Many ‘Cadillac’ Health Plans are Just as Crappy as Cadillacs

Many of you must have heard by now that the Senate finance committee passed its version of health care reform legislation. The bill would expand coverage without increasing the deficit, according to the Congressional Budget Office, in part by taxing the most expensive health insurance plans, the so-called “Cadillac plans.”

The problem is that many of those plans, despite requiring fairly high premiums from both employees and of employers are really not that great at all. The Senate finance committee’s thinking is not along the lines of quality coverage, but rather along the actual cost of the plan.

There is a big difference between the $40,000-a-year plan offered to Goldman Sachs CEOs, with no co-payments, no deductibles, few limits on how much you can spend, and no need for prior authorization, before you get treated and other, run-of-the-mill “Cadillac plans” offered to average government, or corporate employees.

Many not so fancy plans, which also qualify as “Cadillacs” under the finance committee’s definition are so defined because the term refers to total cost – and not a particular set of benefits – and many factors, like for example the state you live in, the size of your company, and the makeup of that company’s work force, which can affect costs.

Premiums tend to be significantly higher in some states. The employer/employee contribution also varies by state. In addition, the smaller the business, the fewer employees who participate, the less leverage the organization has to negotiate lower premiums. And if the workers have an average age of, say, 55, their premiums are going to be a lot higher than if the average is 24.

As it stands, there should be considerably more emphasis on improving the coverage of existing health insurance plans, rather than just emphasizing the total cost. There is no doubt that the cost of health care in the United States has gone through the roof a long time ago and that issue needs to be urgently addressed, rather than only worrying whether the reform is going to increase our already skyrocketing deficit. Just think about the trillions of dollars doled out to banks and other financial conglomerates. That seemed to be quite painless to those who are now worrying about increasing our deficit. Couldn’t we have used that money to improve our health insurance system and our crumbling infrastructure, rather than bailing out the fat cats, who have actually caused the financial disaster?

If we are to truly reform the U.S. health care insurance system, along with the health care itself, the main points of the so-called reform should be: how to reduce the exorbitant costs of both the care and the insurance, to improve the quality of often substandard care (unless you are willing and able to pay for the very best care available) and to broaden, rather than reduce the coverage that the health plans offer.

Providing health care insurance to the uninsured is a noble quest, to be sure, but to further penalize others, who are ‘covered”, but who do pay their premiums, their ever-rising co-pays and who’s “Cadillac” plans do not offer coverage for such common procedures such as dental care in general, specifically root canals, crowns and necessary oral surgery is the wrong way to go about it.

We have strongly supported the reform of U.S. health care system as a whole for some time now, but taxing the people, already penalized by the inadequacies of some of our health insurance plans, including some of the “Cadillac” ones, seems more like an idea of still another bean counter, rather than a true reformer.

Let’s get this done now and lets get it done right!

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