Undoubtedly, President Obama's health care speech touched nerves here on Kos. Now, forgive me for being so general, but from what I have seen most Kossacks are rather disappointed.
The 64,000 dollar question is: Is that disappointment merited? Yes, and no.
Most of you who have read "Eighteen and Uninsurable" know that I was born in full renal failure, and now live with impaired renal function. I have a huge stake in meaningful healthcare reform; I, like the President, am not willing to accept the Status Quo as a solution. It goes without saying that America's healthcare system is dangerously broken. I do not support Snowe's "trigger" idea, nor do I support Bacaus' plan. Both are illogical solutions to a very serious problem.
I believe there are things all Kossacks can agree on when talking about healthcare reform.
- It must be universal, with no denials for pre-existing conditions and no recisson.
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- It must be affordable so every single American can have coverage.
Single payer fits that criteria.
However, so does a system like Germany's.
What President Obama is proposing, keeping insurance companies intact while denying them the ability to deny applicants based on pre-existing conditions and denying their ability to rescind coverage when people get ill, sounds a lot like the German system.
In essence, the German System is this: 90% of Germans gain access to quality, affordable healthcare through companies not funded by taxpayer dollars. Instead, German workers put up to 8% (it can be less) of their gross income to sickness funds. Their employers match that amount. There are 240 sickness funds any German can choose from. The premiums an employee in Germany must pay (yes, it is compulsory) are based on their income. The less one makes, the less one pays into the sickness fund. In fact, about 8% is what Americans pay, but our employers pay upwards of 18% to insurance companies. Why? Because, unlike in the German system, we also pay for insurance company profits.
The remaining 10% of Germans buy their insurance from private entities. However, those people make upwards of 72,000 dollars per annum and/or work as Civil Servants. Germany's private helath care system is, even in the private sector, more affordable and higher quality than the American one. Of course, those who can pay get more perks, but the quality of care does not differ. Yes, those who are in the private German system can see any doctor they want (even the Chief of Medicine), get free cups of coffee, a private room and be ushered to the front of the line. However, the main point to keep in mind is this: the quality and accessability of care does not change. Some Americans who are skeptical of the German plan may have problems with the fact that those who are in private insurance companies in Germany can choose the "cream of the crop" in terms of Doctors. Afterall, being the Chief of Medicine is a pretty high honor to attain.
That point calls for an old joke:
What do you call a Doctor that graduated at the bottom of his class?
A: A Doctor.
Think of it this way, the healthcare of 90% of the German population is like a laptop computer. Sleek, shiny, and if we're talking about mine, a lovely light pink. The private healthcare bought by those who make more than $72,000 dollars per annum is like a lovely pink laptop coupled with a lap table. A lap table for your laptop is a perk, not a necessity, nor does it change the quality of one's iTunes collection. It merely allows you to be given a cup of coffee while at the Doctor's office.
As I mentioned before, the things all Kossacks can agree on in regards to healthcare reform is are the following points:
- It must be universal.
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- It must be affordable.
The German system meets both of those criteria, and the changes President Obama proposed in his speech Wednesday sound like the German system. However, there are two things the German system has that makes it work for the people that President Obama's proposed solution does not have.
- The "insurance companies" or sickness funds in Germany are heavily reguated by the Federal Government. They must take everyone, regardless of health conditions. No recission, and the only way to be cut-off is if you don't pay your premiums. President Obama proposed regulation, but not heavy regulation.
- The Germans pay 8% of their income into sickness funds, an amount matched by their employer. Americans also pay 8% of their income, but American employers pay 18%. Why is Germany able to get away with having employers pay so little? Because the German system is nonprofit. The President mentioned nothing about this very good idea of disallowing profit from healthcare.
It is a very good idea to disallow insurance companies to make profits. In fact, one could argue that there is no moral reason Aetna, PacifiCare, or Blue Cross Blue Shield should be making the profits they do now. Their profits come from denial of care, and a system like Germany's disallows such practices. If one has paid, one gets care regardless of cost.
Many Kossacks are up in arms about having to pay insurance companies money when all they have done is finacially ruin and kill by denial. Those worries are merited. There are two things I'd like to point out.
- If heavy, binding regulations pass, then insurance companies will be unable to deny or rescind policies. No financial ruin, no death.
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- Mandates can lower cost.
Calliope, mandates can have the potential to lower costs? I don't believe you. Yes, my fellow Kossack, mandates can lower costs. Under universal coverage with mandates, obviously everyone pays. If everyone pays, then the overall cost is brought down. How? Not everyone who pays gets sick, but because everyone pays the same amount it will ultimately cost less than if just the infirm paid sky high premiums. Responsiblity is spread across the board equally, as it should be. No man is an island.
However, mandating will only work properly if insurance companies are disallowed the profits they gain now.
That, my friends, is a damn good system if I do say so myself.
President Obama's proposals are not without flaws. There is too little mentioned about heavy regulation and no mention of disallowing insurance companies to make profits off the backs of the poor and infirm. That is what we must fight for. It would be prudent to have a back-up plan for healthcare reform. Therefore,I propose a faithful adaptation of the German system.
There are two 64,000 dollar questions, the last one is this: How long will it take to regulate America's insurance industry? I believe if we work on regulaton intensely, and close discovered loopholes promptly, it won't take too long. Obviously, we need some sort of public option that would act as a life boat for those who cannot wait that long. Where it goes from there, I do not know.
*Editted to add: Thanks for the rescue. :)