August 2009 Archives

How much more should insurers be allowed to charge older people than younger people?

So far, health care reform legislation in Congress has included language to allow insurers to charge older people twice as much as their younger counterparts. While that would lower premiums for people at, say, 60, whose medical costs might be higher, it would raise premiums for the younger, generally healthier, generation.

But legislators have given some consideration to allowing insurers to charge older people five times as much as younger people, which more closely resembles the differential today.

Which makes more sense, and how important is this distinction? Is age rating even something the government should regulate?

8 responses: John C. Goodman, Len Nichols, Scott P. Serota, Stuart Butler, Uwe Reinhardt, John C. Goodman, Uwe Reinhardt, John Rother

Updated at 9:17 a.m. on Aug. 26.

Do you see health insurance co-ops as helpful, harmful or pointless? What would be the benefits, and would people sign up? Would they be more cost-effective than private insurance options?

The health insurance co-op concept drew increased attention last week after top officials indicated that the administration wasn't tied to the inclusion of a public insurance option in health reform legislation. The idea behind co-ops is to create a nonprofit health plan that would be owned and operated by the patients it serves. The co-op would compete with private insurance plans.

Remembrances of Ted Kennedy

In light of the passing of Sen. Edward Kennedy, National Journal invites you to share your remembrances, whether they're personal or about Kennedy's accomplishments on health care or other matters during his long tenure in Congress.

18 responses: J. James Rohack, Grace-Marie Turner, Stuart Butler, Darrell G. Kirch, John C. Goodman, Marilyn Werber Serafini, Marilyn Werber Serafini, Henry Simmons, Billy Tauzin, J. James Rohack, Karen Davis, Ron Pollack, Jack Lewin, Jason Rosenbaum, John Rother, Jason Rosenbaum, Karen Davis, Stuart Butler

Who do you think is winning the August PR offensive on health care reform?

What kinds of ads, messages and events are you seeing or hearing about that could have an impact on the reform debate during the congressional August recess?

What is working -- or not working -- and what's crossed the line?

6 responses: David B. Kendall, Darrell G. Kirch, Henry Simmons, Drew Altman, John C. Goodman, Donna Shalala

What are you reading -- or what have you already read -- that you would recommend to your fellow experts and to blog readers for the August congressional recess? Books about the failed health reform efforts, think tank reports, the Congressional Budget Office's budget options book, MedPAC's last report, the actual House health reform bill, and even novels are all fair game as long as you explain why they are significant or interesting.

Also, while you are lounging at the beach (hopefully), what news source are you relying on to stay up to date on health reform developments (excluding National Journal, of course)? Feel free to list Internet sites, news shows or print media.

9 responses: Marilyn Werber Serafini, Len Nichols, Gail Wilensky, Molly E. Sandvig, Karen Davis, Jason Rosenbaum, John C. Goodman, Drew Altman, Henry J. Aaron

What needs to be in (or out of) health reform legislation to win the support of the middle class? A public plan? Universal coverage? Taxes? Requirements on insurers? A certain level of premium subsidies? What are the critical elements for health reform to meet the "what's in it for me" test?

Clinton White House pollster Stan Greenberg cited the failure to the meet the "me" test in the 1990s as critical to the failure of the Clinton health reform effort. "The more we told them how good this plan was, the more people thought it was going to cost more, taxes are going to go up, because it had to cost more money," he said in an interview with National Journal last week. "In our modeling, the most important predictor of your views of health care [was] on whether it was good or bad for your family."

Today, President Obama is spending significant time appealing to the middle class for their support. Obama's job approval rating has fallen from 61 percent to 54 percent since mid-June, according to a national survey conducted by the Pew Research Center for the People & the Press, which cited health care as one reason. "The health care proposals being debated in Congress are sparking negative reactions, especially from those following the debate most closely. By a 44% to 38% margin, more Americans generally oppose than favor the health care proposals now before Congress," Pew found. Pew reported that public interest in health reform has increased in recent weeks, with nearly a third naming it their top story. About 20 percent cited the economy.

12 responses: Jack Lewin, David B. Kendall, Billy Tauzin, Molly E. Sandvig, Uwe Reinhardt, Jason Rosenbaum, Karen Davis, John C. Goodman, James P. Gelfand, Uwe Reinhardt, Drew Altman, Ron Pollack