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We have certainly been inundated with campaign rhetoric, listened to debates, and seen many opinion articles on the health care insurance challenge. Professionally speaking as an insurance agent, and specifically as a health insurance specialist, I must admit I was not impressed with either presidential candidate''s solution to health care. For such an important issue, I was unimpressed with the alternatives presented.

If congress's governmental health program becomes available to everyone, who will control the pricing and how is that going to be paid for other than by raising your taxes? On the other hand, to dissolve employer group plans and suggest everyone go out and buy individual policies ignores a lot of folks that won't pass medical underwriting to get an individual plan and the fact that prices will go through the ceiling if insurance companies are forced to take on any and all risks. I don't have the perfect solution either, but I think the issue has everyone's attention, and perhaps by addressing certain elements, common good can be established.

The State of Minnesota should be a role model for other states regarding programs already in place to assist those who cannot afford health insurance. 'MN Care', is one program, available to those of low income and without an employer sponsored group health program. There is also MCHA (Minnesota Comprehensive Health Act), for those whose health prevents them from obtaining individual insurance. We all pay for these programs through our taxes, premiums, and our local insurance companies are also required to fund these programs.

As a result Minnesota is one of the lowest uninsured states for health insurance. Insurance administrative expense (7-9%), often blamed for raising premiums, is not what's driving costs. In fact the benefits of company negotiated contracts with medical providers (remember the Fairview dispute?) and tracking results of treatment, far outweighs these administrative costs. Health insurance availability is not the issue, the cost of insurance is. My daughter's annual physical was $500+ without insurance and $254 with.

"Over the past five years, health insurance premiums have risen 5.5 times faster on average than inflation".

Politicians blame insurance companies and insurers blame medical providers.

"Most of the relentless rise can be attributed to the expansion of hospitals and other health-care sectors and the rapid adoption of expensive new technologies, new drugs, devices, tests and procedures".

Unfortunately, even with better technology, our health delivery and follow-up system involves wasteful expense. Better follow up care such as tracking results and progress, eliminating questionable procedures, and accounting for the total picture, are all relevant goals for medical providers.

No doubt, the medical community plays a big role in soaring costs, but what about taking some ownership in this challenge ourselves. Understanding the ramifications of an obesity epidemic also means big dollar medical expenses. Unlimited prescription drugs for some, with no coordination system to monitor if one medication is canceling the effectiveness of another, runs up thousands of dollars. HSA's and HRA's have certainly engaged people into more responsible spending, but it's going to take continued effort from many more, to get a handle on this spending.

A new age is dawning as consumers are questioning and comparing medical treatment fees and management of their health. We have more resources now to do our homework and the provider's accountability is being stretched. And what about the responsible consumer who carefully monitors their diet, exercise, and environment; shouldn't they be given a price break in premium for healthy living?

Non smoking rates are available in the individual market and large group programs do sometimes sponsor healthy living awards, but we need more. We need more incentives and rewards for people taking this seriously, and even if some see it as unfair pressure or invasion of their privacy, the bottom line is that we all have to be accountable, or we pay the price. Automobile insurance is handled that way, why not health insurance? I see this slowly trending more positively in 2009 and in years to come.

Brownley, Shannon & Emanuel, Ezekiel. "5 Misconceptions about Healthcare." Star Tribune 7 December 2008: OP1

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