New York Times Letter, August 10, 2010
http://www.nytimes.com/2010/08/10/opinion/lweb10health.html?ref=opinion
To the Editor:
Re “A Fair Exchange” (Op-Ed, July 28):
I agree with Frank Micciche that creation of the state health insurance exchanges is a key to achieving health care reform’s lofty goals.
But I do not understand why states need flexibility “to determine which benefits their exchanges must offer” because “each state has different needs.” For policy holders, health insurance has only one goal: to help them pay for needed medical care. One of the new law’s regrettable provisions already permits health insurers to offer four levels of plans. The least expensive ones reduce the comprehensiveness of coverage by requiring more out-of-pocket payments — up to 40 percent of the cost of services.
People who can afford only less expensive plans often cannot pay the out-of-pocket cost of the care they need. That is the story of the 25 million underinsured Americans who value insurance enough to buy it, but then find that it does not provide access to needed care because of the high cost sharing.
Instead of giving states flexibility to vary the content and terms of coverage still more, federal regulators should require that the states’ exchanges carry out the intent of the law by making comprehensive coverage accessible to those who do not have it through employment.
Stephen M. Davidson
Boston, July 29, 2010
The writer is a professor at the Boston University School of Management and the author of “Still Broken: Understanding the U.S. Health Care System.”
