Under section 2718 of the Senate Healthcare Bill, three key implementations will be mandated: clear accounting for costs, ensuring that consumers receive full value for the premiums they pay, and standard hospital charges will be published and accessible to the pubic.
To provide clear accounting for costs, a health insurance issuer offering either group or individual coverage must submit to the Secretary their reports regarding the percentage of total premium spent. This cost includes expenditures on reimbursement for clinical claims, for spending to improve the quality of care, and on all other non-claim costs with an explanation of the nature of these costs. These reports will then be made available to the public. In my opinion, this is an economically savvy decision. Establishing accounting rules will segregate medical claims and non-medical costs so consumers can see where their money is being spent and help emphasize where improvements in spending can be made.
The second major provision of section 2718 will ensure that consumers are getting their money's worth for the premiums they pay. To do so will require the health insurance providers to rebate excess margins back to consumers. Beginning in 2011, large group plans spending less than 85% of premium revenue and small group and individual market plans spending less than 80% of premium revenue on clinical services and quality must provide a rebate to enrollees.
Lastly, each hospital operating in the United States must establish a list of their standard charges. Doing so will remove some of the secrecy surrounding hospital pricing and potentially help to build up some trust in the healthcare system. Making this information publically available will also allow consumers to make informed decisions regarding costs.
Looking at these provisions economically poses some problems. The bill claims it will bring down the cost of healthcare coverage, but this will actually cost consumers flexibility and options in the healthcare market. Choices will be limited in areas such as preventive care coverage, lifetime limits, extension of dependent coverage, and prohibition against rescission. This provision for me is a "catch 22", if you will. What are we willing to give up in order to ensure that Americans do not lose their benefits? It seems to be a matter of personal opinion. The bill needs to go to a joint Senate House resolution committee to answer this fundamental question.
Under section 2718 of the Senate Healthcare Bill, three key implementations will be mandated: clear accounting for costs, ensuring that consumers receive full value for the premiums they pay, and standard hospital charges will be published and accessible to the pubic.
To provide clear accounting for costs, a health insurance issuer offering either group or individual coverage must submit to the Secretary their reports regarding the percentage of total premium spent. This cost includes expenditures on reimbursement for clinical claims, for spending to improve the quality of care, and on all other non-claim costs with an explanation of the nature of these costs. These reports will then be made available to the public. In my opinion, this is an economically savvy decision. Establishing accounting rules will segregate medical claims and non-medical costs so consumers can see where their money is being spent and help emphasize where improvements in spending can be made.
The second major provision of section 2718 will ensure that consumers are getting their money's worth for the premiums they pay. To do so will require the health insurance providers to rebate excess margins back to consumers. Beginning in 2011, large group plans spending less than 85% of premium revenue and small group and individual market plans spending less than 80% of premium revenue on clinical services and quality must provide a rebate to enrollees.
Lastly, each hospital operating in the United States must establish a list of their standard charges. Doing so will remove some of the secrecy surrounding hospital pricing and potentially help to build up some trust in the healthcare system. Making this information publically available will also allow consumers to make informed decisions regarding costs.
Looking at these provisions economically poses some problems. The bill claims it will bring down the cost of healthcare coverage, but this will actually cost consumers flexibility and options in the healthcare market. Choices will be limited in areas such as preventive care coverage, lifetime limits, extension of dependent coverage, and prohibition against rescission. This provision for me is a "catch 22", if you will. What are we willing to give up in order to ensure that Americans do not lose their benefits? It seems to be a matter of personal opinion. The bill needs to go to a joint Senate House resolution committee to answer this fundamental question.
Under section 2718 of the Senate Healthcare Bill, three key implementations will be mandated: clear accounting for costs, ensuring that consumers receive full value for the premiums they pay, and standard hospital charges will be published and accessible to the pubic.
To provide clear accounting for costs, a health insurance issuer offering either group or individual coverage must submit to the Secretary their reports regarding the percentage of total premium spent. This cost includes expenditures on reimbursement for clinical claims, for spending to improve the quality of care, and on all other non-claim costs with an explanation of the nature of these costs. These reports will then be made available to the public. In my opinion, this is an economically savvy decision. Establishing accounting rules will segregate medical claims and non-medical costs so consumers can see where their money is being spent and help emphasize where improvements in spending can be made.
The second major provision of section 2718 will ensure that consumers are getting their money's worth for the premiums they pay. To do so will require the health insurance providers to rebate excess margins back to consumers. Beginning in 2011, large group plans spending less than 85% of premium revenue and small group and individual market plans spending less than 80% of premium revenue on clinical services and quality must provide a rebate to enrollees.
Lastly, each hospital operating in the United States must establish a list of their standard charges. Doing so will remove some of the secrecy surrounding hospital pricing and potentially help to build up some trust in the healthcare system. Making this information publically available will also allow consumers to make informed decisions regarding costs.
Looking at these provisions economically poses some problems. The bill claims it will bring down the cost of healthcare coverage, but this will actually cost consumers flexibility and options in the healthcare market. Choices will be limited in areas such as preventive care coverage, lifetime limits, extension of dependent coverage, and prohibition against rescission. This provision for me is a "catch 22", if you will. What are we willing to give up in order to ensure that Americans do not lose their benefits? It seems to be a matter of personal opinion. The bill needs to go to a joint Senate House resolution committee to answer this fundamental question.
