copyright © 2007 Betsy L. Angert. BeThink.org
Health care is in the news again. This week, Senator, and Presidential hopeful, Hillary Clinton proposed the latest cure for what ails this country. Clinton declared medical insurance must be mandatory. Under her plan, all Americans will be covered. Days later, President George W. Bush spoke of how he believes we can best heal the ills of impoverished children in this country. Mister Bush proclaimed parents must pay for the care of their progeny. The medical system must remain in the hands of private industry. There are no handouts here. If Moms and Dads have income, they must provide for their children. While the plans may seem drastically different, they are very similar.
In each, the “citizen” is still basically a “consumer,” not part of the commonweal Thomas Paine spoke of in 1776 when he explained, to ensure shared stability, government and society must be intertwined.
In order to gain a clear and just idea of the design and end of government, let us suppose a small number of persons settled in some sequestered part of the earth, unconnected with the rest; they will then represent the first peopling of any country, or of the world. In this state of natural liberty, society will be their first thought.
A thousand motives will excite them thereto; the strength of one man is so unequal to his wants, and his mind so unfitted for perpetual solitude, that he is soon obliged to seek assistance and relief of another, who in his turn requires the same.
Four or five united would be able to raise a tolerable dwelling in the midst of a wilderness, but one man might labor out the common period of life without accomplishing any thing; when he had felled his timber he could not remove it, nor erect it after it was removed; hunger in the mean time would urge him to quit his work, and every different want would call him a different way. Disease, nay even misfortune, would be death; for though neither might be mortal, yet either would disable him from living, and reduce him to a state in which he might rather be said to perish than to die.
People rarely relate to the idea of death or serious illness. Most of us imagine we are immortal. As a child, many believe in fairy tales. Some trust a fairy Godmother will come and care for them when they are ill. The Wizard lives in Oz, and he too can heal a heart, or mend an injured brain. In our youth we are certain, “There is no place like home.” Mom and Dad will keep us safe and warm. Parents provide food, shelter, and when we do not feel well, they will take us to a capable physician. The compassionate doctor will cure our pain. Ah, the miracle of medical science is better than fancy.
As adults, we accept there is a need for medical care in our lives. After a certain age, we understand; we are mere mortals. Accidents occur. Infirmity is inevitable. Dream as we might that we are and will remain healthy throughout the course of our lives, as years go by we learn everlasting good health is not likely to be. There is no assurance that we will always be fit. We understand that we must do what we can to prevent illness and injury.
A mature mind grasps that mishaps happen. As an individual, we recognize health insurance is a must. Still, in the Wild West, independent-minded Americans are reluctant to insure every individual. The notion of natural liberty negates the necessity we experience as a society. Much as we would wish to believe I am separate from my neighbor, none of us are. If my fellow citizen cannot care for himself, the cost of his illness, injury, and demise will be mine to bear. Just as I need to garner support from my friend to acquire funds for my needed health insurance, so too does my brother, my sister, and their child.
Most civilized nations realize the dire need for universal medical indemnity. Other countries have established plans to ensure that preventative measures will be taken, whenever possible, to stave off sickness. Traditionally, in America, each man, woman, and apparently, child must fend for themselves.
There is talk; perhaps, it is time to change. Nonetheless, the conversation is convoluted. Some speakers say those that are happy need not consider how their choice to stay with a plan might affect another. The words of founding father Thomas Paine have not helped Hillary Clinton or George Bush to appreciate every American is part of a broader society. Clinton and Bush are not alone. Virtually every Presidential candidate and citizen mirrors the idea of independence as they discuss health insurance.
In this tome, I could continue to analyze the oratories, as others have done before me, or I could pen, as I believe I must. As political campaigns progress and people posture, I realize I need to disclose more. I thought to broach the discussion more than a year ago, and I did, although, in truth, I was evasive.
This topic is an embarrassing one for me. Since the age of seventeen, when I first left my parents home to live on my own, I became a national statistic. I was one of the shunned, those that suffer in silence. I was a person most Americans look down upon. I remained so for all but twelve months of my adult life. I was not among the acceptable for all but a scant time. When I was covered, it was only for a few weeks at a time. For all but those periods, I did not have medical insurance.
