This was in the NY Times today. I am tired of listening to people here say stupid things about healthcare reform. This woman at the bank a few days ago was going from person to person saying that she "didn't want government to take away her insurance" from what I've seen the insurance splits here are pretty shitty. In Cali most businesses pay 80% and you pay 20%. Its a tax deduction for them. I've listened to other people say that we will have to stand in line for visits to the doctor. Thats absurd. Stop drinking the Fox "News" koolaid.
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Health Care Realities..
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Published: July 30, 2009
At a recent town hall meeting, a man stood up
and told Representative Bob Inglis to “keep your government hands off
my Medicare.” The congressman, a Republican from South Carolina, tried
to explain that Medicare is already a government program — but the
voter, Mr. Inglis said, “wasn’t having any of it.”
It’s
a funny story — but it illustrates the extent to which health reform
must climb a wall of misinformation. It’s not just that many Americans
don’t understand what President Obama is proposing; many people don’t
understand the way American health care works right now. They don’t
understand, in particular, that getting the government involved in
health care wouldn’t be a radical step: the government is already
deeply involved, even in private insurance.
And that government involvement is the only reason our system works at all.
The
key thing you need to know about health care is that it depends
crucially on insurance. You don’t know when or whether you’ll need
treatment — but if you do, treatment can be extremely expensive, well
beyond what most people can pay out of pocket. Triple coronary
bypasses, not routine doctor’s visits, are where the real money is, so
insurance is essential.
Yet private markets for health insurance,
left to their own devices, work very badly: insurers deny as many
claims as possible, and they also try to avoid covering people who are
likely to need care. Horror stories are legion: the insurance company
that refused to pay for urgently needed cancer surgery because of
questions about the patient’s acne treatment; the healthy young woman
denied coverage because she briefly saw a psychologist after breaking
up with her boyfriend.
And in their efforts to avoid “medical
losses,” the industry term for paying medical bills, insurers spend
much of the money taken in through premiums not on medical treatment,
but on “underwriting” — screening out people likely to make insurance
claims. In the individual insurance market, where people buy insurance
directly rather than getting it through their employers, so much money
goes into underwriting and other expenses that only around 70 cents of
each premium dollar actually goes to care.
Still, most
Americans do have health insurance, and are reasonably satisfied with
it. How is that possible, when insurance markets work so badly? The
answer is government intervention.
Most obviously, the government
directly provides insurance via Medicare and other programs. Before
Medicare was established, more than 40 percent of elderly Americans
lacked any kind of health insurance. Today, Medicare — which is, by the
way, one of those “single payer” systems conservatives love to demonize
— covers everyone 65 and older. And surveys show that Medicare
recipients are much more satisfied with their coverage than Americans
with private insurance.
Still, most Americans under 65 do have
some form of private insurance. The vast majority, however, don’t buy
it directly: they get it through their employers. There’s a big tax
advantage to doing it that way, since employer contributions to health
care aren’t considered taxable income. But to get that tax advantage
employers have to follow a number of rules; roughly speaking, they
can’t discriminate based on pre-existing medical conditions or restrict
benefits to highly paid employees.
And it’s thanks to these
rules that employment-based insurance more or less works, at least in
the sense that horror stories are a lot less common than they are in
the individual insurance market.
So here’s the bottom line: if
you currently have decent health insurance, thank the government. It’s
true that if you’re young and healthy, with nothing in your medical
history that could possibly have raised red flags with corporate
accountants, you might have been able to get insurance without
government intervention. But time and chance happen to us all, and the
only reason you have a reasonable prospect of still having insurance
coverage when you need it is the large role the government already
plays.
Which brings us to the current debate over reform.
Right-wing
opponents of reform would have you believe that President Obama is a
wild-eyed socialist, attacking the free market. But unregulated markets
don’t work for health care — never have, never will. To the extent we
have a working health care system at all right now it’s only because
the government covers the elderly, while a combination of regulation
and tax subsidies makes it possible for many, but not all, nonelderly
Americans to get decent private coverage.
Now Mr. Obama
basically proposes using additional regulation and subsidies to make
decent insurance available to all of us. That’s not radical; it’s as
American as, well, Medicare.