More Health Care

One of the primary arguments against a public insurance option in the current healthcare debate is that this is a form of Socialized Medicine, and Socialized Medicine is bad. Such statements are usually followed up with anecdotes about how messed up healthcare is in England or Canada or France, because people have to wait for service (which, of course, we do in the US), and the technology lags.

The funny thing of it is, as bad as the healthcare systems are in these countries, people still live longer than they do in the US.

I've included Switzerland in the comparison below because, as Paul Krugman points out, the "Public Option" plan favored by many Democrats most closely resembles the Swiss system. And Cuba, because we all know that everything sucks in Commie Cuba.

Average life expectancy in 2007, per the World Health Organization:
Switzerland 82
Canada 81
France 81
England 80
Cuba 78
USA 78


Infant mortality rate in 2007, same source:
France 3 deaths per 1,000 live births
Switzerland 4
Canada 5
England 5
Cuba 5
USA 6

The fact of the matter is that basically all developed countries other than the US guarantee health care coverage for all their citizens. And all of them fare better in life expectancy and infant mortality rates than does the US. Do we have the best healthcare facilities in the world? Perhaps we do. But that doesn't do any good when there are 50 million people who can't get treatment because they don't have coverage. (Or often, even if they do, but that's another story.)

Let's care for our fellow countrymen, folks. Let's ensure healthcare for all.

More Health Care Thoughts

This part two of a thought experiment about the US Health Insurance industry.

I am employed by a not-for-profit organization that provides medical and dental insurance to its employees. Employees are required to share in the cost of this program, and a variety of competitive options are provided. I opt for the so-called “80/20 plan,” in which essentially 80% of costs are covered following a $20 copay, subject to an annual deductible. I have approximately $50 withheld pre-tax from my paycheck every two weeks, for a cost to me of about $1,300. In addition, I have a Flexible Spending plan available to reimburse me for the things not covered by the plan, including vision care as well as the aforementioned copays and deductibles. For 2009, I am withholding $750 from my pay to co-insure myself for healthcare.

In all, my insurance will cost me over $2,000 this year. (Of course, my employer is also bearing a significant amount of the cost of my coverage, an amount unknown to me.) Let me reiterate – the amount of your copays and deductibles also comprise the cost of your health insurance. These are the conditions imposed by the insurance company to provide healthcare coverage. They won’t pay the bill until you pay these costs above and beyond your premiums.

Unfortunately for me, in addition to my normal checkups (physical, eye exam, two dental exams) I had one trip to the Emergency Room last winter, and I broke a tooth later in the year, which have added over $1,000 out of my own pocket to the total bill. But fortunately I am in generally good health, with no chronic issues to deal with.

The Federal Government will withhold about $5,600 in estimated income taxes from my paycheck this year. My actual final bill will likely be less than that, but for purposes of this discussion let’s use the higher number. My health insurance costs - not including the emergency situations - equal about 36 percent of my annual federal income tax bill. If the Federal Government became the sole provider of health insurance in this country, but the result was a 30% increase in my Federal income taxes – it would save me money.

Let me repeat that – I would be better off with a 30% tax increase it the tradeoff is that I have no medical bills to pay.

This is a very simplistic calculation, to be sure. For one thing, every employer is different in the amount that they ask employees to pay. Some people pay no premiums out of their own pockets, while others pay significantly higher amounts. But I have a competitive plan, and I earn more money than the average worker in this country. I also am not covering anybody else under my plan, unlike many who cover spouses and children. I suspect that most people pay more than 36% of their federal tax bill in health insurance costs.

It is for this reason that I don’t understand why a tax increase is anathema to so many. For most US citizens, publicly-provided health care coverage would put more money in their pockets. Quite the opposite to the message promoted by the conservatives, this would be an economic boon rather than a burden. Some people would have higher tax bills as a result, but those people would be the mega-rich of this country. I submit that adding a few hundred or a couple of thousand dollars to the pockets of the average American will result in greater economic stimulus than keeping it in the investment portfolios of our country’s wealthiest citizens. The middle class are far more likely to actually buy stuff with their extra cash.

Thoughts on Health Care

The latest political boogeyman is Universal Health Care, as proposed by the Obama administration. Lots of rhetoric is thrown back and forth on the issue, and the Right Wing, while offering little in the way of alternatives, continues to snipe at the proposal.

Some of the common themes:

It's going to lead us to socialism!
Please. For one thing, the checks and balances in our government are too strong, and the election cycles are too short, for us to become a socialist society. If the people don't want the US to become a socialist society, we'll vote out those who we think are leading us in that direction.

Besides, the government has been providing essential services that benefit the public good for a long, long time. Having a state-sponsored police force hasn't led us to socialism. Nor, for that matter, has publicly-run health care, like Medicare.

