KFF Primer on private coverage
How Private Coverage Works: A Primer
Kaiser Family Foundation
2008 Update (April 2008)
This primer provides a basic overview of private coverage for health care.
Conclusion
Health coverage is subject to significant requirements at both the state and federal level. While new laws and regulations have created important protections for consumers, they have also produced overlapping and sometimes duplicative or conflicting state and federal rules.
Continued interest by policymakers in expanding access to health care coverage may lead policymakers to revisit current regulatory standards. For example, proposals to provide federal tax credits for people purchasing individual health insurance are likely to prompt discussion of how to permit people in poorer health to have access to private individual coverage so that they can make use of the tax credit. As some state policymakers have discovered in addressing this issue, it will be a challenge to find ways to expand access to those in poorer health without undermining the stability of risk pools in this market.
As federal policy issues increasingly focus on regulation or expanded use of the private health insurance market, there will be greater need for policymakers to understand how this market functions and how state and federal rules interact.
http://www.kff.org/insurance/7766.cfm
Comment:
By Don McCanne, MD
Much of the discussion on reform that will take place in the next couple of years will be on reform of the private insurance market. Of course, that is not the discussion we need to have. We should be discussing how to replace the private insurance market with a single payer national health program.
But the discussion of the private insurance model will be taking place, whether we want it to or not. It is important that we are well informed on the details of the current status of the private insurance market so that we are able to respond with the reasons why the framing of reform must be changed from repairing the private insurance industry to replacing it with a financing system that truly would provide affordable health care for everyone.
This primer is worth reading both to update your knowledge about private insurance and to provide you with confidence in your framing of the important issues for reform.