NHIS numbers, and building on what works
Town Hall on Health Care
President Obama
The White House
July 1, 2009
Here’s the problem, is that the way our health care system evolved in the United States, it evolved based on employers providing health insurance to their employees through private insurers. And so that’s still the way that the vast majority of you get your insurance. And for us to transition completely from an employer-based system of private insurance to a single-payer system could be hugely disruptive. And my attitude has been that we should be able to find a way to create a uniquely American solution to this problem that controls costs but preserves the innovation that is introduced in part with a free market system.
We want to build on what works about the system and fix what’s broken about the system.
And…
Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2008
by Robin A. Cohen, Ph.D. and Michael E. Martinez, M.P.H., M.H.S.A.
CDC
In 2008, 60.2% of unemployed adults aged 18-64 years and 22.2% of employed adults in this age group had been uninsured for at least part of the past year.
Among persons under age 65 with private health insurance, 17% with employer-based coverage were enrolled in a HDHP, compared with almost 45% of those with a private plan that was directly purchased or obtained through means other than an employer.
http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur200906.pdf
Comment:
By Don McCanne, MD
Everywhere you turn those rejecting single payer, including President Obama, say that we want to build on what works and fix what’s broken. They say that what works is our employer-sponsored system of coverage. But does it?
Employer-sponsored plans fail to cover about one-fifth of the workforce. Of those who are covered many have been switched to high-deductible health plans (HDHP), a form of inadequate underinsurance that has been more characteristic of the individual insurance market.
Although the employer-sponsored system falls short for far too many of us, one of the most serious deficiencies is that it is dependent on employment. Well, of course. But that means that three-fifths of the unemployed remain without coverage. And of those insured who do not receive their coverage through their work, 45% have HDHP underinsurance products.
This is really a lousy insurance infrastructure that we are trying to prop up. And nobody in Washington is considering seriously the massive amount of tax subsidies that would be required to help everyone purchase plans with adequate benefits. Establishing an insurance exchange for employers and individuals is of little help if the subsidies won’t fill the gap of affordability. But adequate subsidies are off the table because they are budget busters.
How about dumping what’s broken, and building on a system that works - Medicare.