America already has several models for health-care reform
By Christine B. Helfrich
The Salt Lake Tribune
05/23/2008
The May 11 Salt Lake Tribune editorial endorsed the Hillary Clinton plan for health-care reform and on May 12 gave support to the Bennett/Wyden Senate proposal.
The Tribune sought to reassure us that these plans would not be a single-payer, government-financed plan but would “force insurance companies to compete on price, benefits and quality.”
Let’s be clear, universal coverage, as discussed by the current presidential candidates and the Bennett/Wyden plan, does not mean equal coverage.
Let’s look at the much-maligned term “socialized medicine.” As op-ed writer Stas Mintowt-Czyz (“Look to England’s example for ways to solve America’s health-care problem,” Opinion, May 18) points out, this system works quite well in England.
The government both provides and pays for the health care. Hospital doctors are paid salaries, and office-based health-care providers are paid based on the number of patients they see. In fact, our own Veterans Health Administration is also government-owned and the physicians are government employees. Apparently socialized medicine is acceptable for our veterans.
In Canada health care is provided in the “social insurance” model, which means health-care providers are self-employed but the government pays for the services in the private health-care delivery system.
The Canadians call their system “Medicare” and coincidentally this is exactly how our U.S. system of Medicare works.
So, if we have successful models of socialized medicine and social insurance operating in our country, why is it such a leap to consider covering all Americans under a single system? I fear our presidential candidates have been intimidated by the “Harry and Louise” misinformation campaigns of the 1990s.
Next time you visit your health-care provider, ask how many office employees are required for the billing and preauthorization of insurance claims. This administrative burden is estimated to consume 12 percent of insurance premiums. Another 20 percent is consumed by private insurance industry administration, marketing and profits.
UnitedHealth Group CEO Stephen Hemsley recently told investors, “We will not sacrifice profitability for membership.” Do we really think the private insurance industry is going to step forward to care for our uninsured with chronic health problems?
In fact, the current position of AHIP, the national trade association representing 1,300 health insurance companies, is that private industry should not cover individuals with significant health-care needs because that drives premiums so high that they are priced out of the market. AHIP prefers that taxpayer-funded programs pay for the 80 percent of health care used by the 20 percent who have chronic or serious health-care needs.
Those of us with employer-subsidized health insurance may be unaware of some of the deficiencies of our own insurance plans. You may have a plan that allows $120 per month for prescription drugs. This sounds generous until you get a cancer diagnosis and discover that you need $13,000 (Gleevec) a month, or $150,000 (Avastin) a year, or $100,000 (Herceptin) a year for drugs delivered in an outpatient setting. And you thought hospitalization insurance was your biggest concern?
Did you know that more than half of the insurance plans offered to college students offer benefits of $30,000 or less? Hope your college kid doesn’t need a bone marrow transplant for leukemia.
If we replaced all of our public and private insurance plans with a single national health insurance plan we could eliminate $350 billion in wasteful administrative and marketing expenditures.
The United States already has a successful program that covers 40 million people and allows us to choose our health-care providers and facilities and it manages this with only 3 percent overhead for administrative expense. This health-care plan is called Medicare. Don’t we all deserve Medicare?
CHRISTINE B. HELFRICH is an employee of the University of Utah.