Twitter
StumbleUpon
Facebook
Delicious
Digg
Newsvine
Google
Yahoo
TechnoratiUniversal Health Care Makes More Sense Than Ever
In the midst of a Democratic convention that is high on psychodrama and necessarily low on wonkish detail, it hardly seems fair to throw around a word like entitlements. Besides, Republicans are set to commandeer the media spotlight with their own convention next week, and they can be expected to use the E-word once or twice, probably with modifiers to make it sound dirty. Examples: references to "runaway spending'' on "entitlements" and the need to "rein them in."
So it is worth pausing during these orchestrated partisan celebrations to look afresh at entitlements. There is no more recent evidence of their enduring value than the latest report from the Census Bureau on the number of Americans who are doing without health insurance.
The headline seems counterintuitive, if not downright baffling: The number of people without insurance dipped in 2007, falling from 47 million to just under 46 million. Did the private insurance industry suddenly make it easier for employers to pay for this benefit and so make fewer of their workers do without? No. Did more Americans manage to buy policies on their own, using the magic of the free market coupled with such conservative panaceas as tax-favored health savings accounts? No.
The government became the insurer of last resort.
Without a boost in Medicare and Medicaid enrollment, the number of uninsured people would have risen once again last year. The census data show that the percentage of Americans getting their coverage through the government jumped almost a full percentage point, from 27 to 27.8 percent. Most of the increase came in Medicaid, the joint state and federal program that insures the poor. Medicare, which insures the elderly, and Medicaid combined now provide coverage for 81 million Americans.
At the same time, the percentage of people who get private insurance through employers fell again, to 59.3 percent from 59.7 percent in 2006. It's this decline that has driven up the number of uninsured people - there are about 6 million more uninsured now than there were in 2001.
Which means, of course, that in the current economic downturn more people will become uninsured as businesses shed jobs and try to contain their own costs by curtailing coverage. The employer-based health insurance system, for anyone who hasn't yet noticed, is crumbling.
So why would the two presidential candidates seek to build a new system upon such a creaky foundation? There are only bad answers.
To be honest, Republican John McCain would effectively destroy the employer-based system by breaking it up even further, giving individuals tax breaks to buy insurance on their own. It won't work for the simple reason that the whole concept of insurance is based upon pooling risk: Those who stay healthy effectively subsidize those who get sick, and premiums remain lower than they otherwise would be for a sole individual or family. Besides, after years of tax breaks and other efforts to boost the individual insurance market that were put in place by congressional Republicans, the percentage of people who directly purchase insurance on their own also is declining, the Census Bureau says.
McCain at least has a partisan excuse for taking this approach. The free-market ideologues in his own party are convinced of their correctness, even when their faith is easily punctured by facts.
But what about the Democrats? From the start of their primaries, it was clear that the major candidates were too skittish about taking their talk about universal, affordable health insurance to the logical conclusion: that there is no simple or affordable way to achieve this so long as we continue to rely on something that's neither universal nor even predictable - employment - as the basis for coverage. All of the health insurance plans outlined by the major Democratic contenders, including Barack Obama, essentially would patch holes in the existing system.
Yet the employment-based system of insurance is providing coverage to fewer people while costs, even for the best-insured families, continue to mount. Meanwhile, government programs are performing exactly as they were intended to, providing a necessary safety net-so long as the state and federal governments fund them sufficiently.
All of us would rather build a house on a firm foundation rather than a shaky one. The illogic of doing just the opposite on health care has never been more apparent.
31 Comments so far
Show AllEven with health care insurance we need to have much higher 'acceptable standard of health care'. An ounce of prevention is worth a pound of cure.
http://caringbridge.org/visit/timmullins
http://www.wisecountyissues.com
I got health insurance that is supposed to cover 100 percent in-network. My wife has had some serious problems lately and we are getting billed for shit that somehow is not covered or a screw-up or God knows what. We recently got a summons to appear in court for hospital related charges.
The system sucks!
Some things only the government can do well and health care is one of them. Only the government can operate at a loss on an ongoing basis as a service to to its citizenry.
