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Yahoo!Winston Churchill noted that Americans always do the right thing, after they have tried everything else first. We are well on our way to doing just that as we struggle to make healthcare affordable and available to all.
Consider one magic-wand approach: If we make everyone buy health insurance, we will eliminate the uninsured. But pay no attention to the evidence that 25 percent of drivers are uninsured despite current mandatory auto insurance laws. And Massachusetts is discovering that the premiums needed to run this type of system using private insurers are unaffordable for 25 percent of the population the state expected not to have to subsidize.
Another magic wand solution is getting all the eligible kids enrolled in public programs for which states pay only half or less of the cost. Has anyone heard anything about excess federal and state funds being available to fund this approach? My understanding is that there is a mighty struggle just to preserve the current coverage for low-income children.
Then there is the “confuse them with choice” approach. This is the method undertaken with Medicare Part D. We pretend to solve the drug price problem by offering an array of plans whose formulary can change, whose prices still far exceed those of other nations, and which herd people into HMOs that are costing the Medicare system 15 percent more than the fee-for-service plans.
Lastly, there is the “let’s pretend” approach, as in “Let’s pretend that people can self-diagnose accurately enough to know when they really need to go to the doctor or to the emergency room.” Included in this category is the notion that if you have to pay a $30 co-pay or a $1,000 deductible, your utilization of medical services that turn out to be unnecessary will decrease. Unfortunately, co-pays, deductibles, and other out-of-pocket costs also decrease usage of necessary medical services, often leading to more expensive treatment for a more advanced stage of a disease.
The “let’s pretend” approach also ignores the fact that 80 percent of the healthcare budget is spent on only 20 percent of the population with serious or chronic diseases. The pretend part here is that you are going to save significant amounts of money by discouraging people from accessing health services for minor conditions.
These are but a few of the many side roads taken off the path to a sensible, sustainable, and affordable health system. It took 50 years to get Medicare enacted, and only then because 70 percent of the over-65 population was uninsured. But rather than expand on that single-payer universal model to include everyone, we have fragmented the system until the cost of administering it has grown to 30 percent of the healthcare dollar. For example, the cost of administering private health insurance grew by 143 percent, from $81 billion to $143 billion, between 2000 and 2005, while the number of privately insured shrank by 2 million people. Employment at health insurance companies grew by 31 percent during that same time. As an editorial in the February 6 St. Louis Post-Dispatch said, “… getting people into private health plans isn’t the long-term solution to America’s healthcare problem. It IS America’s healthcare problem.”
Change will come as more of those who are hurt by the present system join grassroots movements demanding real reform. Today, on Thursday, June 7, you have a chance to demand change, as the OneCareNow 365-City Campaign for single-payer universal healthcare will hold its 300th consecutive event. Meet at De la Guerra Plaza at 5 p.m., and then march up State Street to the County Courthouse for a short rally and speeches beginning around 6.
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For more information, call 682-5183, email pconnt43@cox.net, or visit onecarenow.org.
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