjoy better care for more people at lower cost than we do. But the European business model differs radically from that in the U.S. In fact, American insurance companies find the European model not only alien, but intolerable. Imagine American insurance companies playing by these European rules:

* You can set any price on your policy, but you must sell it at the same price to everyone, regardless of health.
* You must sell a policy to anyone who applies, no exceptions.
* No policy can be cancelled for any reason, not even failure to pay (the government will step in). Patients, however, can change companies without notice.
* Every policy must cover all treatable diseases. No matter what policy they purchase, patients will never risk destitution (or death) if they suffer a treatable condition.
* Your company must pay every claim from every licensed provider within 30 days. You can protest the payment, but only after you pay the bill.
* Every provider receives the same payment for the same service, regardless of patient or their insurance.
* Your records are an open book. Every dollar (or Euro) that passes through your hands is open to the public. There are no proprietary secrets.
* If you still manage to cherry pick healthier patients, the government will impose a premium to subsidize other companies with sicker patients.

With this model, European companies compete with lower prices, extra benefits, and better customer service. Isnít that a refreshing change?

The American business model has no such rules. How do American insurance companies compete?

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