On occasion, I would have to divulge this reality outside of a physicians’ office. Those that heard of my plight were surprised. Subtly, statements were made. Friendly faces turn sour when they learn that you have no health care.
My dentist knew. Granted, some health care packages do not include dental plans. However, most provide a bit of protection. I had none. I had to tell my sweet dental care physician. Paul pleaded with me. Take a job, any job, that had excellent benefits, dental in particular.
I am a very well educated person. As are many Americans that have no insurance. I worked in many prestigious places and held positions that one would think included health insurance as part of the standard package. In one University teaching assignment I learned more than a decade later, an offer of coverage is not required although it is available to those that know they can request it.
In that situation and other similar circumstances, people are purposely not placed on tenure tracks for it is too costly to the college. A large portion of the faculty, while teaching the same number of hours as a full time professors are considered only “part-time.” Contracts are renewed. Workers Unions do not assist employees such as I. Nonetheless, people assume they do.
Much is taken for granted. We all have appearances to uphold. Even if the illusion is maintained only to save ourselves from what we fear, what we project others accept. At times, even the most knowledgeable among us is confronted with stark realities they never imagined.
The majority of people we [Authors of Uninsured in America, Susan Starr Sered and Rushika Fernandopulle] met in our travels across the country lack consistent access to health care of reasonable quality despite having been employed all or most of their adult lives. Approximately one-third of the people with whom we spoke are well educated but have had the misfortune to end up in jobs that do not offer insurance: substitute teachers, adjunct professors, part-time social workers. These Americans have not chosen to be uninsured; rather, their employers have found it cost-effective to reduce the number of permanent full-time positions while maintaining an unprotected pool of workers whose jobs by definition do not offer benefits.
In America, in a free enterprise Capitalist system, costs are the central concern. Profits are primary. This is true for publicly traded companies and for private or state funded institutions. People are only a means for principal gains. Perhaps, that is the problem. In a market economy, products are sold. Image is everything. We all wish to appear well and well-off. That may be the reason that millions of Americans do not speak of their health care situation. They, we, do not wish to seem unstable, inadequate, or unworthy, although we may feel as though we are. I definitely did.
As a mature individual, I contribute to society. Often, I maintained and sustained a job that was somewhat secure, as much as anyone might make that claim in modern America. I am a professional person. Postgraduate degrees adorn my walls, or they would if I ever chose to hang them. Yet, I did not have the where-with-all, nor the worth of a person with health insurance. My employer did not pay for my care, and I certainly could not afford the benefit.
On the radio and television, we hear the numbers. As many as forty-seven million Americans are uninsured. At times, I have heard figures far higher. In periodicals, “average” Americans read the data. The assumption is, “those” people are uneducated, low wage, service workers. Those in the mainstream think, surely, no one similar to me, would be without a health care plan.
The homeless, the impoverished, the immigrants, these individuals must be the persons included in the tens of millions without medical coverage. At least that is what Rushika, a physician specializing in health policy, thought. This medical expert turned researcher and author was certain public programs must attend to the needs of those without health insurance. She never imagined what might be true. Most people do not. Those without health care do not speak of their predicament. Persons satisfied with provisions medical services provide have no reason to ponder the possibilities, let alone the realities others face.
(W)hen Rushika, a physician specializing in health policy, met Susan, an anthropologist who recently had returned to the United States after living for two decades in Israel and Japan, countries that have national health care programs. With the fresh eyes that an outsider sometimes can bring to a situation most of us take for granted, Susan asked Rushika: “Where are the bodies? If forty million Americans don’t have health insurance, there must be a lot of bodies. I would think that American cities would look like Delhi or Calcutta, where trucks collect corpses from the streets each morning. Where is America hiding its uninsured sick and dying citizens?”
Rushika initially responded with standard answers: We have government programs such as Medicaid and Medicare. Many counties run clinics with sliding-scale fees. Our hospitals offer charity care to indigent patients. And, with the support of the Bush administration, churches have opened up faith-based clinics.
