Health care has been a universal topic of discussion this political season. Candidates from both parties say they are in favor of it, although definitions of “it” vary widely. But what all agree is that it has to do with access. Can I get the care I need when it is needed, or are there barriers such as pre-existing conditions? These are questions that vex patients and insurers including me in my former role as CEO of a health plan.
Politicians have been talking mostly about pre-existing conditions as the way to ensure access to health care. But as a former health care insurance company CEO who now studies health care finance, I see this view as too simple. There are multiple levels of access relevant here – availability of insurance, affordable premiums, limited cost-sharing, sufficient number of providers and freedom of choice.
Is access just having any insurance policy?
Republicans generally define access in terms of insurance coverage, at low premiums. And this election cycle, many of them have professed their support for coverage of pre-existing conditions. But they haven’t said how insurers would do this. However, many believe that the full coverage plans required by the Affordable Care Act overshoot the mark, as they drive premiums up.