There will be a government bureaucrat standing between you and your doctor!
I'm not sure how this is worse than having an insurance industry bureaucrat standing between you and your doctor. Or between you and your reimbursement, for that matter.

Private capital is incented to operate more efficiently!
Private capital is incented to maximize profits. Sure, they might provide health insurance with fewer employees than the government will provide it with, but they are also looking for ways to get more money into the pockets of the executives and shareholders. Some of this is done by operating more efficiently. Some of this is done by increasing premiums. And some of this is done by denying coverage to people who believe they've purchased it. In a government-run universal system, there is no profit or bonus incentive, so those costs are eliminated.

As for operating efficiently - raise your hand if you've never heard of governmental entities cutting jobs? I thought so.

Government spending will increase! Taxes will go up!!!
And spending on private healthcare coverage will go down. Again, I fail to see the difference between a dollar sent to the government and a dollar sent to a private company.

You'll have to wait in line to get treatment!
Which is no different from today. People don't get surgery on the same day they sign up for it, they have to wait a couple of weeks. As for the converse, it's simply not true that in countries with socialized medicine that a person in cardiac arrest (for example) has to wait for the doctor to treat a kid with a skinned knee. Would any civilized society stand for that?

I admit that I can't begin to do an analysis of all the dollars associated with a government-sponsored health coverage system. I also don't deign to understand all the details of the Obama package. There is no doubt that there are tremendous flaws in the system, many of which are the result of granting too many concessions to the insurance industry.

But common sense tells me that, in the long run, a government-sponsored health industry will be cheaper than privately run insurance companies. Yes, more people will be covered, but those people already incur costs that the rest of us cover through Medicare, or rate increases needed to offset charity care. If covered, those currently uninsured are also more likely to receive preventative treatment rather than more costly critical care.

And since the government already provides Medicare and Medicaid, there is already an infrastructure in place upon which the new system can be built.

Health insurance should be about providing for the health care of people, not about increased profits. We will never have adequate coverage until those providing the coverage have the patient's health as their primary focus. That is not currently the case.

Open the door.

Doorknob
Originally uploaded by Roadduck99

If you’re still with me on this thing, be advised that what follows isn’t what you’ve come to expect from me. This isn’t intended to be a naval-gazer blog. Sometimes that’s just what’s needed.

I’m looking for a door to open. I think there’s one around here someplace, and perhaps it’s already open, like the one in the photo. Perhaps, like the photo, there’s a window that reveals what is on the other side, and perhaps the door is already open wide enough that the outside is reflected in the doorknob. And perhaps it has been there all along, but I’ve only seen the door separating me from the other side and never looked closely enough to notice the knob was ready for me to turn.

The 12 months or so have been difficult for me. Almost exactly a year ago, my wife and I moved into a new house in the heart of town. This was supposed to be an exciting new beginning, with a smaller mortgage and a smaller commute. What it has turned into, for me, has been a lot of dissatisfaction. I’ve had difficulty sorting out priorities and setting goals, or even seeing the value in doing so. I haven’t given the attention deserved by my marriage, my job, or myself. I have sought counsel to sort things out. I have, I am sad to say, come away with a lesser opinion of myself.

I have discovered that the doors I believed were keeping me out of a good place, may in fact be keeping me in a bad place. I don’t need to arrive so much as I need to escape.

I began this blog because I had stories to tell. I have not been allowing myself to tell these stories for a couple of years now. I have many excuses, but it doesn’t seem important to hash through those here. I’ve got people with whom I can discuss those. In recent months I have taken up telling stories through photographs that I post at flickr. The doorknob photo, I think, tells more of a story about me than about the old building that houses it. (The farmhouse at the McLaughlin Garden in South Paris, if you’re curious.) Other photos that I have posted tell stories about my gardens at home and the world that I see around me.

They say a picture tells a thousand words. I like them because, though I have much to learn, a photograph can be quick and easy to produce. They are also quick and easy for many people to enjoy. Writing, for me, is usually fairly quick and easy, too. When I have a story to tell, I can produce half a picture in a fairly short amount of time. But somewhere along the way I have closed myself in a room thinking that it’s not so quick and easy to write – not if I want to “do it the right way.” But I think it’s time to try turning the knob and see if the door will open.

I have stories to tell. I won’t be telling one every day, and not all will appear here, but I will be telling them. The door is open.

Googleblogging

Blogger has apparently been acquired by Google, and one of the new features is the ability to label posts. I labelled the last one as "politics". I guess if a reader really likes ones take on politics but could give a crap about, say, guitar playing or Joe Pez, they can have a listing of all those posts just a click away. I guess the possibilities are endless. I am guessing that the labels will also be endless. I hope it makes your blog-reading experience even more enjoyable.

New Look

Hopefully more readable. Tell me what you think?