Members of Congress have their health care paid courtesy of Uncle Sam. Works great for them but not the rest of us?
Welfare is ok for corporations but not single mothers? We can afford billions in tax breaks for the super rich but the very idea that some poor person on welfare might be driving a Cadillac strikes us as being criminal.
For those who prefer facts to undocumented opinion:
http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared
Government involvement
Canada and the United States had similar health care systems in the early 1960s,[1] but now have a different mix of funding mechanisms. Canada's universal single-payer health care system covers about 70% of expenditures, and the Canada Health Act requires that all insured persons be fully insured, without co-payments or user fees, for all medically necessary hospital and physician care. In the United States, with its mixed public-private system, 16% are uninsured at any one time.[18] The U.S. is one of three OECD countries not to have some form of universal health coverage; the other two being Turkey and Mexico.[19]
The governments of both nations are closely involved in health care. The central structural difference between the two is in health insurance. In Canada, the federal government is committed to providing funding support to its provincial governments for health care expenditures as long as the province in question abides by accessibility guarantees as set out in the Canada Health Act, which explicitly prohibits billing end users for procedures that are covered by Medicare. While some label Canada's system as "socialized medicine," the term is inaccurate. Unlike systems with public delivery, such as the UK, the Canadian system provides public coverage for private delivery. As Princeton University health economist Uwe E. Reinhardt notes, single-payer systems are not "socialized medicine" but "social insurance" systems, because doctors are in the private sector.[20] Similarly, Canadian hospitals are controlled by private boards and/or regional health authorities, rather than being part of government.
In the U.S., direct federal and state government funding of health care needs of its citizens is limited to Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP), which cover eligible senior citizens, the very poor, disabled persons, and children. The federal government also runs the Veterans Administration, which provides care to veterans, their families, and survivors through medical centers and clinics. One study estimates that about 25 percent of the uninsured in the U.S. are eligible for these programs but remain unenrolled; however, extending coverage to all who are eligible remains a fiscal and political challenge.[21]
For everyone else, health insurance must be paid for privately. Some 59% of U.S. residents have access to health care insurance through employers, although this figure is decreasing, and coverages as well as workers' expected contributions vary widely.[22] Those whose employers do not offer health insurance, as well as those who are self-employed or unemployed, must purchase it on their own. Nearly 27 million of the 45 million uninsured U.S. residents worked at least part-time in 2007, and more than a third were in households that earned $50,000 or more per year.[22]
Despite the greater role of private business in the U.S., federal and state agencies are increasingly involved in U.S. health care spending, paying about 45% of the $2.2 trillion the nation spent on medical care in 2004.[23] The U.S. government spends more on health care than on Social Security and national defense combined, according to the Brookings Institute.[24]
We see things, not as they are, but as we are.
Anais Nin
We need a comprehensive, PREVENTATIVE health care system that allows everyone to have medical coverage much like the Canadians. We need to encourage people to practice healthy lifestyles. This also includes making a healthy lifestyle accessible to all socio-economic levels of our society. I recently saw a PBS program that included statistical information that indicated that social class and health status were directly related. The inequalities in social class and economic status directly affect our longevity. THIS IS VERY IMPORTANT! Because I am in health care, I see this on a daily basis and yet it is like the elephant in the room- no one wants to talk about the archaic class system in this country and how it directly affects our health. Addressing social inequalities, providing FREE preventative screenings and basic health care sound health care for all citizens is good for our economic standing as well. If we are healthier, we can be more productive. Stress is a major source of physical and mental illness. That's a proven fact. The sad fact is the elites do not care if the common working people get any care. It's not on their radar screen- they live a different life. I am not happy about any of the choices I have to pick from for president BUT, if Obama's camp even attempts to universalize health care...I'll just go with them. Lack of health care coverage combined with a stressful, unhealthy population is what's wrecking our society and economy.
Space Cadet. Not quite true. Some provinces charge a monthly fee. In BC it is $54/month single & $92 for a family. It was 1/2 that before Campbell but is still a bargain.Also, wait times are a red herring. If you are in need of help now you get it NOW!
Since I pay $275/month for my health insurance, I would regard $54/month as "free".
