Like millions of Americans my husband and I have begun our search for affordable, quality health insurance. See, we’re both self-employed, plus we’re both over 55 and we don’t qualify for subsidies. We’re the ones in GA whose insurance plan has risen 52.7% this year, exactly what healthcare policy wonks said would happen when the cost reduction subsidies were not funded. And we have two choices, Ambetter and Kaiser Permanente. While we’re lucky enough to have money to buy health insurance, it has become our most expensive monthly bill, almost double our mortgage payment. We’re not the only ones. My Facebook feed is littered with folks just like us, searching for a plan with a deductible under $6,000. We officially moved into the ridiculous, $1500-$1800 (for us both) per month with a $7,250 per person deductible.
As a family which owns two small businesses, we’ve always paid for our health insurance out of pocket. My small company even covered an employee when it was not obligated to do so but right to do so. We also contribute tax free dollars to Health Savings Accounts for everyone. I’ve calculated how much my business has paid for health insurance for my employee, my husband, my daughter and me over its 26-year history: it’s over $200,000! We’ve had a few medical situations over the 26 years: delivery of our beautiful daughter, thyroid cancer diagnosis and treatment for me, Type 2 diabetes for my husband, but we’re really healthy (knock on wood) and don’t have any ongoing big issues. Last year my husband and I only consumed $2,000 each in actual medical expenses. Even with our medical history, paying $200,000 up front for our small business is a major drain. It has prevented me from expanding, giving raises, hiring more employees, buying equipment—the things that small businesses across America want to do. We’re risk takers by nature or we would go draw a guaranteed paycheck at someone else’s business, but we haven’t ever gone without health insurance—as a cancer survivor I’m not willing to roll the dice.
For the last year I’ve been educating myself on our national healthcare situation and policies. I have learned a lot about the “complex” nature of our healthcare industry: understanding the workings of the ACA, including what has worked well and what hasn’t, and the changes made to the ACA in Congress that have almost doomed it. I’ve been talking to doctors and insurance brokers; reading research papers on other healthcare around the world; and following healthcare policymakers and analysts (both liberal and conservative) on Twitter. I have dissected the policy changes coming out of Washington and have, in turn, discussed these with small groups around my area. I feel that I understand a good chunk of how healthcare “works.”
There are many things that we can disagree on regarding healthcare, but I think we can all agree that when we get sick, we want to be treated by the medical community and not go bankrupt in the process. This is the basic mantra that all other large countries in the world have figured out for their citizens. We are the last industrialized country that guarantees healthcare not for everyone, but for some. I hear my conservative colleagues rolling their eyes right now, and while I understand they want everyone to be “responsible” for themselves and their own family’s needs, when I ask each of them will they be going on Medicare when they turn 65 they always say, “yes.”
Let’s talk about Medicare. I would say that until someone turns 65 they haven’t a clue about Medicare, how it works and how well it works. Switzerland’s national healthcare program is also called Medicare and is similar to ours. Every citizen in America currently pays a “tax” (1.45%) on our earnings that goes toward Medicare and the federal government matches that tax. There are many levels (Medicare A, B and D) which pay for a variety of care including physician services, some medical services and supplies, ambulance services, hospitalizations, skilled nursing facilities, rehabilitation and hospice care. There are no $6,000 deductibles to meet. For the things that Medicare does not cover, (some prescription drugs, for instance) we can shop and buy a private supplemental health insurance policy from dozens of insurance providers (competition at its best). Medicare is the perfect combo of federal government and private, capitalistic health insurance.
Recently, I was among a large group of physicians who were asked a series of “anonymous” questions regarding healthcare. They rated Medicare as the most favorable “payer,” ahead of Aetna, BCBS, Humana, Medicaid, and United Healthcare. When I asked a physician about this he said that Medicare is great and has changed a lot over the last couple of years. It’s more efficient, less burdensome administratively and helps control healthcare costs. I was surprised by his answer. I also learned that there’s a shift in physicians’ practices, they are being bought by large hospital companies and corporations. He had just sold his practice to a hospital system. Private practice physicians are becoming rare. New doctors coming out of medical school have a ton of debt and setting up your own practice is almost financially impossible. This physician also said new physicians don’t want the hassle—they want to help patients, earn a paycheck, and let someone else worry about running the practice. I think even physicians are tiring of an insurance actuary in an office building somewhere controlling their profession.
So, a question: why can’t all of us who pay health insurance premiums pay into a #Medicare for All program? Why should we pay ridiculous premiums for essentially “catastrophic” health insurance to a for-profit business? Over the 26 years I’ve paid a lot for a little. We all have. I know that’s how insurance works, but what if we move our “premium” money into the system that actually provides medical services? Our large country neighbors like Canada pay half of what American’s pay and they cover everyone. We pay +/-$10,000 per person when other countries average $4,500 or $375 per month (premium, if you will). We spend $49T on healthcare currently, while analysts estimate it will cost $32T to cover everyone. The math works if “everyone’s in and no one is out.” I’m a capitalistic, small business owner and when I look at this, all I can think about it what we, as a nation, could do with the $17 TRILLION we’d save. What would you suggest? Infrastructure? Education? Supporting small businesses?
I’ve heard every criticism about an “everyone in, no one out” healthcare program…long wait lines, Canadians flocking to the US for medical care, services not covered, etc. (I’d be happy to direct you to white papers regarding these criticisms.) To you naysayers, take a long, long look at your present situation: it sucks, admit it, it sucks. If you don’t think it does you need to look at it again, because I believe it does. We’re the smartest people in the world and have used federal dollars and private capital dollars to invent utilities, pharmaceuticals, create the space program, the internet…I don’t believe that we can’t figure this out. As a matter of fact, and being the optimist that I am, I believe we can make an “everyone in, no one out” the best program in the world.
Join me, let’s get started. Demand that our Congress consider #medicareforall.
#2018 & #2020