There's been a lot of smoke and heat over "health care" in recent months, but most of it is only peripherally about health care, mostly it's about health insurance. I'm pretty sure that almost everyone with some sort of health insurance will get better health care than those with no health insurance. So getting everyone covered is a good idea. One, it should actually save money overall if everyone is covered. Two, it might not be a "right" in the Constitutional sense, but, by golly it's something that this country should do
But is that all health care is about? Getting everybody in some sort of health insurance plan? I don't think so, but those other issues are topics for another day. Today let's address this question ...
Is your health insurance plan worth the money you’re paying for it?
At one extreme is the government-run, single payer plan...represented by Medicare. Medicare isn’t allowed to drop you if you get sick, doesn’t care when you first came down with rickets, and accounts for 3.5% of the total health care cost of participants. That's important...3.5% overhead, 3.5 to cover all the administrative costs. Yes, Medicare has some limits on what doctor you can see, has limits on who gets what treatments, and it's not up to just you and your doctor about those treatments it's up to "a board" somewhere.
Pretty much everyone else is on some sort of private health insurance plan. Private insurance companies are businesses who are in the business, first and foremost of earning profits. The quality of health care for their clients is secondary, and if you don't believe that I've got this bridge I'd like to sell you. Private insurance will drop you if you gain weight, get sick, or age, considers freckles to be a reason not to treat your melanoma, and administrative overhead costs 30% of the total bill. Thirty percent of the total bill? 30%...30%! Think about that!
Now keep in mind that most of us are in some sort of HMO where you can only see certain doctors, there are limits on who gets what treatments and it's not up to just you and your doctor deciding about a lot of those treatments, it's up to "a board" somewhere Geeze! How is that different from Medicare, how is that better for anyone?
Okay, private insurance must offer something that Medicare doesn’t, right? Private insurance advocates will tell you that private plans will eliminate waste that government run Medicare doesn’t eliminate. Er....3% vs 30%...what I'm I missing here? Is the claim that private insurance saves you money by costing you nearly ten times as much as government insurance costs you? No, that can't be it! Just what “waste” do these private plan advocates mean? It can't be the overhead. Oh, I know, they must mean the waste of treatments that doctors advise their patients to take that insurance administrators refuse to allow. Oy vey, I shudder to be the cause of such waste.
A useful tool to understand what I'm actually talking about here is to understand what health insurance actually does. You give somebody some money every month, and when you need medical attention, they give some of your money to doctors, hospitals, etc. That’s it! That's all health insurance is. Well, to be fair it's a bit more than that...folks, like me, pay in several thousand dollars a year and hardly ever see the doctor are financing all the sick folks out there. Hey, but on the bright side, maybe I'll come down with something and get all of my money back one day, maybe if I'm lucky I'll get really sick and get back more than I put in! Oh, but I'm sure my private insurance company will drop me before that happens...that would be the business like thing to do, don't you agree?
If you took the money you and your employer pay to your insurance company and put it into a bank instead, by the time you really needed it you'd probably be able to pay for all the treatment you would ever need, and pay for your retirement, too. Most people haven't done that, won't do that, many simply can't do that! It isn’t realistic to expect people to start doing it now, and it wouldn't protect you if you came down with something really costly. But the fact remains that with private insurance, in essence, you are paying an extra 30% to a company to hold your money, then to tell you how you are allowed to spend it, and giving them the right do drop you if you become a drag on their profits.
Does Medicare do this to you as well? Yes and no. Yes, they are taking your money, charging a 3% fee to hold it, and paying it out when you need it, but no, they can't drop you if you cost too much. Maybe they can deny, or delay, certain costly treatments, but are they any worse about that than private companies?. Nope. But according to the people who prefer private insurance, government run plans don’t do as good a job and would do it worse if they were the only ones allowed to insure you. Frankly, I don't believe it.
If we had a state-run, single payer plan for everyone in America would it tell you which medical treatments you are allowed to receive? Sure, it would! But, so does a privately run HMO? But, if Medicare is any prognosticator (and we have no reason to assume it is not), it will cost 27% less in overhead than what you're getting from that HMO to get what treatments you do get. That looks like Medicare you do a better job not a worse one. Maybe those guys mean a worse job in the sense that they, the executives of those private companies, wouldn't get as much money.
I did a little reading. In 2007, 60% of American bankruptcies were said to be due to medical costs. Of those bankruptcies, nearly 80% held private insurance at the beginning of their medical emergency. To narrow that down even more, half of that 80% had lost their insurance by the time they filed for bankruptcy. Private health insurance seems to be a fine idea, as long as you're healthy, but if you get really sick down the rat hole you go!
In conclusion, here's my take on Single Payer Government vs Private Health Insurance. Neither system is great. Neither system is without flaws. Both could be better, but...
A Government run system, like Medicare, needs some reformatting to keep up with tax cuts, which threaten to put it under water. But this is doable. It's doable, but it means taxes would have to go up to cover it. We'd have to pay the government what we've (and our employer) has been paying some HMO, but most likely no more and maybe even less...remember that 3% is a lot less than 30% On the plus side, 3% costs and being required by law to, mostly, be there for you when you need it seems like a win to me.
Private insurance, otoh, is a boil on the butt of America. It’s painful, unsightly, and interferes with your life. I'm trying really hard to think of something nice to say about it...ur...still thinking...okay, I've got it! At it's best, it is no worse than a Single-Payer system.
If you listen to all the talk, nobody disagrees that the current system is broken, but I'll lay odds that many of the "players" are lying when they say they want to see it fixed. There is a lot of money getting passed around over over health care, and the pigs at the trough might grunt about reforms, but what they want is more slop, not less. That's why "health care reform" won't include a real Public Option and that's a crying shame!
What do you think?
