There’s a lot of screaming just now. A lot of fear mongering about what might happen if private health insurance must compete with public health benefits. I’ll tell you why I don’t want access to health insurance. I want access to health care.
This is the way health insurance works: The insurance company bets that you will stay healthy; you bet you’ll get sick. Sometimes you’re right and sometimes the insurance company is right, but like gambling in Reno or Los Vegas, the house wins over time. The odds are rigged to ensure that while sometimes the gambler goes home with money, the overall profit is retained by the casino. Insurance has it even better. If they charge too little for insurance in a given period so that profits drop, they simply raise the rates for everyone to ensure they keep their profit margin where they want it—high. This margin is based on a percentage of the amount you spend for coverage. Let’s say they want 10% (or 15%?). Last year, my employer paid over $12,000 a year for my medical insurance. Ten percent of that would be $1,200. But the cost of medical care continues to rise and my insurance costs must rise with them. The insurance company is tracking these costs and soon my medical insurance might cost $14,000. Hey, their profit rises to $1,400. And it didn’t cost them anything to rake in that extra $200. Multiply my premium by the millions of premiums paid each year and you can see why the major lobbying against nationalized health care is coming from health insurance companies. It’s in the interests of insurance companies that the cost of health care continue to rise. The more expensive the care, the higher their profit and they don’t have to do a thing but track their money and raise rates to ensure they stay in business.
I don’t have major issues with paying for auto insurance which protects me from bankruptcy at the hands of litigious drivers, but I do have trouble with the idea of middlemen profiting from my health care. Doctors and nurses, hospitals, medical research, even pharmaceutical companies contribute to the health of Americans. The insurance industry profits from my medical care while contributing nothing. The thousands spent on my medical insurance have nothing to do with my health or lack of health. My insurance isn’t based on my healthy diet, a lifetime of nonsmoking, moderate alcohol intake, no illegal drug use, and regular exercise. I pay the same rate as my coworker who is overweight, has high cholesterol and blood pressure, and type two diabetes—though the rate we all pay is based on an average of her health needs and mine and of everyone else in the program. If I get sick and my insurance pays for my care, everyone will pay. And unless someone else gets really healthy, all our rates rise.
The insurance companies claim that nationalizing health care will result in a whole raft of problems—losing access to a chosen physician, long waits for care, etc. etc. But if you’ve ever fought with insurance over coverage, you already know the truth. The insurance company exists to make a profit, not to make you well. The more claims they deny, the better their bottom line. And the higher health costs go, the higher will be the costs of health insurance and higher profits for insurance companies. It’s a win-win for them.
In the mean time, many Americans can’t afford health care at all, much less insurance. And many small businesses suffer from the unfair burden of providing healthcare to their employees, or, when they can’t, must compete with larger companies who can. Medicare overhead costs amount to about 3%; the cost of private insurance plus profit runs up over 20%. Imagine if those private costs went away. My medical insurance would have cost less than $10,000 last year. And then we start negotiating about prescription drug costs with the pharmaceutical companies (an industry with one of the highest profit margins in the nation). Though we rank low in overall health compared to other nations, we pay more for it than anyone.
If America has the strength to take over health care, we’ll also have the strength to demand that it cost us less. Canada, for example, pays 40% less that we do for health care and Canadians live longer, healthier lives. Am I supposed to believe that Canadians are naturally 40% healthier and less susceptible to illness. No, their drug costs are lower. Is it magic that they pay less and stay healthier? No, it’s simpler. My one personal experience with Canadian health care was an emergency that was handled swiftly, gently, and without cost. My Canadian friends have personal physicians and all the benefits I have with private health care, only it doesn’t cost them anything. Maybe there are problems with the national health care systems in all of Europe and most of the rest of the industrialized world. Maybe it’s risky to change—the devil you know, rather than the one you don’t know—but poor people, children, and the elderly have health care under those systems. In America, 44,000,000 people have no access to health care they can afford, and every year the most common cause of bankruptcy is catastrophic health emergencies. A child becomes sick and her parents lose their home paying for care that exceeds what their private insurance allows. The local school throws a spaghetti dinner to help out. Free market? Nothing’s free. But too much is at stake to allow private interests to trump the public good.
So where am I? My employer can pay $12,000 a year for my medical care (a hardship for any small business) or he could pay me a higher salary and I could be taxed more in order to provide medical care for everyone. The Declaration of Independence recognizes the rights to Life, Liberty, and the Pursuit of Happiness. Start with life and ensure that every American has access to what every Brit, Canadian, and Japanese assumes as a right—health care. It’s about life. Just tax me already.