Re "Health Insurance Exchanges Scramble to Be Ready as Opening Day Nears" (news article, Sept. 30):
In trying to understand the complex arguments around the new health care law, with the opening of insurance exchanges on Tuesday, it is important to note its basic thesis. It is meant to provide health care for the most vulnerable and disabled of our fellow citizens. Our community, our state and our nation are as strong as our weakest links.
Our American moral and religious foundations place compassion and support for the weakest and most vulnerable among us as a measure of our character and culture.
When we lose that moral compass, we compromise the cultural fabric that makes America an exceptional nation.
We can defend self-reliance and personal freedom as counterarguments to providing health care to all, but in our hearts, if we know that we are rationalizing individual greed and selfishness, we are left diminished and vacant. Compassion is the essence of the American spirit. At the end of the day, we must each ask ourselves, Can we afford not to care?
KENNETH COHEN
Kensington, N.H., Sept. 30, 2013
The writer is a psychiatrist.
To the Editor:
Our son called from California to say that he was considering a new exchange under the Affordable Care Act. It looks as if he can get a silver-level policy for $65 per month after subsidies. The deductible will be $500, and the co-payment will be $15.
He is currently paying $192 per month (we convinced him that he should have insurance last year) with a much higher deductible and co-payment. He was very excited about the savings.
He is a contract worker paying all his health insurance costs and both the employer and employee portions of Social Security. He is not alone. He is exactly the type of person who will make this program a success — and it is a good deal for him as well.
I don't understand the demonization of this act that Congress passed. Do the members of Congress have amnesia and forget that it is they who approved it? The law is good, so leave it alone. Congress should go do something productive — like pass a budget.
DEIRDRE SEARLES
Ajijic, Mexico, Sept. 30, 2013
To the Editor:
It is unclear if patients will benefit from lower premiums because of additional insurers with the new health insurance exchanges. Enhancing choice and competition in private health insurance would fragment the market and undercut each insurer's market share. This would dilute the insurer's leverage in negotiating for lower prices with hospitals, physicians and other providers. The increased costs would then be passed on to consumers in the form of higher premiums.
Hawaii and Virginia offer telling examples of this phenomenon. As described in an Economix column last year, Hawaii has one of the most consolidated insurance markets, with two insurers dominating over 90 percent of the state's market.
Conversely, Virginia has one of the least concentrated markets, with its two largest insurers controlling only one-quarter of the industry. Over the last decade, Hawaiians saw their average premiums rise by 72 percent, while Virginians witnessed their premiums soar by 140 percent.
Exchange administrators should be wary of viewing insurance competition as a panacea for rising health care costs.
NATHAN PUNWANI
Washington, Sept. 30, 2013
The writer is an internal medicine resident at George Washington University.
To the Editor:
For years now it has been clear that the Tea Partyers have only one goal: to defeat President Obama, on any field, anywhere. The future of this country and its citizens seems to be irrelevant to them.
It is no coincidence that this battle is being fought on the eve of the opening of the health exchanges. Their greatest fear is that the whole thing might actually work.
JOLYON JESTY
Mount Sinai, N.Y., Sept. 30, 2013
To the Editor:
Re "A Guide to the New Exchanges for Health Insurance," by Tara Siegel Bernard (Your Money column, Sept. 28):
For some 30 years, a large segment of gay and bisexual men have been excluded from individual health insurance. We have been denied coverage based on our pre-existing condition: H.I.V./AIDS.
Quite frankly, I did not think I would live to see it, but as of next year health insurance companies will not be permitted to discriminate against people with H.I.V./AIDS. This is a huge win for our physical and psychological health.
This development rivals other recent advances in lesbian, gay, bisexual and transgender rights, because for people with H.I.V./AIDS, better access to health insurance is as important as the right to serve in the military or marry a same-sex partner.
Thank you, President Obama, for the Affordable Care Act.
JOHN MEHRING
San Francisco, Sept. 28, 2013
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