Yet, when the two of us began to look more closely at the statistics, we saw that these responses did not speak to the actual experiences of many people in our country. In 2003, Medicaid covered only slightly more than half of Americans whose family income was below 200 percent of the poverty line (that is, below $36,800 for a family of four). Public clinics typically are so overwhelmed that the wait for an appointment can be several months.
Hospitals often fail to inform patients that charity programs exist, instead simply billing their uninsured patients and turning their accounts over to collection agencies. In fact, although the government requires not-for-profit hospitals to offer charity care, many hospitals avoid doing so by redefining the uncollectable debt as “charity care.” And faith-based clinics, which were touted as a compassionate safety net to take the place of big government bureaucracies, usually seem to flounder, seeing patients only a few evenings each week and relying on volunteer physicians to squeeze in a couple of clinic hours a month on top of their already overflowing private practices.
Oh, how I know this well. I sat in many a waiting room for hours on end. At times, what might be a hour out of the day for those will medical insurance would be an all day visit for me. The uninsured, and even underinsured, are patient people. They have to be. “Beggars cannot be choosers.” Perhaps, those with little or no coverage are so grateful for a pittance, or they are as mortified as I was. Possibly, we are resigned to what is.
We, the forty-four, forty-seven, or fifty-three million, [I have heard each of these statistics bandied about over the years] feel powerless against the Medical and Pharmaceutical industries. Collectively, or as individuals, there seems little we can do to battle the big businesses that employ us. We need our paycheck to purchase the basics. Food, clothing, and shelter are necessary to survive. Health care, well, as long as I am alive I can endure. The “no pain, no gain” attitude permeates the American culture. I am tough; I can take it. Boys do not cry. Women are willing to make sacrifices. Some say, “I can wait.” “I am fine.”
Years ago, while writhing in pain, sweat poured from every part of my body. Although I am often cold and covered in clothing, I took every garment off,. The fabric irritated my flesh. I curled up into a ball. My hope was this primal position would relief the distress. Oh, to return to the womb, or perhaps perish. Either would be better than what I experienced. I lay on the floor. I moaned; I groaned. None of this is “normal” for me. After a time, the heat that rose from my torso diminished. The ache in my abdomen did not.
Suddenly I had chills. I felt frozen. I covered myself in down. I moved, stayed still. Nothing lessened the sting, the sensation, or the unimaginable, intolerable torment that came from within. I moved to a hammock. The loose support I though might reduce the misery. It did not.
Finally, after seven hours I called my family physician. A pre-existing condition, another unrelated affliction was the reason I knew of a doctor to telephone. The other ailment was also a reason I feared I would not qualify for medical insurance coverage. That aside, my internist suggested I call the paramedics. I could not. I was able to dial 911, just as I had my doctor. However, I knew if I asked for assistance from a medical service, there would e a charge. I could not afford that.
Hours more passed. I fell in and out of consciousness. Nine hours after the first twinge I realized I must seek help. Nine-One-One to the rescue, or so I hoped. The emergency medical transporters arrived. They drove me to the nearest hospital. All I could think of was the cost. The recompense to drive my aching body less than a mile down the road was approximately one thousand dollars. Of course, I would be remiss if I did not state, the paramedics monitored my blood pressure before we drove off. There is more to this story. The details, drama, and trauma abound. I might tell other tales instead. However, I use this one only to illustrate the depth of reluctance to request medical attention when an individual has no insurance.
Many have a narrative to offer. Anecdotes, such as this, in America, are not uncommon. We, as a nation know there are problems with the current system. We have understood this for years. Television, radio, and written reports are abundant, and were long ago, long before this dialogue that aired in 2002.
Gwen Ifill: Today’s new census report boils down the health care affordability crunch into cold, hard numbers. The number of Americans without health insurance keeps rising, but last year so did household income. Here to discuss the reasons why and the policy implications of these findings is Susan Dentzer of our Health Unit. The unit is a partnership with the Robert Wood Johnson Foundation.
So, Susan, a 5 percent increase in the number of uninsured, why?
Susan Dentzer, News Hour Health Correspondent: Gwen, what we see is that, five years into an economic recovery and expansion since the recession of 2001, and six years of rising health uninsurance numbers, we see that basically what’s happening is the performance of the economy and workers’ wages and what’s going on in health insurance are wildly different tracks.
