Health Insurance Reform

Health Insurance Reform appears to be in trouble, or at least that is what the media is telling us.

Should we care? Or is the present system fine for most of us?

These are questions that are legitimate and should be asked by all. After all we are told we have the best medical care in the world. For example Senator Shelby (R-Ala.) told Chris Wallace in June on "Fox News Sunday" that President Barack Obama's proposed health care plan is the "first step in destroying the best health care system the world has ever known" and Senator Mitch McConnell on July 19 said on Meet the Press: “They don't seem to grant that we have the finest health care in the world now. We need to focus on the two problems that we have, cost and access, not sort of scrap the entire healthcare system of the United States.”

These comments are very important because they set up certain premises that if true should give us all pause. Do we have the best health care system in the world? We all would like to think so. We like to think the U.S. is Number I in everything. That is something we should strive for, but in a sense we all come from Missouri, we ask is it true?

Well the World Health Organization has stopped doing these studies, so the latest figures we have date to 1999, but there is no reason to think that much has changed. On the basis of life expectancy the U.S. ranks #24. Japan Ranks #1, France #3, Sweden #4, Canada #12, UK #14. When the rankings are by eight relevant measures the U.S. comes in – hold your breath – comes in at #72.

But many Americans don’t trust the statistics of these “foreigners.” Well the American CDC (Center for Disease Control and Prevention) does a ranking on infant mortality rates. The latest one done as of 2005 shows the U.S. in 30th place.

So much for the claim that we have the best medical care in the world.

It is true, as some Republicans have contended, that the rich, the prominent often come to the U.S. for treatment - the Shah of Iran, with terminal cancer, came to the U.S., but all that shows is that if you have unlimited money excellent care is available in the US. Very few come from Germany or Italy or Canada, etc. Only a very few of us have unlimited money and whether people know it or not, even the insured don’t have unlimited coverage as so many are discovering.

We keep hearing about the uninsured and their lot is indeed serious. But the same goes for most of the insured who don’t know that when they need their insurance most they will discover that they forgot to read the small print. It doesn’t cover the most expensive procedures or they find the condition is a pre-existent one, even though they didn’t know that, and their insurance exempts pre-existent conditions. And then there are the co-pays. They can bankrupt you if you need an expensive procedure even if the procedure is covered by private insurance.

But let us remember what else McConnell said: he doesn’t want to “sort of scrap the entire healthcare system of the United States.” Well who does? What an outrageous setting up of a straw man. The discussion revolves around the insurance system, not the medical delivery system. The most controversial part of the reform is whether to have a government insurance system alongside private insurance and they treat that as though it were the most outrageous idea in the world. Well, Senator McConnell has government run health insurance along with every member of Congress. They all love it. Every American over 65 has a government run health insurance. Its called Medicare. All are very happy with it. Children who are not insured in a private health insurance plan have access to a government health insurance plan. Its called SCHIP. Parents whose children are covered by this plan are very happy to have it. The poor have a government health insurance plan, its called Medicaid. They are grateful to have it even though in many states it is under funded. As for veterans who are insured under the Veterans Administration program, a government program, they wouldn’t exchange it for private insurance.

None of these American Health insurance plans has turned us into a Socialist state and the insurance companies are still in business.

But now they tell us that Medicare may look good but it under-reimburses doctors. It is true that Medicare pays doctors less than they charge their un-insured patients*, but so does every private insurance company. According to Ethical Health Partnerships, “No matter how much we pay for private insurance, their payment to physicians is either slightly above Medicare rates (for better insurance companies) or BELOW Medicare rates. It is not uncommon for some insurance companies to pay 10-20% LESS than Medicare.”

It is no wonder that I have yet to find a notice posted in a doctor’s office that says we no longer take Medicare, though undoubtedly some don't. However, I do frequently find notices, “We don’t take United Health Care” or some other carrier, anymore. That means you lose your choice of doctor, and your choices of doctors are limited, with most private insurance companies having in-plan and non-plan doctors.

But one of the scare tactics used by the opponents of reform, and don’t be fooled by the claim that they want reform but “only the right kind,” is that you will lose your choice of doctor. They turn the facts on their head. Your choice of doctor is limited by the private insurance industry - it is not likely to be limited under any government program.

I realize that there are other issues that are troubling. Most important is cost. I will try to address all of them, or as many of them as I can, in future presentations.



* who are not only subject to the burden of having to pay all their medical expenses out of pocket, but are charged at a substantially higher rate then the insurance companies, so that they end up subsidizing the insured.