Note: This was written for the uninformed...I know I'm preaching to the choir here, but I wanted to share this...
You'd have to be in a coma to not know that our nation is in the midst of a great debate on the future of health care. And yet, with all of the spin, noise, and flack being sent up over this issue it's difficult to separate the wheat from the chaff on this vital subject. The following is my humble attempt to clarify some issues at hand.
One thing that is NOT debatable is whether or not we need health care reform. The only people, and I mean the only people who would say that the status quo is perfectly OK are either extremely uninformed or getting rich off of the current system. Here are some unspun statistics:
* Currently, there are 43.6 million uninsured people in the United States (Source:
http://www.cdc.gov/... )
* The United States spends more on health care than any other industrialized nation in the world and yet, in many respects, it's citizens are not the healthiest. (Source: Iglehart, J.K. "The American health care system--expenditures." The New England Journal of Medicine)
* Not only does the Unites States spend more on health care, but we're not getting a very good return for our investment...the World health Organization ranked the world's health care systems recently, and the US came in 37th...behind countries like Morocco, Chile, and Singapore. Even a nation we see on "Feed The Children" type-ads, Colombia, ranked higher. (Source WHO
http://www.who.int)
* The US healthcare system is the most expensive of systems, outstripping by over half again the health care expenditures of any other country (Source: Iglehart, J.K. "The American health care system--expenditures." The New England Journal of Medicine)
* The amount people pay for health insurance increased 30 percent from 2001 to 2005, while income for the same period of time only increased 3 percent. (Source: Robert Wood Johnson Foundation)
* Healthcare expenditures in the United States exceed $2 trillion a year. (SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group;) In comparison, the federal budget is $3 trillion a year.
It's obvious...something's got to change. Of course, the avarage person knows this...in elections going back 40+ years, politicians have been responding to peoples' health care concerns with words, if little else. Every election cycle, health care is either the top concern of voters, or at least in the top 4.
More than one financial expert, liberal, conservative, and nonpartisan, have said that our spiraling health care costs are in danger of bankrupting the country in our lifetime. And that says nothing for the horror stories we've all heard (or lived) of people having life-saving care denied or withheld, not by doctors, but by insurance company bean-counters.
So, something needs to be done. But what? That's the vexing question. What people have heard is being considered has ranged from the hopeful to the terrifying. Allow me to make a few things clear:
A Coming Government Takeover Of health Care?
Nobody, and I mean NOBODY, is talking about a government "takeover" of health care. There is not one proposal being seriously considered right now that would ban private insurance companies, or force anyone to drop the insurance plan they have right now. Even the most liberal, far-reaching plan calls for one simple principle: if you like what you have right now, you can keep it...PERIOD. Anyone who says otherwise is lying to you, hoping to scare you towards their position. So let's leave that talking point behind right now...there will be no "government takeover" of health care, under any plan bring considered.
"But what about this 'public option' I hear about?" some may ask, "isn't that an example of the government getting involved in health care?" Well, yes, but it's not the first time government has gotten involved in health care. A majority of our senior citizens gets their health care, in some form, through Medicare, which is a government owned and operated system. And as many as 33% of American children get their health care through some form of government-run health system (Medicaid, Healthy Start, etc). So the government's already involved...those who say that the government has "no place" in health care "at all" are either not thinking things through (the charitable option), or want to do away with Medicare and Medicaid entirely (and with all of those politicians who campaigned against sCHIP, a vital safeguard against children being left with no health care, it's more likely the latter).
As an interesting side note: just about every thing said by nay sayers of the public option...that it "is socialized medicine", that it's "a step towards socialism", that it will "ruin our health care system", "it will lead to rationing"...all of these things were said against Medicare when that system was proposed in the 1950's and 60's. Republican scion Ronald Reagan once said: "And if you don't do this (work against the enactment of Medicare) and if I don't do it, one of these days you and I are going to spend our sunset years telling our children, and our children's children, what it once was like in America when men were free." Yes, he was talking about Medicare. We can see that those fears were unfounded.
