Extend Medicare to cover everyone
By Alan A. Pfeffer, Attorney–at-Law, and Richard Propp, MD
Capital District Alliance For Universal Care, Inc.
Who can be surprised that all three leading contenders for the Democratic presidential nominations have based their proposals for health reform on private insurance? This, after all, is what the insurance industry is paying them for.
Unfortunately these unwise proposals are so far off the mark as to be bizarre. But we believe there is good news insofar as an increasing number of citizens understand that fact.
Imagine if they were enacted as proposed. If you have insurance, stay with it, even if the premiums are increasing 8% a year, even if the actual direct and indirect overhead is 35%, even if U.S. industry is becoming progressively less competitive, good jobs are evaporating, road and bridge infrastructure are failing, and public education outcomes are falling behind the rest of the world.
If you don't have insurance, you MUST buy it from a private insurance company. If you have a family of 4 and you make $60,000, your expendable income is $48,000. Health insurance will cost $12,000. That leaves you with $3,000 per month for food, housing, automobile, maintenance, clothing, property taxes, utilities, savings, miscellaneous. You do the math.
If you can't afford it, we taxpayers will subsidize it and subsidize the PROFITS of the private insurance company. (Remember, in order to get $1 worth of healthcare, you must pay $1.35)
None of these plans discusses the delivery side of medical care, possessing major and critical faults in our present system that lead to over-utilization, unwise care, poor patient safety, and excessive deaths.
A recent example of Republican thinking on the question can be found in David Brooks' article on health care reform “The New Social Contract” (OP-ED NY Times September 7). It is filled with the false framing of the arch-conservative. Phrases like "Americans are different from Europeans" ring hollow when it comes to the necessity of healthcare. Does he really believe we are that much different from our British cousins? Reminiscent of the fallacious corporate philosophy of rejecting any improvement not invented here, this kind of thinking also appears increasingly bizarre to most Americans.
Instead of either the Republican model of doing health care reform based on individualism and private enterprise or the Democratic idea of rescuing the private health insurance industry, we would like to see health care reform based on a Judeo/Christian model of a caring community taking care of one another through a single large risk pool.
U.S. Medicare is a remarkable government success run through private physicians and mostly nonprofit hospitals. Do you hear older Americans complaining about their Medicare social insurance which has an overhead of 3%?
Most thoughtful people realize that our 35% overhead private insurance system is driving our country into economic suicide. Just ask General Motors about its healthcare costs. The role of private for profit insurance companies in health care needs to be eliminated or minimized.
We suggest extending Medicare gradually to people of ages below 65 in five year increments, similar to the proposed HR676 bill of John Conyers. At the same time the federal/state health care programs for children, SCHIP, should be expanded in both scope of coverage and the age of eligibility. When an individual reaches 45 the two programs meet and people switch from SCHIP to Medicare.
Our basic premise is that health care is not an insurable risk. It is not the same as car insurance. In the case of car insurance there is a statistical probability of an accident occurring that the car owner insures against. There is no comparable risk equation for health.
Everyone needs preventive health care and at some point we all get sick. We now know that many illnesses are genetically based. If you have the gene you are going to get the illness or at least a predisposition for it. Under the right circumstances the illness is almost certain to occur.
If you have certain illnesses like cancer, in the absence of portability, you either can't buy health insurance or the price will be exorbitant. Insurance companies are not in the business of providing health care to society but are really running an extensive gambling operation, betting on the odds of an event not occurring. Insurance companies spend an enormous amount of administrative effort and cost in denying claims and in cleverly underwriting sick people out of their plans.
Society should be providing preventive health care through non profit social insurance like Medicare to help people avoid getting sick. In a preventive model. for example, people with diabetes can get preventive care to avoid the loss of a limb or a kidney. Under current insurance models no such care is provided. So the insurance company doesn’t pay for a diabetic to get toenails properly trimmed, but insurance will pay after gangrene sets in to have the foot removed.
The idea of rejecting a single payer system simply because it is financed by government is utter nonsense. Polls should be taken to see how many senior citizens have complaints against Medicare versus complaints against private insurance companies. We believe there will be far less complaints against Medicare.
If someone wants to buy private insurance for uncovered special items, they can. It will not be illegal and may be needed as a "wrap-around" for items that SCHIP and Medicare do not cover.
As to the fear of how America pays for it, we are already paying twice as much as other industrialized countries on a per capita basis.
America needs to get its priorities in order. We need a national debate on what is really important: farm subsidies to pay for crops that are not grown, insurance company profits for stockholders, space exploration, bridges to nowhere, foolish wars, or paying for health care so everyone can have a fair chance at life.
