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Health Insurance Reform (Op-Ed on Health Insurance)

Health insurance reform really comes down to several key concepts. The public and trial attorneys must accept limits on litigation for malpractice, health care providers must accept a rigorous federal review board to monitor malpractice and remove bad practitioners on national basis rather than by state, malpractice premiums must be lowered to reflect the decreased risk, a defined set of procedure codes with a prohibition against code-splitting must be enforced, reasonable and customary must be set at the 50th percentile (there are as many fees above the allowed charge and there are below it), coverage must be mandatory for all citizens and plans must provide for some level of deductibles and co-pays.

If the above actions are taken we will remove anti-selection, eliminate the need for health questionnaires, reduce the cost of malpractice insurance thus allowing providers to accept the lower reimbursement rate and reduce the cost of health insurance because premiums will be collected from both healthy and unhealthy thus spreading the risk. This in conjunction with the other factors will enable reduced premium rates.

The problem is all the key players (lawyers, providers, insurance companies and the public) will have to give something up. In a society driven by greed and a Congress run by lawyers and lobbyists that is not a likely outcome.

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