Health insurance premiums are still rising about 7 percentage points a year; that’s more than double workers’ wages and more than double the rate of inflation. So, what’s happening is that health insurance is becoming increasingly unaffordable for many Americans. Concomitant with this, many businesses are dropping health insurance coverage because they find it unaffordable.
Gwen Ifill: So it’s unaffordable for Americans and for the people who they work for?
Susan Dentzer: Exactly, for businesses who are in many cases providing, contributing towards that coverage. In fact, in this most recent set of data, we see that fewer than 60 percent of workers now are covered by employer-provided insurance, 59.7 percent.
So, what’s happening is that health insurance is becoming more expensive, less affordable. Employers are dropping coverage. And as a consequence, what we see out the other end is 2.2 million more Americans uninsured in the most recent year, a total of almost 9 million more Americans now uninsured since 2000.
Affordability problems remain
Gwen Ifill: But the same time, in the same report we hear that household income has gone up. So, doesn’t that make it more affordable?
Susan Dentzer: Well, it’s gone up modestly. The real median income rose in the most recent period measured — again, this was from 2005 to 2006 — by 1.1 percent to $48,500. But again, a 1 percentage point real increase in incomes doesn’t come anywhere near making a 7 percent compounded rate of growth of health insurance more affordable for families.
And in particular, we see this happening now, not just in low-income households, where it’s very difficult to afford — the average family health insurance policy now is pretty close to $12,000 a year. Imagine a family earning $48,500 affording $12,000 a year. But when you look even higher up the income scale, 1.4 million of the people who became uninsured in this most recent period had incomes of $75,000 and more, household incomes.
So it says that even higher-income families now are having enormous difficulty affording insurance and likely to be working for employers who are dropping coverage.
Still we sit settled with what is. We, as individuals, do not wish to show our worry, our fears, or our shaky status. The thought of what might occur, if we allow ourselves to think of our personal situation, might drive any of us insane. Mortality may be on the minds of those without coverage. However, unless there is a need to speak of such, why would we? The fact that I did not have indemnity against illness or injury was not a subject I felt at ease to discuss.
The idea of a life threatening illness deeply effects those that have what they hope is adequate medical care. In truth, most of us know of someone, who lost his or her life savings to illness. The cause for half the bankruptcies in this nation can be traced back to medical maladies.
I could site the statistics with glee. I trust if you chose to, you too could offer chapter and verse. There are facts and figures aplenty. Formulas and figures may vary greatly depending on the source, the situation, and sadly, the scheme that the spokesperson wishes to promote. Nevertheless whichever truth we wish to adopt there are statistics to share.
I know if we engage an exchange of raw information it is merely an intellectual endeavor. For decades, in discussions with those I did not know well, data helped me maintain distance. I dared not state what was my truth. I had no health insurance. I can vouch for the validity of these figures. For this is, was, and I fear may be my life forever and a day.
The number of people without health insurance was 46.6 million in 2005, compared to 45.3 million in 2004, and 41.2 million in 2001 (see table below). The percentage of Americans without insurance rose to 15.9 percent in 2005, higher than the 15.6 percent level in 2004 and much higher than the 14.9 percent level in 2001. The percentage of Americans who are uninsured rose largely because the percentage of people with employer-sponsored coverage continued to decline, as it has in the past several years. The percentage of children under 18 who are uninsured rose from 10.8 percent in 2004 to 11.2 percent in 2005, while the number of uninsured children climbed from 7.9 million in 2004 to 8.3 million in 2005, an increase of 360,000. Lack of insurance is much more common among people with low incomes. Some 24.4 percent of people with incomes below $25,000 were uninsured in 2005, almost triple the rate of 8.5 percent among people with incomes over $75,000.
This is the slant Americans wish to accept. The problem is greatest among the poor. If we focus on the failures of the pitiable, blame the people that we wish to believe have not worked as hard as we have, we can ignore the essential truth. The gap between $25,000 and $75,000 is large and perhaps, this gorge is where millions of uninsured live.
Average families, with children are severely affected by the current health care crisis. The Number of Uninsured Children Rises. “Census Figures Show 8.3 Million Youths Lacked Health Coverage in 2005.” Two, almost three years later, the figures are higher. In 1997, Congress created the State Children’s Health Insurance Plan. The intent was to provide health coverage for children whose families do not qualify for Medicaid but cannot afford insurance on their own. Often these families have incomes that far exceed the poverty level. While the program was popular for well over a decade, the number of uninsured children swells.
The most potent force behind the recent increase in uninsured children, experts said, is the decline in employer-sponsored health insurance as rising costs prompt businesses to raise premiums or cut coverage.
The latest census figures show that a record 46.6 million Americans had no health insurance in 2005, up from 45.3 million in 2004. Among those who did have coverage, fewer were receiving it through their jobs. In 2001, for instance, 62.6 percent of Americans had employer-sponsored coverage. By last year the figure was 59.5 percent, census figures show.
Politicians do not wish to discuss the depth and details of this scenario or those that surround it. People at every income level are losing health insurance coverage. Adults and children are affected by the inefficient and expensive system. Medical service providers place profits above people. Monetary concerns dictate more than a desire to care.
Days ago, George W. Bush justified his intent to veto a Bill that would help provide health care for those most in need. Our dependant children, the little ones, those sweet souls that are our future, and may be reminiscent of our past, apparently, according to the President are too costly.
As mothers and fathers unexpectedly lose their health care coverage, we continue to deny the dilemmas that affect our society. Americans are in dire straits.
If we are to be honest as we assess our circumstances, we must acknowledge that those mothers and fathers who bring home salaries of 75,000 are frequently no longer able to live a comfortable life. Permanence is a precarious term. The expression “benefits” belies the truth that many of us live with. Penury, is but a pay check away. While thirty-seven million people, or about one in eight Americans live below the poverty line, the number of uninsured Americans rose by more than 1 million people. This includes more than 360,000 children added to the rolls. The presumed new total of uninsured person in 2006 is 47.5 million, give or take.
Ray Suarez: For a closer look at the growing numbers of the uninsured, I’m joined by our health correspondent, Susan Dentzer.
And, Susan, unemployment has remained low. Household income ticked up slightly. So why that increase in the number of uninsured?
Susan Dentzer, NewsHour Health Correspondent: Ray, I think what it says is that having a job in America is increasingly becoming detached from the question of whether or not you have health insurance.
We see now, as you said, economic recovery since 2001 has created numbers of new jobs. But, in fact, it hasn’t necessarily translated into more coverage for many people and, in fact, quite the opposite.
We see employment-based coverage continuing to crumble, and that’s the real story of the rise in the health un-insurance numbers that were released yesterday, that the number of people who became uninsured, 1.3 million, the driving force behind that was the loss of employer-based coverage in the private coverage market.
Ray Suarez: Is there such a thing as a typical uninsured person? Or has a lot of that growth come from one kind of worker?
Susan Dentzer: Well, what we’ve known for a long time is that four out of five people without health insurance are workers or in families where somebody is working full time. So the vast majority of the uninsured have, for a long time, been working people, primarily lower paid people, and also, to a large degree, Hispanics and, to a lesser degree, blacks.
But what we saw most recently — and in 2005, the numbers released yesterday bear this out — increasingly we’re seeing also a loss of coverage in households and families earning $50,000 a year and more, in the middle class. And so, that shows that the loss of coverage really is hitting a broad swath of American workers.
It’s tending to be workers who are working for small businesses, people who are working in kind of cyclical-driven industries that go up and down with the economy. But by and large, it’s hitting a broad swath of workers. And the driving force behind that is the cost of health insurance coverage.
Care for single persons soar. For Moms and Dads the price of health care is high. Children, while wonderful, are a costly commodity. The truth of this is more evident when we concede, jobs are not secure. Even careers rarely last a lifetime. Home loans are hefty. The price of gas, food, and the attire needed for work alone is outrageous. Play money? What is that. Little is discretionary; less is disposable. Dollars are tight. Each expense increases daily. The cost of living coupled with the fact that employers are no longer willing to bear the burden of benefits makes what was once a sizable income barely adequate.
