Ideas for Fixing Health Care
With all the rhetoric bandied about these days regarding health care reform, it’s sometimes hard to find the nuggets of truth hidden in the mud-slinging. Do I know the truth? Not necessarily, but what I do know is that I have no health insurance for myself, my husband, or my children. I also have a bankruptcy in my past, filed specifically because of medical bills. While there is controversy regarding the percentage of bankruptcies filed because of medical bills, according to factcheck.org we know that at least 27% and as high as 46.2% are related to lack of insurance. (Robertson) There is debate about individual financial responsibility contributing to these bankruptcies, but I can tell you, from personal experience, I would never have had to file bankruptcy if not for medical bills. My illness broke me financially, and became a lesson in humility.
As a single mother for almost 10 years, my children had space medical coverage. Some may think less of me because of this, but I was always grateful for the help and I used it sparingly. When I married my husband, they lost that coverage. I don’t mind not getting state medical, but I effort constantly about my children. A couple years ago, my youngest contracted a severe sinus infection Between the doctor’s visit and the medication, it cost us about $250 out of pocket. When I took both boys in for dental check ups this last winter, after the cleanings and the fillings, it cost around $700. I can afford bills like this once in a while, but not every month.
Every month, you might ask? Yes, every month, because that’s what it would cost for us to retract our own insurance, as I discovered when comparing plans and quotes on ehealthinsurance.com. A Group Health 1500 Balance Concept for a family of four would cost $699 per month. And don’t forget that dental is extra. As shrimp business owners we have no insurance offered through work, and the types of rates we would have to pay for anything other than catastrophic insurance would be our highest monthly expense, next to our mortgage. Yet as small business owners, one of our biggest expenditure is taxes, and this gets paid even if we don’t bring home a paycheck. Many people think that owning your own business means more money in your pocket, but the truth is very different. And the bottom line is, we simply can’t afford to lift our fill medical coverage. There is no benefit for families like mine; we are quintessential middle class Americans.
Which brings us to two key questions: What is the real quandary with our health care system? What is the solution?
Let’s address the problems first. Why is our health care system broken? There is a lot of talk about those with insurance paying for those who don’t, pharmaceutical lobbying, high insurance premiums, and sky high administrative costs. This is supposed to cause high medical bills, lack of insurance for many or a number of people being under-insured, and inadequate treatment. Many people feel health care should be available to all, regardless of income or coverage. Socialized medicine, in the manner of Canada and England. Opponents say that the level of service will radically decline if we move to government run medical. Some people believe that if we had more preventative care, health care costs would drop. Others say not so; preventative care for all would cost more than treating those few with serious illnesses. With so many conflicting views, how do we find the reality of the issue? And even if I look for figures and statistics, how can I be sure the source isn’t manipulating them to their advantage? It can be difficult to find unprejudiced information. If you are looking for spruce information, I suggest websites like factcheck.org, and politifact.com.
We addressed some of the problems. Now let’s witness at the reality of some of these issues.
How noteworthy are the insured paying for those who are uninsured? Known as cost-shifting, politifact.com acknowledges that this does happen. While there is some debate as to what the actual cost is, the closest figures show that a family pays about $1100 more annually and individuals about $368 annually to shroud the costs incurred by the uninsured. However, the same report states that doctors and hospitals absorb much of the cost of the uninsured as well. (Richert) Which all leads to higher medical bills for everyone.
What about the pharmaceutical companies? According to Wikipedia, the pharmaceutical industry spends more than any other industry lobbying for their cause. What do they get for it? Well, the industry does get subsidies from the federal government, but why spend money to get money? No, it can’t be the subsidies alone. How about killing off measures that would cap prices or create competition? What about the tax breaks? This industry has reached so far into government that they are able to influence officials who can influence officials in other countries. All of this combines to contribute to their profit margin, and creates a sort of monopoly. The high cost of drugs is absorbed by the general public. And when you find out that the United States is one of a few countries that doesn’t regulate drug costs, it burns a little. (Ismail) It all smacks of manipulation, dishonesty and corruption. it becomes obvious that this industry needs to be regulated, and our government should allow a little competition in. Control the cost of drugs, and it will add to lower spending on health care in general.