Why propose a "public", or citizen owned, form of health insurance? Proponents of the "public option" feel that such a citizen-owned health insurance option is the only way to force private insurance companies to curb costs and deliver the care people need. After all, an exclusive free-market approach has NOT done the trick. The current private-only system has lead to spiraling costs and denied medical care. Politicians have been talking about reform for over 40 years, and yet such pressure has not lead private insurers to control costs or respond to their customers' needs.
Why is that? Why haven't the same market that have brought down the costs of High-Definition televisions and personal computers worked on health care? Well, there are several reason for this. One is that health insurance itself is often not paid for by the consumer (it's far too expensive), but by the consumer's employer. An employer buys one health plan for all of it's employees, and the employees have only one plan to choose or reject....with rejection meaning no health coverage at all. This layer of insulation has meant that the people receiving the care are seldom the ones pay for it, so the same customer satisfaction factors that play into most services are abscent in health insurance.
Another thing is a certain amount of price fixing amongst large insurance companies. Basically, one big insurance company is loath to seriously undercut another, because they're all making too much money off of high prices. While they're too careful to get caught doing it in a "going to jail" sense, unspoken agreements can be powerful players in market prices. Besides, cross-invenstment between insurers and pharmaceutical companies means that one of the big culprets for rising heal care costs, drugs, benefits both the manufacturer and purchaser of perscription drugs. This is not a recipie for normal market pressures.
Normally, large purchasers of perscription drugs (like the government-run systems in other countries) can negotiate with drug manufacturers for lower prices. How it works is simple: a large consumer goes to a drug company and says "I've got 50 million people who need you cholestrol drug. You're asking for $10 per pill, but we can only pay $3 per pill. You can either accept our offer and make $4.5 billion per month (50 million customers taking one pill per day for 30 dys), or nsay no and walk away from that 4.5 billion". This happens on a much smaller scale now with individual companies, but a government plan (which tend to be much bigger) can have better bargaining power. And when one entity get a price, others try to get the same deal.
(Another aside: how scared are the big money players of such bargaining power? When a Republican-controlled congress passed a Medicare drug benefit a few years ago, the government was PROHIBITED from such collective bargaining! Obviously the pharmaceutical lobbyists got what they paid for.)
The current private insurance-only system has not delievered on containing costs. Nor has it delievered on giving the kind of care people need. A public option, however, would restore normal market pressures on the health insurance industry. Since it would be owned by the people, and not shareholders, it would not be under the constant pressure to increase profits that has crippled health care in this country. It would be an alternative that people could turn to when they've had enough of high prices and denied care. It would be an OPTION...people could buy into it if they liked. Again...if you like your current plan, YOU CAN KEEP IT. Private insurance will still be there for people who want it. This is about offering people choices...always a plus!
Now, some have said that a public option would destroy private insurance companies. It could...if the private companies refuse to adapt to a revitalized market. If they hold their breath and refuse to control costs, drop people who need treatment, and deny life-saving treatment to their customers, then they could very well go under as more and more people opt into the public option. But would such a thing really be a loss? Again, if you like paying a lot for denied coverage then you could certainly go on doing so. More likely, private insurance companies would streamline and specialize, and become much more responsive to the customers they keep...a win-win for everyone.
For those nervous about an expansion of government involvement in health care, you're not alone. We, as citizens, would have to demand accountability from our elected officials to make sure such a plan didn't become a morass. But what's the alternative? Doing nothing is NOT one. The only other thing we could do to fix the current system without a public option would be to regulate the private insurance system to such a degree that it would be the BIGGEST government intrusion into a private industry in HISTORY. The insurance companies have shown that they will not self-regulate, and any promises to do so now ring hollow. No, to fix helth care without a public option would mean regulating health care and health insurance to such a degree that the beauracracy involved would dwarf anything in existance today! Is this what we want? Is this not more worrisome than a public insurance option?
Let me state it plainly: to fix health care, the only viable options that would do any good are a simple public option, or a massive regulatory system the likes of which we've never seen. I hate to put things across as the lesser of two evils, but...
I'm not 100% on the public option...really, I'm not. I'm someone who would like to see a single-payer system like the rest of the industrialized world has. That's not an option right now. Having looked at all of the possibilities, a public option looks like the simplest, and most likely to have an effect, option we have. One thing we cannot allow, however, is for fear-mongers to cloud our vision. We have to do something. Not acting is no longer on the table.