Friday, June 26, 2009

Mixed feelings on health care reform

Over the years, I have had mixed feelings about health care reform, from being a solid advocate of Canadian-style single payer, to questioning that position, to wondering about some sort of hybrid position, to now, again, thinking we should have Medicare for all.
A couple of weeks ago, the relatively moderate publisher of the Hippo, Jody Reese, came out for Medicare for all in the column and I have to admit that this is where I'm heading too: ["Publisher's Note: Health care solution"].
In the current debate in Washington over health care reform, the single-payer/Medicare for all option seems to be completely out of the discussion. And that's too bad. The simple fact is that shaving the profit motive of insurance carriers, HMOs, and PPOs, is the only way to control costs and cover everyone without more, substantially larger, taxes.
In essence, as Reese notes in his column, most people with private or employer-backed insurance, will just transfer their payments from the private insurance to the government. Other workers who don't have insurance but can't afford the private plans will pay a little bit out of pocket and get something in return. In many cases, like mine, I will have a better deal and the same coverage by making this change, since the PPO plan my company has is too expensive, has too many co-pays and deductibles, or simply put, just plain sucks.
In addition, the drive of the economy recovering is going to be small business, very small business, and entrepreneurs, as Reese notes. Most of these folks can't afford the private insurance. A Medicare for all plan will cost much less while delivering more. Moving away employer monies from health care to investment in the actual business will create more jobs and speed the recovery.
Sure, all those people in private insurance will be out of work. But they will get picked up along the way doing other things like the people who used to make buggy whips and now do, to take a phony argument from the free trade cultists.
One of the other things that really keeps me from fully supporting single-payer/Medicare for all is the fact that we, as a nation, are just not very good at preventive care. Some people presume that this is because we don't have nationalized insurance like they do in Canada, England ... hell, even Costa Rica has it. Some think it is the overwhelming influence of advertising in our lives. Some think it is education - do they still have home economics in school? Some think it is just bad parenting.
I think it is probably a combination of all those things. While I'm not in the best of shape, I cringe every time I see some extremely obese person walking along, with their fat flab hanging over their shorts, lumbering along like Jabba the Hut, thinking, if we had single-payer, that person would be draining away tons of money because they can't control themselves. I think the same thing when I see a person chain-smoking or abusing alcohol.
This is why so many lawmakers want sin taxes on alcohol, smoking, and even, sugar-based products. The problem with these taxes is that they are going into the general fund of most governments and not into health care. One would have to wonder, if all the taxes on these products went straight to health care, would we even be paying a dime out of our paychecks for basic care? Probably not.
In the end, I don't have the answers to this problem but I do know that what is happening in private insurance is an abomination and I do know that the current plans being discussed in D.C. are just not good enough. Health care reform can't occur until there is regulation, control, and restraint of profitable companies who are keeping insurance from being affordable to a good chunk of Americans. And that's why, in the end, like everything else, there will be no real health care reform at all.

No comments: