Wednesday, September 19, 2007

National Health Insurance - Again

I heard Richard Viguerie, a right wing figure, speaking of the weaknesses of the Democratic proposals for National Health Insurance in the US. His framing of the problem was telling. He indicated the necessity of creating disincentives (and incentives) for "younger, healthier people" getting more than the cheapest possible health insurance to counter the costs of the more expensive, more comprehensive policies being held solely by presumably: "older, less healthy people".

A good example of this type of pricing differential is visible on the OPM Federal Employees' benefits website ( http://www.opm.gov/insure/health/08rates/2008non_postal_ffs.pdf ) where employees and retirees in 2008 will pay their portions of Higher Option Blue Cross - $314.47/month and GEHA - $401.79/month vs. some lower costs plans that are $163.85 and $189.37/month.

Employees and retirees with high medical needs will likely pay the higher premium plans which have better benefits, while those with perceived lower medical needs will use lower cost plans.

I know as a Man and as a Human Being that I don't look at things and say to myself: "Well, someday I'm likely to have a stroke or get cancer so I should enroll in a most comprehensive health plan Now to cover that possibility."

I also know that when one has a family and one's baby is born with serious complications and lifelong disabilities, one's life is turned upside down. When one develops diabetes or has a stroke (in one's 40's for example) or similar one has a totally different outlook upon medical care. What also is the young adult to do who works hard despite having serious diabetes issues or other medical needs that cost a lot of money.

I am "socialist" in the sense that I believe that medical care is a right! Unless we all share the costs of those whose medical needs are high, we create a system of "haves" and "haves not" totally separate from issues of our socioeconomic class.

In creating a viable National Health Care System we need some important features:

1.) All are covered
2.) The costs both for coverage and for out-of-pocket expenses take into consideration normal incomes and savings. (One can't expect someone with an income of $50,000/year - to pay 25% of their income on medical care - unless they have very large savings perhaps.)
3.) Provisions need to take care of the needs of lower income people,
4.) Cost containment provisions need to be in place that cut the paperwork costs and really help control costs, rather than simply squeezing middle and lower class USians financially.

Tax incentives as most Republicans propose will work logically for those with high incomes, but not for those who lack a high income.

Choice is a good idea, but choice alone - "the free market" - doesn't make health insurance affordable. Health insurance is not "competitive" in important ways.

Thanks!

1 comment:

Eitan said...

The argument I hate most is the the fact that we would be paying the same out of pocket costs, but they would be in the form of taxes. Did anyone deliberate the out of pocket cost to citizens before we invaded Iraq? It's funny to think that people have a mental image of our government being small and efficient when in fact it actually socializes a lot of stuff, like wars and space programs. In it's current budget today, with a small switch of priorities it could easily provide universal health care.