-- EKATON --
Canadians refer to their system of government-funded healthcare as 'UNIVERSAL' rather than 'SINGLE PAYER' so as not to confuse the public. In Canada no one pays a dime for their health insurance. Over twenty years ago all Canadians, except those with financial hardships, were required to pay around $20 a month for their coverage. However the government found that it cost more money to administer the collection of this paltry sum than the amount collected and therefore just ruled that no one would be required to pay any fees for their government health coverage thereby making it truly 'universal'.
In effect though the Canadian system is a 'single payer' system because every citizen shares in the cost of our universal health coverage. Whether you buy a 415 12 pack of beer or a $9 pack of smokes, this money is generated for sustaining an excellent healthcare system that is accessible to every Canadian citizen.
The results are astounding when compared to the American corporate alternative. Canadians live longer & have far less infant mortality rates than their neighbours to the South, while Canadian taxpayers pay roughly half (per capita of course!) than their US counterparts to fund the system.
Unfortunately though, Corporate America has high jacked the medical industrial complex with an understanding in both political parties that any move towards 'nationalizing' or expanding Medicaid and Medicare, will result in an immediate cessation of corporate funding as well as a permanent, MSM imposed blackout (no media coverage) for potential candidates seeking public office. This is why Hilary, Obama and so many other 'liberal' Democrats never utter those words. No debates, no discussions and no coverage of existing healthcare systems in the rest of the world are ever mentioned.
Of course the option for voting for Ralph Nader always exists... if only the majority of Americans had heard of him, much less understood the issues at stake.
quidam56,
Ther seems to be an enormous misconception here about the health care coverage congresspersons get.
The health care coverage that members of congress get is NOT free! It is not even a very good deal compared to what nealy all employers used to offer not too long ago, and many union workers can still get.
As a US government employee, I am under the same system. I pick from a list of insurers and plans during an "open season" once a year. You pay a portion of the plan, the gov covers the rest. I pay $290 a month for a Blue cross/Blue Shield plan. If I'm laid off, I would get continued coverage for a year or something, but it would be about $1200 per month!
So when a politician tells you that he is offering to solve the healthcare crisis by offering "the same coverage he gets" DONT BUY IT!
You're right. I got the impression from multiple sources that Congress had some gold-plated health care plan. I asked for details from my senator and got the documents. It's not a bad deal, but it certainly isn't stellar. That being said, I'm sure the many uninsured or underinsured in this country would be happy for the opportunity to participate in any plan at all. I maintain, though, that insurance companies have to be removed from the health care delivery equation. Their profit motive is inimical to fair and even-handed access for all citizens.
I am a firm supporter of Universal Health Care for all in the US! But, it's about time we also faced the hard reality of it!!! As long as there are Republican's in this country to scream 'Socialism', 'no new taxes','welfare queen', 'liberal program' and etc. It's never going to happen!!!! People are dreaming if they think it's ever going to happen. Hillary tried it in 92 and was shot down in flames by Republicans!!! All Republican's are interested in is a bigger military so they can run over some poor country and flex there muscles! No taxes for the wealthy. No oversight for big business, and making abortion and birth control illegal! The rest of us can rot in hell as far as they are concerned. So if you are really interested in health care for everyone in this country you had better start voting your beliefs.
www.wisecountyissues.com
These 46 Million individuals help pay for the politicians to have the best health care available for life at our expense. Every American should have the exact same coverage. Folks health care in America is another Katrina on it's way to our shores. MRSA will be the next AIDS.
www.caringbridge.org/visit/timmullins
JH
right on profits that is the problem. Canada spends billions of tax bucks on healthcare and hospitals are millions in the hole in most cases but the different levels of Gov come the rescue.
Trouble is the more I dig for the truth I am of the opinion that the USA is screwed to a point heathcare will not happen.
Maybe everyone should let the WHO take care of global health care as our corporate controlled government refuses to do so. I would rather pay taxes to the UN than to the Bushite tyrants. I wonder if the UN would replace the Pentagram's baby butchers with Blue Hats.
