To the editor:

Maybe health care reform is not dead after all, thanks to Wellpoint. Wellpoint is a major nationwide health care insurer which recently announced a 39 percent increase in premiums in California and similar massive increases in many other states, providing us an instructive preview of a future without health care reform.

The people of California did not suddenly use 39 percent more services, and the health care providers did not increase their fees by 39 percent. Nor did Wellpoint just decide to quadruple their profits. What really happened is much more scary for those opponents of reform who are not interested in the uninsured because “I’ve got mine.” It relates to a phenomenon called risk pool concentration.

When health insurance premiums become unaffordable, the first individuals and businesses to drop coverage are the healthy, who perceive little need for coverage. (Their unexpected, uninsured catastrophes continue to be covered by the rest of us through cost shifting.) The last to drop are those with large, ongoing expenses which exceed their premium costs. The faster the risk pool concentrates, the more rapidly premiums increase, starting the whole cycle all over again.

If reform does not pass, the “I’ve got mine” crowd can start counting the days until they will no longer have theirs. Such is the lesson of Wellpoint, and it couldn’t have come at a better time.

In a time of economic stress and health care inflation, universal coverage is not a luxury, it is an absolute necessity, lest the system collapse around us all.

Dr. Steven Bruner,

Lawrence