Would allowing people to shop for out-of-state insurance lower health costs for all? Or would it lead to a "race to the bottom" with much higher costs for some and worse coverage for everyone else. Check out our Consumer Reports analysis.

And what if we just eliminated pre-existing condition exclusions. Well, some people might wait til they get sick to buy insurance. Coverage is only affordable if healthy people are also paying into the "pool." And if you just mandate that everyone buy coverage, some reasonably can't afford it. So you have to help them out. Before you know it, you've ended up with something that looks a lot like the now-stalled proposals in Congress. We've looked at this idea in detail too.

Finally, we could do a few little things to improve competition, but encouraging competition for a product that's nearly impossible to understand until the day you need it can be quite a challenge. This is not like buying a TV.

Keep an eye on our Consumer Reports Health Blog for more about the ideas for fixing our health care system that everyone is talking about.

comments (2)

I have several problems with your discussions about health care reform, such as this blog and the email of 2/11/10 from action@cosumer.org titled “What they didn’t tell you”.

- The real problem is the cost of medical care, NOT the cost of insurance. If the care costs less, the insurance would cost less. The cost reduction components of both the House and Senate bills are at best minimal, at worst laughable. How do we pay for all of these wonderful benefits as costs that are already out of control continue to rise exponentially?

- Leaving that aside, there are vast differences between the Senate and House versions. So, there IS no actual bill to evaluate.

- Mandatory coverage and payment is essential. If healthy people are not required to contribute and yet are allowed to become covered as soon as they become ill (Remember, no denial or penalty for pre-existing conditions.), why would anyone pay anything in until they need the coverage, and why would they keep paying in once they are well again, since they can just re-enroll the next time they need coverage?

Why not encourage everyone to join an insurance plan without threat of prison for those who don't? Then require that everyone is covered without denial or ridiculous increase if they get sick after they are covered for more than three months. Allow customers to transfer to other insurance companies using guaranteed coverage. If someone opts out of insurance coverage they would lose guaranteed coverage. Subsidize the poor only. Maybe tax medical services 15% or something reasonable to those not in the system - using the money to subsidize those in need. Allow some to set up self coverage plans. They could have money set up in med-sav accounts to be used for medical or retirement/assets to leave to their kids on their death. The very rich could set up a bond of maybe 200k or so that would cover them in case of emergency and pay their medical bills out of pocket with any unpaid bills (in case they lose their money or face excessive med bills) paid from the bond fund. The idea is prevent people from waiting until they get sick to get coverage. Anyone already sick and who did not get coverage previously would be rated as high as now or possibly denied coverage.

Add lower deductible HSA's,tort reform and some other cost saving ideas to lower costs. This would: have more people paying insurance giving a larger pool to insurance companies, stop doctors and hospitals from paying for peoples med bills too poor to pay or who did not plan for medical bills by setting aside money or buying insurance.

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