As we form our political and social views we are, of necessity, influenced by our personal experience. Those of us with money or jobs tend to have had health insurance all of our lives - in the family in which I grew up, not having coverage was unthinkable. In business, health insurance was historically a way of rewarding employees, keeping employees, ensuring a healthy, productive, and secure work force, and helping them keep their minds on work rather than the health of them and their family members. I can't imaging not having coverage, and not offering it to my employees.
I provide health insurance for my staff for all these reasons - on the one hand, it gives me an advantage over my competitors who don't offer the benefit - of greater importance to me is that people I care about don't feel they cannot go to the doctor when they have some minor problem [like a chest pain] out of fear of the cost of an office visit.
And, I don't want them to worry that their children might get sick, and they can't afford to care for them. But more than health care affecting me as an employer, as a Family Law lawyer it affects my clients every day and creates problems for many with which we must deal.
Each week, in one case or another, this is an issue we face. Sometimes it is as "simple" as trying to convince a client he or she needs to make insurance a higher priority, or guiding the client in a job search to a profession where it is routinely provided by employers [large companies, public agencies, etc.] Of greater difficulty is explaining to the soon-to-be ex-spouse that health insurance will soon run out, or may be extended for a number of months at a high rate. Lately, the job choice doesn't exist.
Commonly known as COBRA rights, many larger employers are required by state or Federal law to extend benefits to former employees or their former spouses as an extension of their prior policy. The COBRA cost is supposedly approximately equal to the regular cost of coverage [without subsidies, plus a small handling charge]. Sounds like a good deal? Last month I saw my first quote that caused me pause: My client's ex-wife would be paying more than $750 per month to keep her existing coverage after the divorce - she is in her 40's - that sum is not within her budget, but pre-existing conditions also keep her out of the market for a policy on her own.
The system is clearly beyond our control, for a multitude of reasons. In a recent op-ed piece, Paul O'Neill [W's first Treasury Secretary, and former CEO of ALCOA] wrote that $1 Trillion per year of waste exists in the health delivery system, and that did not include the cost of administration, advertising, salaries, illegal aliens getting emergency room care, or any of the usual suspects - just fixing mistakes.
O'Neill is not a wild-eyed loon. He is a smart, quiet, studied man. But I can add a big one he didn't consider: The cost of confusion when trying to buy a plan. I've been buying insurance for a long time - I rarely change plans because the decision-making process is unbelievably complicated. The mix of benefits, deductibles, co-pays, and limitations, makes it impossible to compare plans between companies - sometimes you buy based on a gut feeling about the company, or how suave the saleswoman is - one policy is cheaper, but the co-pay is higher - maybe a lower deductible, but some benefits are lost.
Now look at Medicare: You get a major medical policy "free" when you register [that's the result of what you've paid in over the years]. If you elect to buy the second part, it is a fixed fee - under $100. This gets you pretty far along in the process, and decent coverage.
Then there's a gap policy that can pick up the rest of the cost, including co-pays and deductibles [I'll stay out of medications for now, as that's another boondoggle]. The good thing about gap coverage is that there is a limited number of programs from which to choose - I think it's "A" through "J," with increasing levels of benefits as you move down the list. Blue Shield's "D" is the same coverage as PacificCare's "D". Suddenly, you can compare the cost from company to company.
If you want cheaper, you can select an HMO - at the higher end, almost everything is covered. You might feel more comfortable with one company or another based on advertising, but at least you know what is being promised and can compare the price.
It is estimated that health care makes up 1/6th the cost of our economy - I'm not qualified to comment on the accuracy of that statement, but the cost of health care is affecting us all, sick or healthy. It is time for us to come together and accept the fact that we need a solution, and that solution cannot be "more of the same."
A small business with which I am familiar has an owner on Medicare, a spouse covered by another employer, 3 employees, and one child - all in pretty good health. Without considering the subsidized Medicare, the monthly health insurance bill for these 6 people is about $2000, paid by various sources. Add to this the co-pays, deductibles, and Medicare subsidies, the cost of health insurance for this business of fairly healthy people is substantial. If the employees had spouses or more children to cover, or Medicare didn't pick up some of the cost, the expense would be substantially higher.
Virtually every industrialized nation has solved this problem, at far less cost per person than we pay, and with results at least as satisfying to their citizens. If we are to compete in an International economy, we need to level the playing field by not burdening our companies [like Ford, GM, and Chrysler] with the high cost of insurance when there are more effective alternatives.
In doing so, we need to lose our fear of the word "socialism," the boogieman used by the insurance industry to prevent reform - sometimes the government can do a better and cheaper job than some other, bloated bureaucracy, simply by taking out the profit and costs of sale. O'Neill and I can suggest some other costs to remove from the equation.
Remember, these people making us fear "socialized medicine" are the same ones who opposed Medicare with the same claim - they have the same stripes of those who claimed that cigarettes weren't addictive and didn't cause health problems. Let's make a decision and pick plan - we really can't afford the alternative of saying "No!" to every proposal.
