Lately, I’ve been hearing a lot of angry words regarding health care in the United States. I saw a photo of protests in my local newspaper and a picture of a man shouting at his representative during a town hall meeting.
It got me to thinking. What have these people got against their fellow citizens that can’t afford health care?
In reality, I don’t think they have anything against them. What I think is at issue, is that they feel that they are paying for their own health insurance and health care so others should be responsible enough to do the same.
The US was founded on the idea of one’s pulling himself up by his own boot straps; of heading out into the wilderness to carve out the good life for himself and his family.
There is nothing wrong with this. But just as we wouldn’t go to fight a war with another country by sending only one man, we can’t always tackle every problem on our own. Sometimes we have to pull together and help each other out.
A few years ago, a hurricane hit my city. Trees fell on homes, power was out for days, water scarce. Neighbors joined together to cut up trees; put tarps on roofs; we got together in homes with gas stoves to boil water and provide communal meals. No one asked, “What are you providing?” We all just pitched in and helped each other. That too is the American way.
When a member of our community gets sick, that too is an emergency. It’s just as much an emergency as when that hurricane hit. Health care reform is a life and death emergency.
I’ve heard that there are 48 million Americans without health insurance.
Some say they can’t afford to buy it. I understand that. I remember when I first started working and only made minimum wage, I couldn’t pay for health insurance. I barely made enough to pay for rent and food.
Luckily, I was young and healthy; staying so until I got my first professional job where health insurance was provided.
There is a second group, however, that can’t get insurance because of pre-existing conditions. They have or have had some illness that makes them unattractive to the insurance companies.
Now, I don’t even blame the insurance companies for not wanting to insure them. You see, the insurance company is in business to make money. It only makes money when the premiums coming in are more than the money going out to treat sick people.
The more sick people it insures, the more money it spends on their medical care. The ideal person for the insurance company to insure is the person who is healthy as a horse and doesn’t ever go to the doctor.
But what about those 48 million uninsured Americans? Don’t they get sick?
Of course they do. Everybody gets sick from time to time.
But if they can’t afford health insurance, how can they possibly pay for a doctor’s visit, medical tests and medicine?
In reality, many get treatment and never pay the bill. So who does? Does the doctor take a loss on his salary? Does the lab eat the cost of those medical tests? I think not.
So who pays?
The reality is that everyone that has health insurance or is self insured paying their own medical bills pays for the people that don’t have health insurance and don’t pay their bills.
Let’s pretend that five people need a medical procedure. The procedure costs $100. The provider feels that four out of five will pay either through insurance or pay direct. The medical office needs $500, so it will charge all five $125. Only four will pay, so the office gets its $500 and the four will in reality pay for the fifth that doesn’t pay.
I know; I know. This is pretty cynical and very simplistic. But when we’re talking a bunch of numbers, simple works best, in my brain at least.
So let’s start thinking about this in a different way. The government doesn’t have to operate with a profit. So it can sell its health insurance for less than a company that has to operate at a profit. This new government insurance could be sold to people at a much lower cost, maybe on a sliding scale making health insurance available to all.
Second, if everyone had health insurance in some form, the doctors know they will be paid and can lower the cost of medical procedures for all. Remember that $100 procedure that the doctor had to charge $125 for? The cost can go back to $100 because all five of the patients will pay for it.
Did I just hear "But I pay my health insurance. What’s in it for me?"
If doctors, knowing they will get paid, lower their prices for all, the insurance companies pay a lower cost for the procedure, as well, and pay out less money. It should be able to lower the cost of premiums.
But what will keep it from just keeping the extra cash and sending it out to share holders? Well, it is now competing with the government which doesn’t have a profit motive. If it keeps all the surplus money, it will loose customers who opt to go to the public plan.
If the insurance company is to survive, it has to cut its premiums to be competitive.
Ok, now I hear you asking, "What about our taxes? Won’t they go up?"
I think taxes will go up a bit, but would be more than covered by the decrease expenses in insurance premiums and lower medical costs in general.
Besides, our taxes already go to public sponsored health insurance in the form of Medicaid and Medicare. Medicare is the leading payer for such procedures as hip replacements. It really does a very good job. How many of our elderly have been denied or even had to wait long for this procedure?
So the end result of the government sponsored health care is:
- Everyone has insurance and health care provided;
- Doctor/hospital fees can be reduced because they are assured of getting paid;
- Insurance premiums can be reduced because less money is going to pay inflated provider prices that cover the uninsured;
- There is pressure on premiums to stay low to compete with the public option.
As I see it, the public health care insurance option is a win-win that will help us all; even if we don’t directly use it.