Medical care co-payments alone can contribute to an impending crisis. Prescription disbursement can be dear. Pills are pricey; injections exorbitant. The family budget in America today is fragile enough. Additional expenditures for health care seem unnecessary in comparison to other considerations.
We resign ourselves, for most of us know not how to stop what politicians endorse. As political campaigns progress and people posture, I realize I needed to reveal more than I wished to. I thought to broach the discussion more than a year ago, and I did, although, in truth, I was evasive. Each time I read statistics on the tens of millions Americans who are uninsured I am not surprised. You, dear reader many have noticed as I frequently have, the numbers vary greatly depending on the source, the situation, and sadly, the scheme
In February, Presidential hopeful John Edwards introduced his health care plan. Many Americans cheered. Finally, someone was willing to discuss Universal Health Care.
I understand Edwards may have been first to offer a “health” plan; however a “first strike” policy, is not always best. We must realize if we adopt his plan or Clinton’s, nothing will change. Big businesses will still control the health care community. Might we read what John Edwards expressed as he documented his plan. I share a snippet from the John Edwards website. I think you might find it informative. There is often more than initially appears behind the rhetoric.
Choice between Public and Private Insurers: Health Care Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan.
In the Iowa debate, held September 20, 2007, candidate Edwards explained he must endorse the agenda Hillary Clinton proposed. It is virtually identical to his agenda. Bravo! I admire the admission. Undeniably, I do not embrace either proposal. Hillary insists we must all have medical care coverage. Can she imagine what a strain that might put on persons such as I, In the past and now, discretionary income is not part of my repertoire. I am unsure how to define “disposable” dollars. Are these the pennies that I accidentally drop and then scrounge around for as I desperately attempt to pay my bills. Perchance, a NewsHour discussion might help to explain.
The costs
Ray Suarez: Well, you talk about this affecting even higher than the median-income workers. If they wanted to buy their own health insurance, what are we talking about as the cost to buy health insurance?Susan Dentzer: The average health insurance premium for a family now exceeds $11,000 a year. It’s higher than the earnings that you could earn, earning a minimum-wage job. It’s about a quarter of that median family income, so it’s a huge, huge dent in the pocketbook.
And it’s because of that rising cost that so many businesses are dropping coverage. Just since the year 2000, according to a survey done by the Kaiser Family Foundation, we’ve lost about — it’s gone from about 69 percent of employers offering coverage to their workers. We’re now down to about 59 percent, just in the period since 2000.
And, again, the reason by and large has been the cost of health insurance. Although the cost is growing now at a lower rate than it was earlier in this decade, it’s still growing annually at about two to three times the rate of inflation overall.
And for some small businesses, premiums can still go up 20, 30, 40 percent a year. That’s pushing a lot of businesses out of the business of offering health insurance to their workers. And to the degree they pass those costs along to workers, sometimes workers are passing up the coverage that is offered to them by their firms.
Ray Suarez: Now, even with those rising costs, if you look at where the action has been on answering the needs of the uninsured, in state legislatures and national government, there’s been a lot of emphasis on children, yet this time we saw 361,000 more children uninsured. Why?
Susan Dentzer: And that’s exactly what makes these numbers so troubling to so many people. Since 1997, as you said, when we enacted the State Children’s Health Insurance Program, coverage has mostly been growing for kids. The deliberate efforts on the parts of states to reach out to low-income families and pull children into both SCHIP coverage, as it’s known — State Children’s Health Insurance Program — and Medicaid.
What seems to have happened in the last couple of years is that states have reversed that. There are fewer outreach efforts; there are more barriers being erected to enrollment of people in those programs.
In some instances, it’s cost — there are deliberate efforts to make it harder to re-enroll once you’re already enrolled in the programs. So the net effect seems to be pushing people, children in particular, who are qualified for these programs out.And that’s especially troubling, because we know that there are probably 4 or 5 million uninsured children still out there who are qualified for these programs but not enrolled. So to the degree we’re adding to the pool of people that are qualified but not enrolled, it’s a serious problem.
Life tells me that as long as medicine is business, we, the people, human beings whose existence is fragile, will be viewed as nothing more than consumers.
