Yet another article in the WSJ today about how the Republicans want to blow up the Affordable Care Act. Great idea. I agree.
Let’s also dump Humana, Anthem, Aetna, etc., etc. and finally replace them all with the dreaded “socialized medicine.”
Goodbye to all you high-priced health-insurance executives: Aetna, $30.7M; Centene, $14.5M; Caremark, $69.6M. After we dismantle the health-care insurance industry, you big rich CEOs can get honest jobs, like driving a truck. Or, if you still need the big bucks, become a pro athlete. They also make obscene amounts of money.
1) Insurance: follow the money
My father was an insurance executive. I value insurance and have dozens of policies. Car insurance: good. Home insurance: good. Life insurance: good.
Health insurance: very bad. A total rip off. Don’t need it.
An insurance agent friend told me, “I used to sell only life insurance. Then I decided to add health insurance. Huge difference. With life insurance you pay your premium and when you die, your family gets the face value of the policy. Straight- forward. With health coverage, it is very dodegy. You pay your premiums, but when you get sick, you have to fight with the insurance companies to get reimbursed. I see people driven into poverty because of health-care bills. I’m sorry I got into this business.”
How we adopted this “fee-for-service,” profit-oriented health-care model after WW II is a mystery to me. Other advanced nations socialized this vital service. Our model is just crazy. Here is how it works: the shareholders of these companies make money by denying you service. You pay huge premiums. When you get sick, the health-care insurance company refuses to pay. It’s called CAPITALISM.
Stay with me here… We “socialize” a lot of what we take for granted in our complex, high-functioning modern society. Fire and police protection, for example. We all pay taxes to support these services and we expect to benefit when we need a cop or a fire truck. Our taxes pay for public education, libraries, highways, and much more. So why don’t the right wingers call these things “socialism”?
Now, of course none of this is “free.” Nor is it free in the advanced European countries who agree to tax themselves in order to assure all citizens are covered for health-care, just like we do for fire and police protection, and public education.
My friend and PowerSpeaking colleague, John Warren, was visiting Ireland when he got pneumonia. He was in the hospital for five days, three in ICU. He needed IV antibiotics. When he was released, there was no bill to pay. They shook his hand and said, “Have a good life. ”
Who paid for all that care? The tax payers of Ireland, that’s who. Wow. Think what that would cost here. Imagine if a foreign tourist in the U.S. had an event like that, he or she could be looking at a $250,000 bill. Welcome the United States. Have a good trip.
2) Health-care costs and poverty.
Your sweet grandmother has a policy that covers 80% of her health-care costs. She lives alone in a house that is paid for and worth $500K (not in the Bay Area). She ends up in the hospital, including ICU for two weeks. The bill is $900,000. The insurance covers 80%, or $720,000. Where does the remaining $180K come from? Grandma has to sell her home and go on the dole.
3) Ask a Canadian.
Next time you meet a Canadian tourist, with a perplexed expression say, “I’m so sorry to hear about your horrible SOCIALIZED MEDICINE program. It must be awful to have big gubment (as it is pronounced in the red states) in your business, telling you what to do.” I guarantee they will look at you quizzically and say politely (remember they are Canadian), “Oh no, we like our system.”
4) No other world leaders want to adopt our system.
Notice how often you will see a politician in some other country running for election or re-election on a platform of healthcare reform that looks like this: “Let’s adopt the American health-insurance system.” Answer: zero.
5) Health-care insurance is tied to employment.
Really? Why? What a burden for everyone. Employers have to worry about all this administration and cost, and employees may be tied to jobs they hate for fear of losing benefits.
In more forward-looking countries, at birth all citizens are automatically enrolled in the nation’s health-care system. End of story. These countries willingly pay higher taxes, and in exchange do not worry about being thrown into poverty by health-care expenses. They believe it is the job of the entire country to care for all its citizens. (Bunch of commies!)
6) We already have socialized health care.
