June 22, 2009
Health Care Imperative
Paul Krugman asks why are the so-called Centrist Democrats so far outside of the mainstream of most Americans? He is much nicer than I am when hearing about the concern the doubting senators who are more concerned about the health insurance industry than the state of the health care access of Americans. When Democratic Senators worry about the lack of competition if the public option is allowed when within their state one single insurance company has 75% of the market, one might think their Senator is looking out for the wrong constituent.
What will destroy our ability to get the healthcare we need are the Democrats that are standing in the way. What the incrementalists need is a dose of reality and smidgen of courage, because voting for real change (and not just a faux change) based in the best evidence we have today has a great potential of delivering something that really helps Americans. Senators who care about policy must be made aware that the reaction of their constituents to their vote will be based on the effectiveness of the reform. It behooves our Senators to be more aggressive in putting in the right changes rather than being so timid that nothing really changes, because the current system in place is devouring our government and will devour every thing in its path if not fixed. Here's how Dr. Gawande described it on Fresh Air last week:
I think our core understanding here that we just have to keep reminding ourselves is that the road we are on is unsustainable. We have the most expensive health care system in the world, we have a system that is destroying our competitiveness as businesses, it is devouring our government, and its leaving 45 million plus people without coverage. We're bankrupting a million people a year and many of them already have health insurance. The sense that we have a great deal to fear from any change can parallelize us, but if we let it, we will be dooming ourselves as individual people who need to rely on the healthcare system, and we will be dooming ourselves as a country.
Our Democratic Senators must understand that not doing enough is more dangerous than doing too much. And if those fiscal scolds want to hyperventilate about the cost, then they need to be sat down and talked to until they truly understand that the cost for all of us will be much, much worse if we do nothing.
Now is the time for change.
Posted by Mary at June 22, 2009 12:57 AM | Health/Medicine/Health Care
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I agree. Health care should be accessible to as many people as possible.
Is affordable health coverage possible in the United States? While many ideas are being shared and argued over in the name of health care reform, it can be next to impossible for the average person to know what the best options for affordable medical insurance are. One idea is to create a publicly funded insurance pool to help provide affordable health coverage to the uninsured. Other people are in favor of the opposite approach - market based policies.
What are Market-Based Policies?
Market-based medical insurance policies look to the private sector for insurance coverage rather than the government. Supporters of market-based policies believe they are the only way to give the consumer control and choice, as well as fostering competition to keep costs down and quality high.
Market-based policies are more cost effective for the government - and therefore the taxpayers- than publicly funded healthcare. According to the Kaiser Commission on Medicaid and the Uninsured, January 2005, if every uninsured individual was covered by a government program such as Medicaid, the cost to the federal and state governments is approximately $2000 each. If, however, low-income and modest-income Americans could purchase their own health insurance by utilizing a $1000 tax credit, the federal government would save 50% of that money. With over 45 million uninsured Americans, that savings would be substantial indeed.
Market-based insurance would not only be more affordable health coverage, it would also provide consumers with more choice. Because savings come from a tax credit, the option to choose insurance companies, policies and doctors is left to the person who purchases the insurance, not a group of politicians. Health insurance needs vary widely from one individual to the next and having the ability to choose the options that work best for an individual's circumstances is fundamental to quality health care.
Several different market-based solutions could help low and modest-income individuals and families find affordable health coverage. Tax credits, tax deductions, health savings accounts and high-risk pools are all market-based options to make affordable medical insurance a reality for uninsured people who are working, but cannot afford medical insurance.
Tax credits allow people to keep more of their income on a monthly basis in their pay so the can purchase coverage. Because tax credits enable people to make their own choices of providers, plans and doctors, they are considered to be a preferred market-based solution for affordable health coverage. Tax credits enable working people to pay for their own health insurance without having to fall back on Medicare or other government health programs. Because a tax credit would cost only half the amount of Medicare per individual, the burden on all taxpayers is also reduced, saving everyone money.
Private health insurance can be affordable health coverage for every working American. By working with market-based solutions, health care reform can be a workable solution to the millions of Americans living in fear of a medical crisis because they have no medical insurance.
While I share your concerns about the multitudes of un and under insured amongst us I just don't think there is the political will to do anything meaningful about this.
Of course it's an issue but are there any congressmen or senators that will lose their jobs if healthcare reform doesn't get through in the short to medium term? Probably not.
Idealism will only get an idea so far. At some point it must starting hitting the decision makers in the wallet, in their own health or at the ballot box for something meaningful to happen
Healthcare reform proposed by the Federal Government may actually eliminate affordable medical insurance from the private sector entirely. While publicly funded healthcare may seem to create affordable medical insurance for more Americans, it may actually create a bigger problem.
Private medical insurance is not the enemy of affordable healthcare in the US. In fact, if the federal government creates another public healthcare program, it will ultimately raise the costs of private medical insurance to exorbitant levels. While the idea of expanded public healthcare may seem to be the answer to affordable medical insurance, it could be the end of private insurance altogether. Medicare and Medicaid, the two public health programs currently in effect, cost private insurance companies - and by extension, Americans paying premiums for private insurance- $88 billion in 2007, according to the consulting group Milliman, Inc. In fact, the average family of four with private medical insurance saw their premiums increase $1500 because of public programs. In California alone, that represents nearly 10% of every premium dollar paid.
The problem comes because Medicare and Medicaid pay as much as 15% to 30% less than private insurance companies on every doctor and hospital bill. Because the doctors and hospitals aren't willing or able to accept this much loss, they push those losses onto private insurance companies, who, in turn, shift the loss to the consumer through higher premiums.
Private insurance companies must not only cover their costs and earn a profit; they also need to maintain a reserve of cash to pay out claims. If a new public health care program is developed and then pays medical costs at a reduced rate like the current systems do, it means there will be an increase in expense shifted onto private insurance to make up the difference. This increased cost will need to be offset through higher premiums for the people covered under private medical insurance plans. As those who have private insurance become forced to pay increasingly higher premiums, the number of Americans who no longer find private insurance an affordable health coverage option will increase. Those people will then need to turn to the newly formed public healthcare program and will then become part of the increased costs passed on to private insurance by underpaid doctors and hospitals.
I'm not sure if Market-based insurance would not only be more affordable health coverage, it would also provide consumers with more choice. Because savings come from a tax credit, the option to choose insurance companies, policies and doctors is left to the person who purchases the insurance, not a group of politicians.
Health insurance needs vary widely from one individual to the next and having the ability to choose the options that work best for an individual's circumstances is fundamental to quality health care.