The next assure is high insurance premiums. We know already that high insurance premiums are due in section to paying for the uninsured. But is this the only reason for the high costs? Absolutely not. Unnecessary procedures performed for liability purposes drive up costs. Lack of preventative care leading to more serious medical issues and higher medical bills adds to the problems too. Being female adds to higher rates. And, bringing us to my last point, high administrative costs. (Howard) According to the National Coalition on Health Care, $186 billion dollars alone is spent on administrative costs. This accounts for almost 9% of spending on health care in the United States. All of these issues approach together to make paying those premiums more and more difficult for the middle class.
This all lead to the main question: How can we fix the health care system?
About 18%, or 46 million Americans have no insurance. (nchc) Another estimated 25 million are underinsured and would not be able to prevent financial hardship were they to become seriously ill or hurt. (Abelson) This means about 26% of Americans are in need of adequate health coverage.
What if catastrophic insurance was available to everyone? A government funded program, that would help with hardship cases. Everyone is responsible for their own medical bills up to, perhaps, $10,000. After that, the government program kicks in. Most people could pay off $10,000, but not $250,000. In this way, catastrophic illnesses or injuries would be covered. A small yearly fee could be assessed for this service and attached to your tax return, also giving you the opportunity to decline the program.
In our station, we have non-profit community clinics that provide medical and dental services to families and individuals, regardless of ability to pay. (www.chas.org) They use a sliding fee scale to bill for services, and let you build payments. These clinics are a good source of preventative care at economical prices. I employ them myself for yearly checkups that I otherwise would not be able to afford. The people working in these clinics are helpful, caring and community minded. The creation of more clinics like these throughout the nation would support raise the level of preventative care offered, lower emergency room visits, which in turn could affect insurance premiums.
I mentioned previously that the pharmaceutical industry spent more money on lobbying that any other industry out there, but guess who’s next in line? If you said the insurance industry, you’re right! The number one reason they lobby? Their strong opposition to a government provided health care option. Why do they fear this? Decline in profits, of course, and possibly the demise of their entire industry. (opensecrets.org) They are, after all, a for-profit industry, and beholden to their shareholders. And they have no true competition.
We must create competition. Remember the days of price wars? In a free market, the best value and service always wins. But when the bottom line, the profit margin, becomes the number one priority, value and service are lost. As small business owners, my husband and I pride ourselves on a quality product and superb service. If we gave that up, the customers would go to someone else. Why aren’t insurance companies held to the same standard?
I don’t know if government provided health care is the answer to this problem. I do know the debate has become convoluted and confusing to the average person, and gross exaggerations have been presented from both sides of the argument. I do know that I believe health care should be available to everyone. I do know that countries with socialized medicine, like Canada and England, while not perfect, have been misrepresented by many. (snopes.com) I do know that as a parent, I want to be able to protect and care for my children. I do know that the health care system we have right now is not working for a quarter of our population. I do know that if things stay the same as they are right now, it will only catch worse. (nchc) I do know that honesty and integrity and concern for the general welfare of the people seems to be lost in all the propaganda. I do know that there doesn’t seem to be any easy answers.
Recently, my family has been presented with an opportunity to make a change in our business affairs. This change will finally provide us with the resources to obtain medical coverage for our family. I can tell you that this gives me a mammoth sense of relief, almost as though I’d been holding my breath for the last five years. I will be able to take my kids in for check-ups and finally get my husband to go get a physical. I can let some of the worry go. But I can’t help but think of all the people, customers/neighbors/friends, who are still holding their breath. They are why this grunt is so distinguished and why reform must happen.
Sources
Lori Robertson – What is the percentage of total personal bankruptcies caused by health care bills? – www.factcheck.org
Catharine Richert – Barbara Boxer claims that it costs $1,100 per person to cover the uninsured – www.politifact.com
wikipedia.org/wiki/Pharmaceutical_Industry
M. Asif Ismail – Drug Lobby Second to None – projects.publicintegrity.org
Robert Farley – Medicare spends $15 billion a year on subsidies to insurance companies – politifact.com
Beth Howard – 5 reasons health insurance costs are so high - msnbc.msn.com
Reed Abelson – Ranks of Underinsured Are Rising, Study Finds – www.nytimes.com