One For All

Go ahead. Everyone who doesn’t really know the meaning of the word, shout the word socialism at the top of your lungs. Come on, get it over with because, whatever the untutored may think, the subject of this post has nothing whatsoever to do with that awful word.

Anyone thinking that national healthcare is somehow related to socialism needs to read some earlier posts on this site. Anyone who thinks that national healthcare is bad must think it’s quite alright for the United States to rank lower than Cuba in health.

Please don’t worry. The right always screams that dreaded word at anything they don’t like or don’t understand. There’s a lot that they don’t like and a lot that they don’t understand. That’s why you hear it so frequently.

Cuba isn’t the only country ahead of us. In life-expectancy, infant mortality and the usual list of health markers we are in a sad and embarrassing state. The last time I checked we ranked 37th and sinking.  Well, as Bush, McCain and Paulson might say, the fundamentals of our healthcare are sound.

Approximately one dollar out of every six goes towards health care. That’s not strictly true. One dollar out of every six goes towards the healthcare industry. That’s not exactly the same. Twenty-four cents of every healthcare dollar goes to administrative costs, not health care.

Administration includes the costs of supporting that multitude of health insurance companies, plus the concomitant costs they impose. The average physician’s office needs the capability to process 70 different insurance forms. The load is such that the average physician’s office is burdened with the expense of extra staff to handle this problem. Now, imagine the paperwork load of a hospital. Twenty-four cents of every dollar – gone. None of that 24 cents goes to health care, your health care.

In fact, the insurance companies actually cause a degradation in health. First, the leading cause of bankruptcy is medical bills. Bankruptcy is rarely beneficial to one’s health.

Preexisting conditions are not covered by those wonderful companies whose commercials you sometimes see on television and in magazines. When possible, they frequently will deny coverage for conditions that were not preexisting.

They also get to decide which treatments they consider non-standard, and therefore not covered, such as bone marrow transplants. The cost of a copay may cause many to defer or skip getting necessary treatment. Loss of a job often means loss of coverage, as the health insurance of most people is through their employer.

People are afraid of change. They are easy prey to the demigods, the public relations machines and the ignorant. They hear all of those horror stories – and they believe them. Let’s start with one salient fact. Polls in all of the major countries show that the populace of these countries overwhelmingly prefer their healthcare system to ours. Why would they prefer their system when our’s costs more than twice as much per person? They must all be crazy. Well, maybe they prefer a greater life expectancy and all of that other stuff.

How much do these other countries pay for administration? Canada, at 11 cents of every dollar, is the highest. The others range down to 5 cents. How does that work? What is it likely to cost here?

For simplicity, let’s think in terms of Medicare for All. The Centers for Medicare and Medicaid Services (known as CMS) is by far the largest purchaser of medical services in the world. In addition to Medicare and Medicaid it also administers the State Children’s Health Insurance Program. How much does it spend on administration? One point eight cents per dollar ($00.018 per dollar).

There would continue to be some minimal administrative costs involved in the operation of physicians’ offices and hospitals. With the CMS cost as the core, there should be no problem matching the 5 cents per dollar of the most efficient systems.

If we only were able to bring the cost down to Canada’s 11 cents per dollar we would have sufficient savings to cover the 47 million now without health coverage. This presupposes everyone paying the same as they presently pay in taxes, premiums and copays. It also presupposes choosing your own physicians and hospitals, just as Medicare now allows. Just think about the additional savings if we bring it down to 5 cents per dollar, a very reachable mark.

If you are required to pay out a certain amount of money, do you care what it’s called or who collects it? I don’t. Call it premiums or taxes or broccoli, it’s still money you must pay. Think about those savings. Think about living longer. Think able being healthier, longer. Think.

Is health care a matter of national concern? I don’t remember the figures but I do remember being staggered by the numbers of draftees medically unacceptable during the Vietnam War. Even lost productivity due to sick days would be significantly reduced if the experience of other countries is any guide.

Disentangling healthcare insurance from employment will eliminate a competitive disadvantage for American companies. It will also allow employees to feel less bound to one company when maintaining healthcare coverage is an important consideration. As the economy worsens, companies are looking for areas ripe for pruning. Health insurance is a low-hanging fruit. Many employees are finding it too expensive or impossible to replace coverage when their employer eliminates that benefit.

So how would this work? Everyone gets a Medicare card. You present it to the physician’s office or hospital or clinic. It could be similar to a credit card. It is only necessary to swipe the card in an electronic reader and cover your copay. The copay could be covered by something I presently have called Medigap insurance.

What about all of those people losing their jobs with insurance companies? How many jobs is one unnecessary death worth? Actually, the estimates are that we have a shortage of 800,000 to one million nurses. That figure will rise when everyone is insured. There will also be more jobs for various techs in the medical fields. These people could be employed actually promoting health instead of degrading it.

This is known as a single-payer system. It is the most efficient system as it puts a far larger percentage of our health dollars into health, rather than administration and profits for those who are detrimental to our national health, bringing us down to 37th. It is the only system that makes any sense. And, it is not socialism. It is rational.

Solving these problems, covering everyone, reducing waste and costs and improving our health, is not the end of it. There are other problems with our healthcare system. While the overall inflation rate may hover around 3 percent, the costs of medical care stays in the double digits. That is not sustainable. That and other problems need to be addressed. A single-payer system will give us a window of opportunity, a breathing space to really attack those other problems.

To your health.

Tagged as: clinton, Health, insurance, single payer, socialism, tax