A friend said yesterday that she would rather pay the high health care premiums than try to figure out the issue as it was just so mind boggling complex. I know many here are in agreement with that feeling, even if they would rather keep the money. I'll try to keep the numbers simple, understandable, and interesting.
The question always arises as the number one question. If we are to have universal health care, preferably single payer, how can we pay for it? Aren't we already having trouble paying for the entitlements we already give? The answer on how we pay is very simple. We are already paying for it. We just aren't getting it.
One of the things that private health insurance does is they work very hard to get sick people out of their system. They don't even want people who are at risk of being sick. They are mostly successful at this. The people they insure tend to be the young adult population who are fit enough to work full time.
The old get Medicare, paid for by taxes. Those in the riskiest line of work, war, get the Veteran's Administration, paid for by taxes. The poor get Medicaid, paid for by taxes. Then we have those who are employed by the Federal Government, the States, the County, the towns. Their health insurance too, is paid for by taxes, although the tax money mostly goes towards the profits of the private health insurance companies. So tax money directly pays for medical care of the highest risk categories. We pay high profit to the insurance companies for the prime, low health risks of public employees. Put all the people together whose health care is paid by tax dollars already and we've got about 60% of the population covered.
That means that private employers are paying for only four out of ten people who are insured in this nation. Despite this, they are paying vastly increasing premiums, increasing far beyond the rate of inflation and they are paying these large sums mostly on the lowest risk population. Insurance companies are basing their premiums on the loss of their investments in the stock market, not on the cost of providing health care. If the government collected the premiums on this population instead of the private health insurance companies, the first thing that would happen is that the costs would go down by 30% due to the excessive amount of money spent by the insurance companies on people hired to deny payments to those they insure. The second thing that would happen is we'd be adding premium money to government funds from the people most likely to pay more into the system than they take out.
As our system exists now, the private companies get to keep the profitable clients and the rest are picked up either by the government directly or indirectly, due to failure of the uninsured to be able to pay. The insurance companies, in their never ending greed, aren't willing to concede that they've had a system rigged to make them rich all these years, count their winnings and leave the table. No, they want the system to continue forever, and are unconcerned with the fact that people are dying needlessly due to their greed. They will fight tooth and nail to keep their cherry picked clients and keep the profits for themselves rather than using this extra money to pay for additional coverage, benefits, or reduced premiums.
They seem to have made progress even with Obama, who has given the great insurance company giveaway when the government decided to pay 67% of COBRA fees rather than take the unemployed and put them on Medicare. Considering that, again, you are speaking of the healthiest, lowest risk population, the cost to the government of putting these people on Medicare might have mostly been nothing. However, no matter how healthy they stay, the insurance companies are getting hundreds per month per person out of the COBRA subsidy. And it is the taxpayer covering the bill.
Faced with increasing health care costs, some policies are becoming too expensive to use, with deductibles in the $10,000 range. This means that the business is paying more, the employee is paying more, and yet they don't actually get health care. Particularly preventative health care. Doctors and hospitals are reporting that even insured people are coming in later in an illness and sicker. Costs of treating such patients can be exponentially more than if they had sought medical care earlier.
Another thing insurance companies do, and are allowed to do, is to tier their premium price to risk factors such as age or previous illness -- so that the premium for someone who is 60 is three times higher than the twenty something who works in the same office. Guess what? This motivates companies to fire or lay off their veteran employees to save money. Age discrimination, anyone? And heaven help anyone who wants a job who has ever suffered a disability much less someone who is presently disabled. They, too, will face discrimination in hiring despite the fact that such discrimination is against the law. This discrimination is supported and upheld by the private health insurance company premium rates. With universal health care, companies wouldn't feel forced to discriminate in their hiring or to fire loyal, long term employees. Business shouldn't have to chose between losing their ability to price their product competitively and having the best employees they can find due to our inability to realize that the private, unregulated health care experiment has proven a failure.
With the rise in employee contribution and deductibles, many who are employed and eligible for benefits no longer can afford health insurance. Yet, they are still paying for health insurance for 60% of the population out of their payroll taxes. They get to pay for health insurance in which they are unable to participate.
We can pay for universal health care so easily with the money already being spent on health care, that we could cover everyone and even pay less than we do now. Premiums, and even those on Medicare pay premiums, could be pegged to income so that families could pay far less than the average 25% of their income that they are paying now to get covered. Doctors could put their resources into delivering medical care instead of personnel to deal with the endless reams of paperwork and fight for coverage for their patients from the insurance companies, which would bring down medical costs without reducing medical service. The uninsured and the underinsured could get the treatment they need and preventative care, like physical examinations could catch illnesses while it is less expensive to treat. Your doctor could make the medical decisions about your treatment instead of some clerk in an insurance office.
The other cost of our present system where so many are denied treatment either by insurance companies, doctors, or themselves in an effort to save money is that a portion of the population walks around among us with infectious disease. Disease doesn't limit itself to those without insurance. Even the wealthy and celebrities in this nation are threatened by the antibiotic resistant bacteria and other nasty illnesses that an untreated population can spread.
Every day, a few thousand among us declare bankruptcy due to medical bills. These bankruptcies aren't just disaster for those declaring it. They mean that those who sold them merchandise won't get paid for it. That the home on your block becomes foreclosed due to medical bills and drives down the value of your home. That their pets end in shelters or on the street due to the fact that few rentals will take pets. Yet, few among us would choose our homes or pets over the life of someone we love. But in order to keep the profits, our private health insurers would rather say no to those who are ill. They even call payments for medical care "medical loss" So few businesses call the delivery of a product they sold a "loss" but that is the attitude of the private insurers.
If the attitude of the insurers reminds you of the attitude of the bankers with their incentive bonuses, you and I are in agreement. I say, the hell with them. Let's have universal, single payer health insurance now. After all, we've paid enough for it. Call your representatives and let them know that you are a health care voter. Better yet, take out a pen and scrawl an old fashioned snail mail to them. It doesn't have to be long. Representatives think handwritten messages represent far more voters than the phone call or e mail. The private health insurers have raised lots of money to make lots of noise fighting universal, public health care. We have to make even more noise if we want to get good, affordable health care.