Friday, October 26, 2012
Why I Support Universal Health Insurance; the Promised Addendum to Mythmakers: Compassion
In a response to a comment on Mythmakers: Compassion, One of the Things That Makes Us Human, I said I ought to write a post on why I'm for universal health coverage, so here I am doing so! I'm speaking from my own experience and my own predilections, which may not be other peoples. And I ended up getting much more political here than I intended.
One of the things I dislike about modern society is its complexity. I say, "Simplify, simplify, simplify!" I just took a look at the Wikipedia article on the "Patient Protection and Affordable Care Act" and as far as I'm concerned, it's still way too complicated. It's still predicated on the idea that an individual has to buy his or her own insurance from a private company. It was made that complicated to make it more "palatable" to the conservatives (which it didn't really do). But I don't think it does the job it ought to do.
During my lifetime I have spent gobs of money on health insurance. The rates went up constantly even when my employer provided a coverage plan. When I quit my job in 1993 (I was only 53) to take care of two elderly family members, I was on COBRA for awhile -- I think it was over $300.00 a month. When COBRA ended, I couldn't get coverage because I was taking medicine for high blood pressure. Otherwise, I was fit as a fiddle. So I had go through a whole ritual of applying for Blue Cross, being turned down, and then applying for CUHIP (I think that means Colorado Uninsurable Health Insurance Program). I got into that, but the premium went up by buckets every year. By the time I turned 65 and was eligible for Medicare, I had cut my coverage to $5000 annual deductible and the premium was somewhere in the $500-$600/mo range. And I had remained healthy all during that time. I could have had no insurance, continued to see my doc once a year, had a few tests run, and buy my Rx's, and still saved money. But the thing is, you can't predict the future -- I could have been in an auto accident or I could have come down with cancer, and then without health insurance I would run out of savings in short order.
If a universal health insurance program had existed, I could have just continued to pay the premium at the going rate, the same as I paid when I was working, and saved money, time, and hassle.
My mother's situation was quite different. She was a public school teacher and in her day, teachers didn't have Social Security because each state had its own retirement plan. (I don't know what the situation is now.) Therefore, she didn't qualify for Medicare, either, but you can buy into Medicare by paying a premium. When she turned 65 in 1974, she didn't want to buy Medicare -- it cost the whopping sum of something like $37.00/mo (ridiculously low compared to the situation today), and she thought that was horrible. But I insisted that she join up, and, boy, am I glad I did, because later in her life she had gobs of medical problems, and the premiums, even though they went up over the years, were well outweighed by the benefits, even though my mother never had any supplemental insurance to cover the copays and deductibles.
And the Medicare program works great! People don't realize how well it works! In all my many dealings with the system, I never had one problem! The only problem I've had since I went on Medicare back in 2005 was with my doctor. I was paying for supplemental insurance with AARP, because I like to be able to go to specialists of my choice without a referral. This doesn't pay the doctor as much, however, as an Advantage Plan does, which is like being in an HMO. Last year my primary care physician sent out letters saying, basically, get into an Advantage Plan or I'm dropping you as a patient. So I went into an Advantage Plan, because it's almost impossible to find another doctor who will take new Medicare patients. It turns out that the Advantage Plan has no premiums, only copays, so I'm saving a lot of money by doing that; I really don't understand how that works, because if possible I avoid doctors like they had the plague, so they're certainly not making any money off me! So far I've paid only $45 copay for the entire year.
Anyway, Medicare is a great model for what a national health insurance program ought to be! I think it's called a single-payer system. Why is that so bad? It's much simpler! All people pay a fee (or call it a tax if you must), probably graduated by income, throughout their entire life, and get the medical care they need throughout their life. Doctors must treat everybody equally; they can have a specialty, but they can't discriminte by a patient's age or affluence. Part of the revenue is dedicated to caring for the indigent, because we are a compassionate people. There will always be those who can't or don't work for whatever reason, and even if they aren't "deserving," we don't take them out and shoot them. There have to be controls on costs, of course, and that means on doctor's and hospital's fees, too. Doctors obviously require many years of education to learn their skill and so deserve a better-than-average remuneration, but if they went into the field simply to acquire great wealth, then they went into medicine for the wrong reason.
In my future history, a type of system like this is in place, and it's for the whole world, not just little pieces of it, because humans are all one species and deserve equal treatment under the Mythmaker ethic. In the present world, everything in the USA is fragmented by states. I find that complicated and wasteful. Laws should be uniform and resources should be pooled and utilized equally, so that Mississippi or whatever doesn't have a lower standard of care than Massachusetts or New York. It just makes common sense to me.
None of this is easy; it took the future Earth a hundred years to work out the details of the Global Unification Charter and something like 30 years for all the nations of Earth to ratify it. And people had to be willing to give up some freedoms in order to achieve true equality. But that's another story.
Now, to the question of whether this type of change will put a financial burden on future generations, I say, so what? YOU DON'T GET ANYTHING IN LIFE WITHOUT PAYING FOR IT! People seem to forget that. They think you can just cut taxes and everything fixes itself because people have more money to spend, etc. But I don't believe that. My experiences in life have shown me that IF YOU WANT THE SERVICES OF GOVERNMENT (and why else does government exist except to provide services?) YOU HAVE TO PAY FOR IT! (And certainly you have to cut waste and fraud and keep costs down. That may be one of the hardest things to achieve for us self-serving humans -- getting rid of the pork and the bribery, bridges to nowhere and the $800 screwdrivers.)
Yes, I'm very liberal in my views, and I'm pleased to be so. I always vote for tax increases locally, and I just cast my vote a couple of days ago for Pres. Obama.