Vail Daily letter: A better way to handle health care
Vail, CO, Colorado
Many make the mistake of attributing all health-care cost-shifting to the uninsured. If we only insure the uninsured, runs the thinking, cost-shifting in the form of rising premiums for the insured will be ended.
Largely unaddressed is the cost-shift due to the underinsured. As insurance companies guarantee their profits by shifting costs to families by moving more people into “catastrophic” or “consumer-driven” health plans with higher out-of-pocket costs, unpaid medical bills due to growing numbers of underinsured have increased over the past decade.
A 2008 study by doctors at the University of Colorado School of Medicine revealed that of those with insurance for a full year, 36.3 percent were underinsured — that is, they reported the delay or omission of recommended care because of their inability to afford it; half felt that their health suffered because they could not afford recommended care.
A 2009 study by Families USA reported that 32.4 percent of Coloradans were uninsured — nearly one out of three people under age 65 had no health insurance all or part of the two-year period 2007-08. Combined, the numbers indicate that over 68 percent of Coloradans are under- or uninsured.
Health-care reform has been framed by corporate and Republican interests as a gift to insurers, with mandates that require everyone to buy their product, and subsidies to increase their profits.
The U.S. stands alone in propping up for-profit insurances as central to primary health care (a practice illegal in most advanced nations).
Private insurers guarantee their shareholders’ profits by denying health care to their policy holders.
Employer-provided coverage, too, is built on sand, as employers increasingly avoid rising costs by changing policies or shifting costs to employees.
President Obama and the Democrats have not made the best case for meaningful health-care reform as a significant contributor to economic recovery.
A single public-payer health care model that ironically (unlike private insurances) permits true full choice of private providers has demonstrated in over 20 federal and state studies the ability to save enough money to provide comprehensive coverage for all.
Instead, Democrats started with a compromise position, promoting a largely undefined “public option” and permitting the political right to define the terms of the debate with distortion and distraction.
Democrats should reclaim the issue and trump the debate by making Medicare buy-in their public option. Medicare is known and liked by most people, and its structure is in place — no need to create a whole new program at additional cost.
Enlarging Medicare’s risk pool by permitting younger people to buy in on a sliding scale would improve its financial stability.
Additional improvements would encompass eliminating costly high subsidies to privatized Medicare Advantage plans, and permitting negotiation of drug prices as is done in other countries, while improving provider reimbursement.