Sunday, June 15, 2008

Why Not Medicare for Everybody?

Just recently, I was invited to attend a presentation on single-payer health insurance, a system that Medicare is based on to insure citizens who are 65 and older in the US. What it lacked in balance, it sure made up in passionate belief from the presenters and audience for the need for single-payer insurance.

Only a few miles away, I attended another meeting last summer. But this time it was a Town Meeting to meet and ask questions of US Senator Arlen Specter, a Republican representing my home state of Pennsylvania. There too, a number of passionate people asked questions of the Senator on when we can expect help from the government to address what is rapidly becoming a health care crisis in America. While he said that something needed to be done, he firmly declared that the government shouldn’t be getting involved in health insurance — which immediately got a huge ovation from much of the crowd. Many of those clapping were surely over 65 and thus getting their health insurance from the government through Medicare. Did the irony of this dawn on any of these people, I wondered?

Of all the issues facing us this election year, it’s hard to imagine one that directly affects so many people in the US in such a profound way. Most of know about the roughly 47 million without health insurance and the countless millions more who are underinsured. But what the two examples above show is that this is an issue that is often driven far more by political ideology than the search for real solutions.

So maybe we should just strip the BS away and just look at what doesn’t work and what does. Then we can try to solve the problem by getting rid of what doesn’t work and adding more of what does. Are you with me? Let’s go!

What Doesn’t Work

Relying on employers as the basic source of health insurance It works if you can get (and keep) a job at a large company that offers health insurance. But even some large companies only offer health insurance for full-time employees while making sure to keep as many employees as possible at part-time hours. What about those at smaller companies where decent health insurance can be too expensive to offer while at the same time trying to stay competitive? Sometimes companies make the decision on whether to hire American workers and also pick up the tab for health insurance or locate factories out of the country without this worry. And we all know where this has gone lately. What about people who have lost their jobs through illness or otherwise? What about people who want to become entrepreneurs and start their own businesses but cannot because of the cost of health insurance for themselves and possibly their employees? This is especially unfortunate because small businesses generate many of our new jobs.

High-deductible health insurance policies It may sound appealing to some, but it is a phony solution at best. Most of those who need to buy this type of insurance are economically struggling to begin with. So they will likely forgo the preventative care that is not covered and if they have to go to the hospital may well be stuck with a bill that is large enough to cause serious hardship if not bankruptcy. What’s the point of insurance if it doesn’t protect against financial hardship or catastrophe?

Having to buy health insurance directly from insurance companies Some Republican presidential candidates have said that it might be a good idea if we would all do this. For those of us who have been there, it is a plain case of the need to be careful of what you wish for. An individual compared to a large company has almost no bargaining power with insurance companies. And it shows in the often unaffordable premiums that drive many into the ranks of the uninsured. While insurers may be glad to compete for healthy people to insure, those with “pre-existing conditions” often cannot get health insurance at any price, let alone a reasonable one.

What Does Work

Medicare Like any program, it has its problems but overall it does work. I don’t know about you, but I haven’t heard any complaints from senior citizens that they should have the right to buy their own health insurance instead of having to rely on the government. But what is remarkable is how well Medicare works considering that everybody in the program is 65 and older bringing along all of the health issues associated with that age group. If Medicare works for a group like this, wouldn’t it work at least as well if everybody else including all of the younger and healthier people were included? This works in Canada. Other similar systems work throughout the world. So why not Medicare for everybody here in the US?

John McCain's Healthcare Plan and Barack Obama's Healthcare Plan attempt to address the What Doesn’t Work issues by trying to either force or persuade the health insurance companies to offer competitively priced and affordable health insurance to everybody without regard to those pesky “pre-existing conditions” getting in the way. Would either be successful? This would require the insurance companies to completely change the ways they do business that have resulted in their handsome profits. Can you see that happening? I know I can’t.

So looking at What Does Work, why not expand Medicare to include everybody? A bill in the US House of Representatives,
H.R. 676 asks just that! Most Republicans oppose this for ideological reasons like “Socialized Medicine” and “More Big Government”. But even some Democrats are reluctant to support this bill not necessarily on its merits but the fear of being labeled “Too Liberal”. Indeed, only Dennis Kucinich of the Democratic presidential candidates supported this bill. But at this writing, the bill has 90 co-sponsors in the House so the last word on this has yet to be spoken. For those who are interested, an in-depth FAQ on single-payer health insurance that addresses some of the questions and concerns is in this link.

For those who haven’t seen it, the Michael Moore movie Sicko now available on DVD would be a real eye-opener to the suffering (and sometimes needless death) caused by our present health care system. While Moore has a well-deserved reputation as a liberal agitator from his previous movies, I urge those of you who haven’t to at least consider giving this surprisingly apolitical movie a look. And for those who have seen the movie, the 90 minutes of DVD extras are also quite thought provoking.

In closing, I hope you will take the time to become more informed about this vital but complex issue. It has been estimated that nearly 18,000 die annually in the US for lack of health insurance. So for some people, maybe even you or a loved one, it could someday literally mean the difference between life and death! Just something to think about.

1 comment:

Anonymous said...

Tony, you and I believe in basically the same thing, but different versions of it. Medicare is definitely a much better system than it is given credit for; it is actually less expensive than the HMO's, but I believe in National Health Insurance. The French model is a good example. The big problem with going to Medicare for all right now is cost. I don't see how we can now afford it. I believe the French system, which is a cost sharing one, is better.
In France, the employers, the labor unions, the government, the individuals according to their needs, and believe it or not, the insurance companies, all share in the costs. This, to me, is a better idea. The French system took 40 years to evolve; I think we are doing this too fast. We do need to do something now, right away, to cover those who lost their jobs, children, etc., rather than spending stimulus money on things like sidewalks in Ross Park, physical therapy for Beaver county, to mention two of the most ridiculous examples of where the stim money is going in allegheny county.