Bob Laszewski has an excellent post on one of the key lessons from the Massachusetts experiment – the dangers of allowing people to buy into and drop out of coverage whenever they see fit.
Evidently a number of people are buying coverage when they need care, then dropping it when the treatment is over. This is adverse selection from the consumer perspective; they can buy coverage when they need it and insurers are forbidden to do any medical underwriting or charge different premiums.
Before someone way overreacts and says “see universal coverage will never work”, understand that the issue here is very specific – the law in Mass allows this behavior. It is correctable (to a large extent) through two mechanisms:
1.) require everyone to have coverage, and
2.) prohibit members from enrolling and disenrolling except during designated times and require them to maintain enrollment with one plan for a minimum of twelve months.
And, no, the answer is not ‘health status insurance‘.
Jul
1
The Massachusetts experiment may be the best argument for a single payer system with a once-a-year open enrollment period. How silly to allow this kind of adverse selection! I wish that I could have something like this for my pets!
Congress knows a good operating model . . . because all of them have participated in it since the Federal Employees Health Benefits Act of 1960!