I long for a planet where people embrace the construct of mans’ humanity to his fellow man, woman, and child. As the Presidential aspirants attempt to convince us that they are not affected by the financial agendas of their supporters, I sigh in frustration. My own emotional reaction to such duplicity leaves me lost for words. Thus, I turn to Jamie Court. I cannot explain my concerns better than Mister Court did in a recent editorial. I invite your review of the commentary aired on Market Place Morning.
Jamie Court: What do Mitt Romney, Arnold Schwarzenegger and Hillary Clinton all have in common? They all support the government forcing the middle class to buy a private health insurance policy — but none want to limit how much insurers can charge or spend.
And that’s the problem. Mandatory private health insurance proposals are all stick and no carrot.
The average health insurance premium for a family of four is just over 12 grand per year. What middle-class family making, say, 60,000 bucks per year can afford that bill?
What we need is the carrot of affordable health care. That means government standardizing charges by insurers, doctors, hospitals and drug companies. No more $6 Tylenol in the hospital.
The reason health insurance is so unaffordable today is that no one is watching the costs. With standardization, insurance would be cheaper and people would want to buy it — not have to because the government is threatening them with a tax penalty.
Oh wait, I can hear the plaintive cry of the free market. You can’t tell a doctor, insurer, hospital or drug company what’s reasonable to charge. That’s socialism. Well, how reasonable then is it to tell every American you have to buy a product whose cost is obscene if you want to be a U.S. citizen? Isn’t that corporate socialism?
Mandatory health insurance is a government bailout of a free market that’s failed its customers. Fewer people and employers are buying private health insurance because it costs so much more and delivers so little.
So rather than let customers demand a new and better product, politicians are forcing us to buy it. Whatever happened to creative destruction?
There’s a business plan of course. Mitt, Arnold, and Hillary each received six or seven-figure campaign contributions from the insurance industry. The plan is insurers send the bill and we have to pay it.
Jamie Court is president of the Foundation for Taxpayer and Consumer Rights.
We might look at the Obama plan; however, few think his agenda meets the needs of the growing uninsured population. More than one pundit or publication has stated the Obama “program” is sparse on substance and broad on rhetoric. For some, a careful read of the details, reinforces a need to question. Answers are not forthcoming in the Obama agenda.
Obama, who is among the front-runners for the Democratic presidential nomination, offered few new ideas in laying out his plan to expand health insurance and to greatly reduce health-care costs. Instead, he cast his proposal in the themes that have defined his candidacy: optimism and a desire to move beyond partisan politics. He offered ideas that have long been proposed to solve one of the country’s most vexing problems: increasing subsidies for those who cannot afford insurance but do not qualify for public programs, spending more federal money on disease prevention and making health records electronic.
Personally, the only Single Payer Plan which Dennis Kucinich presents speaks to me, the common person. As I peruse a commentary that compares and contrasts the essence of each proposal, I believe the essential concerns are covered in the Kucinich proposal. I am not alone in this view.
Kucinich is right on healthcare
By Derrick Z. Jackson
Boston Globe
August 29, 2007Dennis Kucinich rarely gets much airtime in Democratic presidential debates. That was underscored recently when ABC’s George Stephanopoulos called on him in an Iowa forum to talk about God. Kucinich said, “George, I’ve been standing here for the last 45 minutes praying to God you were going to call on me.” . . .
With poll numbers at 1 or 2 percent, the Ohio congressman is the nudge kicking at the knees of the Democratic Party to offer more than incremental change. He deserves more attention than he gets. On healthcare, he says what Americans believe, even as his rivals rake in contributions from the industry.
In a CNN poll this spring, 64 percent of respondents said the government should “provide a national insurance program for all Americans, even if this would require higher taxes,” and 73 percent approve of higher taxes to insure children under 18. Those results track New York Times and Gallup polls last year, in which about two-thirds of respondents said it is the federal government’s responsibility to guarantee health coverage to all Americans.
Such polls allow Kucinich to joke that, far from being in the loony left, “I’m in the center. Everyone else is to the right of me.” More seriously, in a recent visit to the Globe, he accused the other Democratic candidates of faking it on healthcare reform.
