Health care: entrenched system hangs tough against change…

July 21, 2009

Soaking the rich for universal health care won’t fly. And it should not. Taxing existing health care plans via the employer deduction or through the employees’ individual income is counter productive and unfair, and borrowing more dollars from China is not wise, to say the least.

I’m not sure where that leaves things. But it seems that the cost of health care needs to be a shared thing, not left on the shoulders of just one group, because for one thing they will resist and for another they will get out of it, and soaking the rich is not really right anyway. If health care is to be provided universally then it should be paid for that way. Of course not everyone has equal means to pay.

And I should note here that there is a practical question as to whether there can be a system in which everyone gets identical care, that is everyone has the same level of care available. I personally have always assumed that those with means are going to have an advantage. They can pay cash and/or have better, more expensive, health plans.

And how much is too much to pay for health care? When it comes to your own life or that of a loved one, you can’t come to that ultimate figure, except by what you have available or can raise. But what if someone else is in dire need but has to get help from you through your taxes? As big a heart as you may or may not have, that is where one is liable to think a little more rationally (and ration, as in rationing, is part of that word).

This question becomes especially troublesome when we are only prolonging life for a limited amount of time.

And here’s a problem on a personal level. I’m weighing my options (if I have any) as to whether I can go back to work after being out on disability with cancer (that is not cured and cannot be). My COBRA plan (the federally-mandated program that allows one to keep group health insurance from a job by paying the full premium) is due to run out three or four months before I would be eligible for Medicare. I can extend my insurance beyond COBRA but it will not cover as much and it will cost more, my insurance carrier has told me (what a deal offered by private enterprise).

If I am able to go back to work, I can have a company-sponsored plan (not entirely free for me as in my last job that is no longer available) that will cost me less, but will my employer continue to offer the now tax deducible plan if my employer would have to pay taxes on it as some are proposing? Not likely, especially in this bad business climate. Will the government cover me then? And what hoops and how much waiting is involved in getting on a government plan? It’s two years for Medicare. Taxing health plans as one current Democratic plan seems to be calling for contradicts President Barack Obama’s campaign promise not to mess with anyone’s existing insurance plan while offering some type of government option.

I keep thinking that the point of this whole thing has to be availability and then cost, which sometimes amount to the same thing.

As much as I distrust and even resent at times the health care industry, I think messing up the current system where the majority of people have private or so-called group plans through their work is not the way to provide universal care, if for no other reason than the offering of a universally available plan from the government would probably wipe out private plans, especially if the government plan was free or at a much-reduced price to the consumer, even if it was more bureaucratic and not as good as private coverage (and I don’t mean private coverage is not bureaucratic – it is). Employers are not likely to offer health plans if they know everyone can be covered by the government.

The way to provide universal care – and here I go again – is to cover people who are not able (not just don’t want to bother) to buy their own insurance. While I would not be against in concept, say, a single-payer, government health care system, that seems unlikely when a different system is so entrenched and accepted by the majority.

Yes, Medicare is said to being going broke. But, it would seem the most cost effective and quickest way to extend coverage would be through Medicare, a system already in place.

And now we are being bombarded with the story that people in Canada, Great Britain, and Sweden and other places that have what is often called “socialized medicine” (provided through the government) have to wait for critical care or procedures for months or years or are flat out denied and sometimes resort to going to the U.S. to get care. That’s interesting. You still have to have the money to pay and if you have the money to pay, what’s the problem? The whole problem is people cannot afford medical care without health plans and health plans, whether they be privately run or run by the government, have to have some means of cost control or they would go broke. Waiting can be part of that cost control, as well as outright denial. I am not sure why just because some other country might have a plan that is not consumer friendly why the U.S. cannot improve upon that plan, but still offer universal coverage.

Medicare needs to be improved, to include offering broader coverage (vision, dental), and it needs more funding. Of course that will put a larger strain on the budget. But doing any improvement will necessitate spending more money. Improving an existing and quite workable program would seem to offer the most cost effective solution. 

We face two major needs: one is for everyone to be secure that he or she has health coverage. The other is for everyone to realize that he or she has a responsibility to help fund that coverage to his or her ability. As it is now, we who pay for health insurance share in the cost of health care for all in that we pay higher premiums to help medical providers help defray their mandated care of the indigent and others who do not pay and we are taxed for Medicare and the other public health programs. We need a simpler and more efficient and more equitable way to do all of this.

It’s estimated that current legislation on health care change going through congress could cost $1 trillion over a decade. Strange that it matches with the projected cost of the Iraq War. That war has been rightly called, I think, a war of choice. One wonders why the health of our citizenry was not considered the better choice. Our health care system is pricing people out of the market and people are losing coverage each day due to the current economic catastrophe. It’s estimated that as many as 14,000 people a day lose their insurance due to job cuts (from and article out of the Wall Street Journal online).

An oft cited figure for the uninsured is about 50,000, but a significant part of that is young people who earn enough money but don’t want to pay for insurance, figuring, I guess, that they are healthy. So when something bad happens the rest of us have to pay. We also pay for people who are in this country illegally. One study estimated that insurance ratepayers fork over some $1,000 extra per year to cover the expenses of the uninsured (from an article in the Wall Street Journal online).

Stories like the one I heard today on CNN do not help support the public option. It was revealed that Medicare pays at least one private company a thousand dollars to rent a wheel chair for a year when the same model can be bought for $300 or less from that same private company. That’s because when congress made the deal it was lobbied by the industry on price schedules and bidding procedures. So the same private industry that rails against public health care realizes when it is inevitable and profits from it.

I appreciate the president’s even handedness and willingness to negotiate, but sometimes leadership calls for putting together a workable plan and not letting it be diluted or emasculated by allowing the opposition (which likes the status quo) to get its hands on it, and then sticking to your guns to support your own plan (you have to have your own plan too).

One problem in all of this is that no one seems to identify exactly what the proposed plans supposedly being debated in congress would look like. And most people, quite understandably, do not want to lose what they have if they have it. Another problem that I see is that the president does not seem to offer an identifiable plan, other than in broad generalities, and his own party, the Democrats, have various plans afloat. The Republicans, as far as I can tell, are mostly pretending to be concerned or to want health care reform, but are primarily interested in carrying the water for the health insurance industry (to be fair, sadly many Democrats seem to be in the pocket of the health care industry lobbyists too).

Health care is such big business. There is so much money to be made. It is hard to fight the establishment, even for the yes we can man.


Have you noticed that the Harry and Louise ads on health care from the 90s are back but this time that concerned upper middle class couple wants change? (Things have deteriorated somewhat in their formerly protected world, apparently.)