One of the biggest selling points of the healthcare reform legislation -- a reason why we are supposed to just accept the massive concessions to the insurance industry and drug companies -- has been the promise that the private insurers would finally be banned from the disgraceful practices of denying coverage to people with pre-existing conditions.

Well, not so fast, says a report in the Washington Post Sunday.

Reporter David Hilzenrath interviews several policy wonks and concludes that the insurers will still have a variety of ways to violate the spirit and intent of the law. For example:

they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment

Or how about this scam:

to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions

Some are aware of the problem and trying to find ways to neutralize the abuses.  But, Hilzenrath adds,

Unless lawmakers tackle the problem effectively, a reformed health-care system could continue to reward insurers for avoiding rather than treating illness

We already know how accomplished they are at that practice, as was evident in the report last month from the California Nurses Association/National Nurses Organizing Committee that in California six of the largest insurers have rejected on annual average nearly one-fourth of all claims since 2002.

Here's CNA/NNOC representative Donna Smith debating an insurance executive on the data on CBS Friday.

The insurance trade lobby AHIP (America's Health Insurance Plans) agreed to the idea of what is called "guaranteed issue", the willingness to sell policies to people even if they did once have acne or a yeast infection.

But only in exchange for an individual mandate forcing everyone not covered to buy insurance. Big of them.

The mandate alone will be a massive bailout, especially as accompanied by the public subsidies for middle income people to buy private insurance and what are, at best, dubious controls on price gouging by the insurers.

It's not just that the insurers are greedy -- well maybe just a little -- but that their first obligation is to make profits, not to guarantee care.
As Hilzenrath notes:

AHIP has been trying to shape the legislation in ways that could help insurers attract the healthy and avoid the sick

And, they have long perfected marketing techniques to do so --

From the messages they advertise to the overall level of coverage they provide and the smallest enticements they add to their benefits packages.

Techniques for which they will now have a lot more money to exploit in advertising.

If we should have learned anything about the insurance industry, it's that they can not be reformed, and will find ways to abuse whatever regulations and restrictions the Congress may impose.

That's exactly why many of us have continued to advocate for removing their choke hold over our health care system by adopting a single payer/Medicare for all reform.

Rep. Anthony Weiner is sponsoring a Medicare for all amendment that will come up on the House floor presumably sometime this month.  And with the travesty that has been unrolling in the Senate Finance Committee, wouldn't it be nice to see the House leaders walk into a conference committee session with Baucus and company with a Medicare for all bill on the table.

Ask your Congress member to support Medicare for all, for the best reform. It might be the best vote they will ever make.

Originally posted to National Nurses Movement on Sat Oct 03, 2009 at 09:55 PM PDT.

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