I was chatting with a manager at work last night about the health care reform that could be coming our way soon if all these politicians can get their crap together.  His biggest concern, actually, was that employees would be elegible for employer-provided coverage after 30 days of employment, mandated by law, as opposed to 90 days, which it is currently.  He figures that after 30 days, company pays for the insurance, and if, on day 31, the employee quits, he gets to keep the coverage for the whole year.

First, he's assuming that people don't do the same thing for the 90 day probationary period as the law tands right now.  I suspect that a) they are, and b) that number of people that will work a job and quit after being insured is very small.  Honestly, I'm not even sure that they get to remain insured.  Whether the company gets any rebate on that policy if the employee IS dropped, is another question indeed.

At any rate, I'm really wondering how the hard-fast cuts are going to pan out.  The way it was explained to me is that doctors would have to take a pay cut on certain procedures, which I don't think has ever happened, and Medicare would have to be reduced, which I don't think has ever happened.  How do you like that? We would have to start using the insurance companies to provide Medicare supplement insurance to cover for the cost cuts designed to put restrictions on the insurance companies to begin with.

At any rate, I think there are a lot of really great ideas in there, like making the insurance compnanies deal ethically with people by preventing them from dropping people as soon as they start needing the insurance they've been paying for, and also by limiting them to reasonable profits.  For the record, I had a lot of disonance on this one.  At first blush, I'm not a big fan of the government putting restrictions on how much people or companies can earn, but therein lies the problem.  They don't really earn it, do they?  They don't run any tests, they don't diagnose any illness, they don't prescribe any medicine, nothing.  You can't even really say they provide a service, since all too often, they find reasons to NOT pay as opposed to finding ways to pay for medical bills.  In fact, after reading about the insurance companies and listening to people who used to work for them, I wouldn't be surprised at all if they would try to drop everyone except that the government does have some kind of regulation working on them.  So with that being the case, go ahead and limit their profits to something reasonable for shuffling papers around and give the rest back to us, or encourage them to invest it in medical infrastructure like electronic billing, or a fund for public health awareness.  That might be alright with me.  Company X made 200 million dollars more than it was allowed to by law.  Refund $50 to each of its 4 million customers or invest that money in flu vaccines or AIDS awareness, or playgrounds (that inspire exercise, you know) or funding YMCAs (that make exercise affordable, right) or something like that.  Even if it was just returned as a discount for all customers that signed back up again the next year.  $50 off next year's coverage, to make the next year more competitive so they didn't lose the "work" they did at managing costs.  Of course, if half the customers went somewhere else, then the other half would get $100 off.  The company couldn't keep it.  I like this more and more, although I'm sure I've made it altogether too simple.