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Articles of Interest

Only in our failed health care system

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CHARLES I. WOHL, M.D.
Berkshire Eagle
Letters
Tuesday, December 16

The extensive layoffs at KB Toys, as described in the Dec. 13 Eagle, will cause far more misery for KB employees than the loss of their jobs alone.

The laid-off workers also lost their medical insurance on the day their jobs ended. Many unemployed KB workers will not receive subsidized health insurance through Commonwealth Care, the Massachusetts health plan, because their incomes before the layoffs exceeded 300 per cent of the poverty level, making them ineligible for subsidized coverage. They must buy health insurance or they face fines; and if they require medical care while uninsured, they face bankruptcy. Adequate health insurance for a family of four can cost around $12,000 per year, unaffordable for many laid-off workers — and for many employed people as well. The only affordable coverage for such people will have high deductibles and co-pays, meaning that many will have to choose between paying for medicine and paying for food and housing.

The KB layoffs are just the tip of the iceberg. As the unemployment rate rises throughout Massachusetts, tens of thousands will remain unemployed long enough to qualify for state subsidized health insurance through Commonwealth Care. When this happens, the Massachusetts health plan, already under great financial stress, will simply run out of money.

What is happening in Massachusetts is a microcosm of the severe economic recession in the U.S. and much of the world. As more Americans lose their jobs and thus their employer-based health insurance, the ranks of the uninsured (now 47 million and counting) and underinsured will swell, meaning that many millions will forego or delay medical care.

This scenario can only happen in America and is the result of our perverse health system in which employer-based health insurance written by private for-profit insurance companies is the predominant form of health coverage for those under age 65. This has lead to a fragmented, inefficient system in which nearly one-third of medical expenditures is consumed by insurance company profits and administrative costs. Medicare overhead is under five per cent. The expense and administrative costs of providing private health insurance for their employees has greatly burdened small and large American businesses, such as the automobile companies, and has made it difficult to compete with foreign companies whose workers are covered by government insurance.

Many small businesses have dropped health insurance for their employees all together or are asking them to contribute to their insurance premiums, which many employees cannot afford to do. And, as we have seen with the laid-off KB workers, when employees lose their jobs they often lose their health insurance. This cannot happen anywhere else in the industrialized world, even though unemployment is rising in Canada and Europe. Every other industrialized country has some form of universal health care. None uses profit making, investor-owned insurance companies like ours to provide health care for their citizens.

Most of my fellow physicians and an even larger proportion of other Americans believe it is time for single-payer national health insurance or “Medicare for All” in the U.S. This system is embodied in a bill in Congress, H.R. 676, sponsored by Rep. John Conyers and 92 other members of Congress. Urge Congressman John Olver to support this legislation.

President-elect Barack Obama has promised to reform the health care system from the grassroots up. As a first step in this effort, Secretary-Designate of Health and Human Services Tom Daschle is organizing Health Care Community Discussions all over the country. One such forum will be at Bagels Too, 166 North St., Pittsfield, on Wednesday, Dec. 17 from 5 p.m. until 7 p.m.. Members of MassCare will be there to discuss health care reform and the Massachusetts health plan and to elicit your views. Your feedback will be transmitted to Secretary-Designate Daschle and, through him, to President-elect Obama’s transition team. We look forward to seeing you there.

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