"GENEVA (Reuters) - Major inequalities in health and life expectancy persist worldwide, according to an independent World Health Organization commission which on Thursday called for all countries to offer universal health care."
The UN has trouble even delivering food. Its one of the most inept organizations in the world (though our government under Bush/Vader) has been worse. You sure you want them handling your health care? I'm not sure I do.
Isn't most of this "ineptness" of the UN the result of deliberate underfunding and organizational sabotage?
It is a tried and true trick used by reactionary "free market" forces opposed to any of the good things government can do:
1. First, underfund the organization; then,
2. staff it with people who are incopetent or openly hostile to the agencies mission.
3. Then, turn around and say: "See? Socialsitic government services doesn't work!"
Be it Amtrak, State DOT's, Public transit, public aschools, and Canada's health care system under Harper, it works the same way.
As long as insurance companies are part of the formula, there will be no equitable, universal health care for all citizens. Profit-motive dictates that "loss" be minimized. Loss is payments for benefits (that's health care). The obvious motive is, therefore, to pay as little as possible in benefits. Works if you are the shareholders in the insurance company, but sucks if you are the enrollee hoping to have health care services paid. It doesn't take a genius to see this. We need to remove insurance companies from the equation.
Poet is correct. Single payer is the only way to go. The only way.
Business has decided they want to dump the responsibility and vacation medical care is breaking the medical monopoly so we will have a form of health care for all. Its up to us to make sure its the correct form.....single payer.
Is the Canadian system single payer?
and heavily subsidised by the govt.......a good thing.
We see things, not as they are, but as we are.
Anais Nin
"and heavily subsidised by the govt.......a good thing."
Never forget that "the government" has no money of its own and never will. It is all provided by the taxpayers, a good thing to keep in mind. Having said that, I am all in favor of the taxpayers in the U.S. providing universal health coverage. I see it as no different than providing good roads, clean water and air, and national defense.
-- EKATON --
Yes.
--
Eric Patton
Cincinnati, OH
ebpatton@yahoo.com
http://www.zcommunications.org/zspace/ebpatton
At last! Progress on the health insurance issue! Or maybe not...
Maybe a million people without insurance died and that's why we have fewer people without insurance?
Every developed country, big and small, has figured out how to take care of it's citizens (that's called civilization) ... except the US which is using it's citizens for Corporate feedstock.
With the price of food going up so much maybe we will need to start eating congress and the boards of directors they road in on.
Nice post!
No, No No, to universal healthcare!
Universal healthcare = letting Insurance companies, HMO's and Big Pharma dictate the terms of both the cost and availability of healthcare coverage.
Single payer government run healthcare (like that envisioned by the Conyers Bill)= all of us who comnprise "We the People" can bargain as a unified front with healthcare providers for better prices for the treatment and drugs we need.
The current gate-keepers of healthcare can either work for the government agency administering the program or seek other more appropriate employment working for Las Vegas gambling houses or perhaps as bookkeepers for Ebenezer Scrooge.
Poet
What's the difference between this and Canada's system? I hear it works quite well in Canada.
Canada's system is single-payer. It has been in existence since the mid 60's, it has consistently adminstered itself at lower overhead than private insurance plans, and today (like in Britain and everywhere else that single-payer exists) not even the conservatives would seriously argue for its removal because to do such would be political suicide.
Poet
Britains system is socialized not single payer and you would not want their system.
Universal coverage for everyone in Great Britain beats absolutely no coverage for 47 million of our citizens, 11 million of them children. If you wish to criticise the system in place in England why not post something substantial?
We see things, not as they are, but as we are.
Anais Nin
As long as the Pharmaceutical Industry (don't forget the for-profit Insurance Industry as well) remains the single largest lobby in Washington D.C., the actuality of achieving single payer health care is quite remote. In a republic, political power is vested in two things: money and votes. The aforementioned industries have had the money to "persuade" just enough of the electorate so they continue to make money hand over foot. What remains to be seen is if a potential Obama administration has enough political courage to take on those industries (the indications are not too portentous). Hopefully, Obama will adopt some of Clinton's ideas, but I am not holding my breath on that one.