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I've come to think elected officials have such good,
taxpayer-subsidized health insurance that they're blind to what
insurance companies do the rest of us. They don't grasp that low
premiums can put actual health care out of reach. Sen. Hillary Clinton
fell into the "premium cap" trap in a New York Times interview published
today, saying that, in her mandatory insurance proposal, she would cap
premiums at up to 10 percent of total family income. It's a meaningless
guarantee when insurance companies can cut premiums by requiring
thousands of dollars in deductibles, charging high--even unlimited--
out of pocket costs and cutting back on coverage.

It's the same
trap that California legislators fell for in their failed mandatory
insurance plan. The middle-class families who could least afford the
premiums to begin with would have been pushed into the lowest-quality 
plans, with deductibles of $5,000 or more, high co-pays and the most
limited doctor networks. In Massachusetts, families that stretched to
buy the lowest-cost mandatory policies this year will face even higher deductibles and co-pays next year, suppressing premiums but heaping more costs on both taxpayers and families.

What
might work for a year or two will inevitably crush middle-class and
working class families as the actual cost of seeing a doctor or going
to a hospital spirals upward.

I was also disappointed that the
Times didn't probe the difference between health care affordability and
premium cost. The author accepted without question the assertion of the
insurance industry's Washington lobby, America's Health Insurance
Plans, that the average individually purchased family policy costs
$5,799. Such policies are offered only to families who pass insurers'
underwriting tests and have no unhealthy parent or child whose costs
might drag down profits. Policies at that price are also full of holes,
including high deductibles, high out of pocket caps and
exclusions--like no maternity coverage. 

The honest measure is the annual Kaiser Family Foundation survey, which
finds that employer-provided family policies cost on average more than
$12,000 a year, of which the employee pays on average about $3,800. The
Kaiser survey also measured an 87% premium increase from 2000 to 2006.

Employers
can't exclude employees with pre-existing health conditions, and tend
to provide actual comprehensive insurance, even though deductibles and
co-pays are growing in such policies. So that's the right cost
comparison, no matter what a lobbyist claims.