The following editorial is from www.Courier-Journal.com.
By now it is almost a cliche to say that America’s health care system is broken. In response, many politicians who are calling for “reform” and “universal health coverage” are not, in fact, clarifying the situation because they include in their new plans the very elements that have busted the system. So the political battle in the first days of 2009 will be over “token reform” or a bold, truly universal type of health insurance.
The challenge is for citizens to get involved. the public must do its part by educating itself about the various alternatives, and letting their representatives in Washington know what they conclude.
How broken is our current system?
Some 47 million Americans are uninsured; another 50 million are underinsured (not fully covered).
About 8.7 million children are uninsured.
Most bankruptcies have a health reason as a major cause, and 68 percent of those people who have gone belly up do have health insurance policies.
The World Health Organization ranks the level of U.S. health care at 37th in the world.
Private health insurance companies, which have doubled the premiums since 2000, have a bureaucratic overhead of 28-31 percent while Medicare operates at 3 percent efficiency. Therein lies a large part of the problem. These companies have an incentive to reduce benefits to patients.
The most persistent solution on the grassroots level is a single-payer system, the single payer being the federal government. This program involves a Medicare-type approach for everyone, but it would be expanded to include dental care, vision care and preventive programs. Overall, it would cost about the same — maybe a little more, maybe a little less — as the present 15 percent of the Gross National Product (GNP). All other industrialized nations with full coverage for all citizens average about half the costs in total medical care.
A single-payer system is best outlined in congressional bill HR676, which would set up the National Health Insurance (NHI) program. What it is not is “socialized medicine.” England and Spain have socialized medicine, wherein the doctors and hospitals are all employees of the federal government. Under HR676 the present system would stay; doctors would remain private vendors and would submit their bills to one payer, the U.S. government, not to the 1,500 private health insurance companies. Patients would still choose their doctors. (More about HR676 later)
Is a single-payer system just the blue-sky proposal of some Washington, D.C., think tank? Not by a long shot. It is the work product of Rep. John Conyers and has 90 other congressmen as co-sponsors. This is about one in five House members. Also endorsing HR676 are the U.S. Conference of Mayors (a nonpartisan group of 1,100 members), Physicians for National Health Care Program (more than 10,000 doctors), League of Independent Voters, the United Church of Christ and the United Methodist Board of Church and Society, 32 city councils (including Louisville, Indianapolis, Baltimore, Detroit and Boston), 14 national and international labor organizations, the American Medical Students’ Association, the National Family Farm Coalition and more.
There was a time when the doctors would (and did) kill any national health care plan in the womb. Today a solid 59 percent of U.S. physicians now support national health insurance. Particularly strong on the issue are psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general internists (64 percent) and family physicians (60 percent). Doctors and hospitals have to employ huge staffs just to process insurance claims from a multiplicity of insurance firms. About 20 percent of private doctors’ income goes to pay for this staff.
Businesses are now leaning toward a national program. The Business Coalition for Single Payer Healthcare in New York (www.BusinessCoalition.net) poses this scenario: “If you own a small business with a $100,000-per-month payroll, your health care costs can be reduced from typically $15,000 per month to just $3,300 — from 15 percent to 3.3 percent of wages, a savings of $140,400 per year.”
General Motors, which says health care adds at least $1,500 to each car, is paying people to leave their jobs so they can hire replacements at 50 cents on the dollar with reduced health benefits. This may help the bottom line and the company can compete better, but it is a sad commentary on the state of American health care, especially for the newest of workers.
Neither of the two major presidential candidates favored a single-payer program. Democrat Barack Obama comes up with a halfway reform that includes the insurance companies in the mix. His plan would offer help to nearly half of the uninsured people and would cover all children. Republican John McCain’s plan was only a small reform that features a tax credit plan of $5,000 for a family. This wouldn’t come close to paying a normal $12,000 premium for family health care. And the McCain plan, from some analysts’ viewpoint, would offer help to only about 4 to 5 million uninsured people.
Neither Republican nor Democrat solutions take advantage of the tremendous savings realized from eliminating the waste in the private health insurance industry. This waste alone, by the estimates of several studies, would pay for health coverage for all of the uninsured. More than several states have tried systems of mandating and subsidizing policies from insurance companies. Minnesota, Tennessee, Vermont, Washington and Massachusetts have learned the hard way in failing to fix the system by including the health insurance industry.
Where else would the money come from to support a national program? HR676 calls for a modest payroll tax on all employers and employees of 3.3 percent each, in addition to a 1.45 percent tax that they are already paying for a total of 4.75 percent each. Also there would be a 5 percent health tax on the top 5 percent of income earners and a 10 percent tax on the richest 1 percent . A small tax on stock and bond transfers is also envisioned along with the closing of corporate tax loopholes and repealing the Bush tax cut for the highest 1 percent of income earners.
When you subtract the cost of insurance premiums, the deductibles and the co-pays, most businesses and most people would pay less for national health care than they do today. Even if the cost did go up some, the coverage would be much broader and medical needs would be met much more easily.
What we are learning is that the United States is all alone among its peers in the whole world. This is the only country that treats health care as a commodity distributed according to ability to pay, rather than as a social service distributed according to medical need.
The challenge is to get fully informed citizens involved in changing things for the better.
DAVID ROSS STEVENS
Mr. Stevens is a member of the Southern Indiana branch of Hoosiers for a Commonsense Health Plan (whose Kentucky counterpart can be reached at www.kyhealthcare.org).