“One of the greatest hoaxes of this campaign — everyone’s for universal healthcare,” Kucinich said. “It’s like a mantra. But when you get into the details, you find out that all the other candidates are talking about maintaining the existing for-profit system.”
‘Tis true; as long as health care remains in the hands of big business, the Pharmaceuticals, Insurers, Health Maintenance Organizations, and Preferred Providers will continue to profit. If we embrace the Edwards, Obama, or Clinton plan, health care costs will continue to rise. The quality of services will deteriorate.
Granted, I hear the concerns. However, I also understand the research. Dear reader, you may recall the change in health care considerations after the Harry and Louise advertisements were aired. This provocative and cute commercial funded by the Health Insurance Association of America [HIAA] altered public opinion. Citizens ready to embrace Universal Health Care proposals were convinced the possibility was nothing but a problem.
Few welcome change. Thus, it is easy to accept a fictional anecdote that helps affirm or remind us, our life is “pretty good” or at least good enough, and indeed, it is for those with excellent health care coverage. However, that benefit is fragile.
In my own life, on many occasions, I spoke with individuals that live elsewhere. Those in countries that provide universal health care to all citizens may complain in a moment of frustration. Nonetheless, when they compare their circumstances with those in America, they rejoice.
One unfortunate soul, mentioned a family member became ill while on vacation in the States. She shared horror upon horror. The hospital was ill equipped to care for her kin. The charge was beyond anything she and her relatives could comprehend. They could not possibly afford to pay the bills. After she told the tale, she explained, her family decided they have no desire to travel to America again. To politely paraphrase the assessment this native of another nation, the health care system in America is ‘heartless, ‘inhumane,’ and the costs were ‘extremely inflated.’
Indeed, the price and the problems connected with receiving reasonable health care are daunting. Steve Burd, Chairman, and Chief Executive Officer of Safeway supermarkets learned this from personal experience.
(The younger Burd) he works hard to keep in top physical shape. But because he injured his back a few months ago, and received cortisone treatments for it, insurance carriers have been turning down his insurance applications.
Most likely, Burd’s son will be just fine. One of the perks of being a nationally prominent C.E.O. is that you tend to know other C.E.O.’s, including those who run insurance companies. Burd has sent off a few pointed inquiries, and, he told me with a grin, he’s pretty sure one company or another will find a way to write a policy for his son. But Burd has also taken note of the experience: it’s just one more sign that American health insurance doesn’t work the way it should.
Burd understands corporate America can no longer endorse plans that keep health care in the hands of industry. Burd may be thought a maverick; however, this industrialist is not the only individual to act on his concerns. In April, Steve Burd stated . . .
(H)e expected dozens of companies to join a nonprofit advocacy group.” Burd declined to reveal their names or the exact number of corporations participating. He did say that they represent a broad swath of corporate America and that all will be known when the group goes public later this spring.
Burd also confirmed that one of the coalition’s officers in Washington will be the longtime Republican Party operative Ed Gillespie — whose presence in an organization explicitly endorsing “universal health coverage,” as the coalition’s founding principles do, would seem about as likely as the presence of George W. Bush himself, whose disdain for anything resembling “government-run health care” is a matter of public record.
By May, an Alliance comprised of thirty-six [36] large businesses was busy at work. While the details of how to best provide universal health care are still being debated, there is a common consensus among eighteen [18] of the largest Fortune 500 companies within this group.
Most of the member companies provide health insurance benefits to workers but are becoming concerned about rising premium costs. In its statement of principles, the coalition wrote, “By next year, the average Fortune 500 firm will have a health care bill that exceeds its net income.”
Hence, we may conclude, as in years past, those now content with their employer paid health benefits , may not have these “luxuries” in the near future.
Circumstances were bad five years ago. They are worse now. Those elated by the notion that the Clinton, Edwards, or Obama plan will not force them to forego their coverage may wish to contemplate, there is more to consider. As the clock ticks on, and coverage for the masses and even the classes flies the coop, I ask. How long might it be before you, the wealthy he, or the affluent she is I, me?
Insurance Woes, the Words, and Data . . .