Capital District Alliance For Universal Care, Inc.
Who can be surprised that all three leading contenders for the Democratic presidential nominations have based their proposals for health reform on private insurance? This, after all, is what the insurance industry is paying them for.
Unfortunately these unwise proposals are so far off the mark as to be bizarre. But we believe there is good news insofar as an increasing number of citizens understand that fact.
Imagine if they were enacted as proposed. If you have insurance, stay with it, even if the premiums are increasing 8% a year, even if the actual direct and indirect overhead is 35%, even if U.S. industry is becoming progressively less competitive, good jobs are evaporating, road and bridge infrastructure are failing, and public education outcomes are falling behind the rest of the world.
If you don't have insurance, you MUST buy it from a private insurance company. If you have a family of 4 and you make $60,000, your expendable income is $48,000. Health insurance will cost $12,000. That leaves you with $3,000 per month for food, housing, automobile, maintenance, clothing, property taxes, utilities, savings, miscellaneous. You do the math.
If you can't afford it, we taxpayers will subsidize it and subsidize the PROFITS of the private insurance company. (Remember, in order to get $1 worth of healthcare, you must pay $1.35)
None of these plans discusses the delivery side of medical care, possessing major and critical faults in our present system that lead to over-utilization, unwise care, poor patient safety, and excessive deaths.
A recent example of Republican thinking on the question can be found in David Brooks' article on health care reform “The New Social Contract” (OP-ED NY Times September 7). It is filled with the false framing of the arch-conservative. Phrases like "Americans are different from Europeans" ring hollow when it comes to the necessity of healthcare. Does he really believe we are that much different from our British cousins? Reminiscent of the fallacious corporate philosophy of rejecting any improvement not invented here, this kind of thinking also appears increasingly bizarre to most Americans.
Instead of either the Republican model of doing health care reform based on individualism and private enterprise or the Democratic idea of rescuing the private health insurance industry, we would like to see health care reform based on a Judeo/Christian model of a caring community taking care of one another through a single large risk pool.
U.S. Medicare is a remarkable government success run through private physicians and mostly nonprofit hospitals. Do you hear older Americans complaining about their Medicare social insurance which has an overhead of 3%?
Most thoughtful people realize that our 35% overhead private insurance system is driving our country into economic suicide. Just ask General Motors about its healthcare costs. The role of private for profit insurance companies in health care needs to be eliminated or minimized.
We suggest extending Medicare gradually to people of ages below 65 in five year increments, similar to the proposed HR676 bill of John Conyers. At the same time the federal/state health care programs for children, SCHIP, should be expanded in both scope of coverage and the age of eligibility. When an individual reaches 45 the two programs meet and people switch from SCHIP to Medicare.
Our basic premise is that health care is not an insurable risk. It is not the same as car insurance. In the case of car insurance there is a statistical probability of an accident occurring that the car owner insures against. There is no comparable risk equation for health.
Everyone needs preventive health care and at some point we all get sick. We now know that many illnesses are genetically based. If you have the gene you are going to get the illness or at least a predisposition for it. Under the right circumstances the illness is almost certain to occur.
If you have certain illnesses like cancer, in the absence of portability, you either can't buy health insurance or the price will be exorbitant. Insurance companies are not in the business of providing health care to society but are really running an extensive gambling operation, betting on the odds of an event not occurring. Insurance companies spend an enormous amount of administrative effort and cost in denying claims and in cleverly underwriting sick people out of their plans.
Society should be providing preventive health care through non profit social insurance like Medicare to help people avoid getting sick. In a preventive model. for example, people with diabetes can get preventive care to avoid the loss of a limb or a kidney. Under current insurance models no such care is provided. So the insurance company doesn’t pay for a diabetic to get toenails properly trimmed, but insurance will pay after gangrene sets in to have the foot removed.
The idea of rejecting a single payer system simply because it is financed by government is utter nonsense. Polls should be taken to see how many senior citizens have complaints against Medicare versus complaints against private insurance companies. We believe there will be far less complaints against Medicare.
If someone wants to buy private insurance for uncovered special items, they can. It will not be illegal and may be needed as a "wrap-around" for items that SCHIP and Medicare do not cover.
As to the fear of how America pays for it, we are already paying twice as much as other industrialized countries on a per capita basis.
America needs to get its priorities in order. We need a national debate on what is really important: farm subsidies to pay for crops that are not grown, insurance company profits for stockholders, space exploration, bridges to nowhere, foolish wars, or paying for health care so everyone can have a fair chance at life.
posted by Andy at Sunday, November 04, 2007
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