In “A Dangerous Plan for Health Care” Roger Hickey hopes that an advertisement in the New York Times might help rescue private health insurance from its own failings. But where does the danger really lie?
With exuberance Hickey makes a strange assertion: that “the employer-based health care system” in the United States is “the one part of our insurance system that works.”
Say what? Not the Veterans’ Administration, when it boasts the best primary care outcomes in the United States? Not Medicare, when it covers 45 million people yet keeps overhead below 3%?
But Hickey instead issues a false alarm, warning of “dangerous” proposals like those made by McCain, Bush and Company, calling them “ideas off the shelf of right-wing think tanks.” These proposals call for things like federal deregulation of the health insurance industry, taxes on employee health insurance benefits and initiatives based upon personal responsibility — when costly illness strikes … go shopping! (And go bankrupt.)
But these schemes are a joke. Not funny — simply a joke. Such notions, lacking any basis in reality, will not come into reality. They amount to ideological assertions.
Hickey raises the threat of right-wing “reform” because the rhetorical device gives him permission to attempt the impossible: to rush to the defense of employer-sponsored health coverage. Ironically he undermines his conclusions by straying too close to the deplorable facts about private health insurance.
“Those who have insurance are paying higher costs for policies that often have gaping holes in coverage,” Hickey exclaims. “And insurance companies flat-out refuse to sell coverage to those already sick. And businesses, large and small, are burdened with rising costs.” He also bemoans that “millions of dollars the insurance and pharmaceutical industries spend on lobbying and political contributions have only served to prop up a failing system and drown out the voices for change.”
Yet somehow Mr. Hickey draws a crucial distinction between employer-sponsored private health insurance and buying private health insurance as an individual: “dismantling the one part of our insurance system that somewhat works, forcing everyone to buy health insurance on their own, hardly seems a step forward for most people.”
Therefore, he concludes:
“… we need clear rules requiring private insurance companies to cover everyone – even those with pre-existing conditions. And we need the security of knowing we can keep our current health plan, or we can choose a public plan like Medicare, so we’re not at the mercy of the same profit-driven companies that got us into this mess!”
There is some wishful thinking, and some deception too, that if people could only “choose a public plan like Medicare” the public entity could hold the private industry in check, or even that it could grow like Topsy and magically morph into single payer. Yet there is no evidence to support these assertions. The most likely outcome, based upon the bitter experience of several states, as well as the effort to privatize Medicare, would be a failed reform.
To summarize: Hickey argues that the economic crisis and the past failures of private health insurance have renewed a conservative call to dismantle employer-sponsored health insurance. Therefore, the government should rescue the private health insurance industry through regulation. In other words, to answer the conservatives, Hickey offers another ideological assertion, known as Health Care for America Now.
In order to improve the health of the inhabitants of the United States we must rise above a contest of ideological assertions. Meaningful reform will mean measurable progress, facts, evidence. Yes, it will take a social movement. Improving health care must become a question of understanding the evidence — and having confidence that our fellow human beings can and will do the same.
Look at the evidence: reforms based upon regulating and expanding private health insurance have failed, in many forms, many times over many years. This is because because private health insurance stands in contradiction to caring for the sick and preventing illness among the healthy.
A single-payer program is not only eminently feasible (over 40 years ago Medicare was put in place within a year!), but has the economy to save costs by eliminating preposterous administrative waste, reduce disparities by redirecting resources, improve quality by redirecting resources, protect the caregiver-patient relationship by eliminating a tangle of red tape, allow free choice of care providers because if everybody is in and nobody is out then everybody is in — while providing access to care for everyone in the United States.
Because of the evidence, moral imperative is on our side. Society should offer every person the best possible chance at health. The public should set health priorities. Profit-making should be banished when it comes to caring for the sick. Access to health care should not be tied to a job.
Public opinion is on our side. People are ready for a change. It is not only a degree of frustration with insurance companies, but rising expectations about our nation’s promise.
Meanwhile our children need to see a dentist. Our parents need home health aides. Prescription drugs have become a racket. In short, everyday experience makes the case for single payer.
The idea that regulation of private health insurance is the best we might hope for amounts to a dangerous plan for health care. It is a far cry from a “people’s movement” — and it simply will not work.
We need single payer now. HR 676.