Medicare and the VA are very popular health-care programs paid for largely through taxation. Before I was eligible for Medicare, our family of three paid Kaiser about $15,000 / year for coverage. Under a socialized system, we’d pay that in taxes and be covered for life wherever we lived, and whether or not we had a job. Also, we would not be limited to any one hospital system.
What could be wrong with that? Answer: Investors and over-paid health-care executives would not be making a killing on our illnesses. It is obscene that our capitalistic, fee-for-service, free-market system allows this group of the very wealthy to get even richer when we get sick.
I thought Christianity says, “I am my brother’s keeper.” Guess that only means in places like Sweden, England, France, Germany, Canada, etc, etc., but not in this country. Hmmm, is Christianity preaching socialism? Wonder if they know that in the Bible Belt.
7) Effects on other health-care costs.
Notice how television advertising is heavily weighted toward health- insurance promotion? Imagine the cost of that to the health-insurance companies. Under universal coverage… no need for that expense. You don’t see expensive ads on TV for the VA.
Under a socialized system medical school would be free or low- fee. For example the average new MD in Canada is $28,000 in debt, whereas in the US, it is closer to $230,000.
If the profit motive is taken out of health care, imagine what it could do to reduce the cost of medicine. Big Pharma would be whittled down in size.
So I agree with the Republicans. Let’s blow up Obamacare…and the whole goddamned industry. Let’s design health care for the people who need it, not the billionaires who profit from it.
Robert Reich makes this argument beautifully in a recent opinion piece in SF Gate:
7 thoughts on “Kill Obamacare !!!”
Right on Rick! You summed it up very well. As a Canadian by birth, and a naturalized American, I enjoy most aspects of living here in Silicon Valley EXCEPT for the unfair & expensive health care system. Thanks for your article.
Well said, well thought out, well researched. I personally perplexed at all the people (fiscal conservatives) in their 60’s who rail against entitlements yet nix thought of altering both Social Security and Medicare…their "entitlements".
We need a single-provider, single-payer system as you say, Rick. And that (government) system needs to bargain with pharma for reasonable drug prices. Many providers are "non profits." I think those providers’ prices would mitigate when they no longer have to gouge those who can pay, to pay for those who can’t–because EVERYONE would be covered and thus be a payer. They don’t have to make money to satisfy stockholders, so they can aim to cover actual costs.
With the ACA, the insurers have just figured out how to further game the system. Now that they can’t deny coverage because of pre-existing conditions, they charge more for deductibles and co-pays. I thank heaven for Medicare.
Susan, dang straight I don’t want anyone messing with my social security (that I paid into for 47 years) or my Medicare (that I paid into since it was instituted). I paid for them just as I paid into my 403(b)s and 401(k)s. They and their appreciation and interest are owed to me. I am entitled to them in the real, dictionary sense of the word.
Your piece is well thought out and well expressed, Rick. The concept of people getting rich by charging as much as the market will bear for medical necessities is morally bankrupt, as far as I’m concerned. The health insurance industry is presently an important part of the system for allocating medical resources, a necessary function that I’m sure is done more cheaply by HMO’s like Kaiser (which I think provides a positive model for how a single-payer system would work). But the other activities of health insurance companies would no longer be necessary: huge advertising and promotional expenses, salaries for legions of sales people, lobbying in state capitols and Washington DC, and people who negotiate between different healthcare providers and facilities for advantageous pricing. All of that would hardly be necessary except as part of a private Cadillac-style servicing system for the super-rich (if enough of them want it).
I couldn’t agree more!
Employer-provided health care following WW II was a means to avoid wage controls in that era. What became a recruiting tool to differentiate employers was soon a price of entry ticket for employers. Probably cost effective in its day, but now is a hidden tax on employers. I would argue that American industry is less cost competitive on the world economic stage because employers face staggering costs … as do their employees. And, society still bears the burden of the uninsured and underinsured. What we have is one of the least efficient and lesser effective health care delivery systems in the developed world. 1st world standards of living with a 2nd class health care system equals a recipe for failure in global competition. Now let’s turn to public education funding for a less controversial topic…