- Employee Retirement Income Security Act of 1974 (ERISA) This is the Big One, since most large employers are required to follow these regs. If you can stomach it, read a little bit (emphasis added):
ERISA covers pension plans and welfare benefit plans (e.g., employment based medical and hospitalization benefits, apprenticeship plans, and other plans described in section 3(1) of Title I). Plan sponsors must design and administer their plans in accordance with ERISA. Title II of ERISA contains standards that must be met by employee pension benefit plans in order to qualify for favorable tax treatment. Noncompliance with these tax qualification requirements of ERISA may result in disqualification of a plan and/or other penalties.
Important legislation has amended ERISA and increased the responsibilities of EBSA. For example, the Retirement Equity Act of 1984 reduced the maximum age that an employer may require for participation in a pension plan; lengthened the period of time a participant could be absent from work without losing pension credits; and created spousal rights to pension benefits through qualified domestic relations orders (QDROs) in the event of divorce, and through pre-retirement survivor annuities. The Omnibus Budget Reconciliation Act of 1986 eliminated the ability of employers to limit participation in their retirement plans for new employees who are close to retirement and the ability to freeze benefits for participants over age 65. The Omnibus Budget Reconciliation Act of 1989 requires the Secretary of Labor to assess a civil penalty equal to 20% of any amount recovered for violations of fiduciary responsibility.
- Continuation of Health Coverage--COBRA
- Health Insurance Portability and Accountability Act (HIPAA)
- Mental Health Parity Act (MHPA)
- The Newborns’ and Mothers’ Health Protection Act of 1996
- Women's Health & Cancer Rights Act of 1998
- Here is a copy of the Georgia Statute, complete with a list of health issues that must be covered by law.
Anybody thinking that the health care mess is all a result of Big Bad Insurance Companies obviously has no clue that the federal and state governments are chaining them with regulations and adding more chains all the time. (Unfortunately, as we have found out to our fury, some insurance companies have lost the ability to see those regulations for what they are--chains--and consequently have NO idea how to operate as an actual business, but more on that another time.) Actually, now that I think about it, some of the Big Bad Insurance Companies were in fact created by an act of government: the Health Maintenance Organization Act of 1973. Free market, my butt. (I'm in kind of a mood today, can't you tell?)
All of the above-named Acts sound just fine and dandy to the vast majority of Americans, many of whom haven't even bothered to question the morality or even practicality of sustaining such a heavily-regulated system. I bet most people have no idea of their existence, unless they get laid off and need COBRA.
Sometimes, I let that thought get me down, but then I try to turn my brain cells toward dreaming up more creative solutions to the problem (and believe me, I've got TONS of answers, because, well, I'm Jenn and a big Know-It-All and I can pretty much solve any problem in the best possible manner, just ask my husband).
When the government interferes with the market, costs necessarily increase. How do insurance companies recover those costs associated with being required to provide extra coverage? By raising premiums (employer AND employee), cutting patient benefits, and lowering reimbursement to doctors and hospitals. All in the name of government compliance.
Requiring ALL health insurance plans to fund, for example, reconstructive surgery for women who have had mastectomies increases premiums for EVERYBODY covered by that plan.
Oh, but how would such women be covered if there weren't laws requiring it? I can think of a few ways just off the top of my head. Some insurance companies would cover that kind of surgery in a traditional-type of plan and account for those costs in the premiums. I can also imagine that insurance companies specializing in women's health would spring up, limiting their coverage options to certain women's health issues. Or surgical insurance. There are such things as cancer policies, vision policies, dental policies. And the costs would be lower, too.
For a great illustration of the difference between the costs of government-subsidized medical services and the costs of mostly private medical services (in this case, plastic surgery), check out Update 2006: Why Are Health Costs Rising? by the National Center for Policy Analysis.
I can foresee true "cafeteria" type coverage in a truly free market. For my family, I'd purchase catastrophic and surgical coverage, diabetes and allergy coverage for the children to have (since they have these afflictions or a terribly high risk for them), maybe a general cancer policy for my husband and myself for when we're older (we fortunately don't have too much cancer in the family), and we'd pay for our well-baby checkups out of our own pockets--don't need insurance for that. Add some vision and dental coverage, maybe something to round out our pharmaceutical needs. That's just me--somebody else would buy a completely different set of insurance, or none at all. It wouldn't be required of employers (and what a positive effect on the economy would that have, because you know, they build all of their costs of doing business into their product prices).
I can dream, anyway! Hopefully, the more Americans are educated about the dangers of more government intervention in medical care and health insurance (two separate things), the quicker we can fix things. So consider this little post (really, I've got other things I should be doing right now!) just Doing My Part To Help The Team. And myself (of course).