Disclosed recently by the Insurance Institute was the “average” annual per worker health premium employers are paying: $10,000. Few employees have even a slight clue that that’s one of the most compelling reasons US employers are confronted by the absolute need to cut payroll, cut wages, hold wages static, cut benefits, or all the above. Here’s a tool that might prove helpful; the Rule of 72. It tells how long it will take to double a base figure, given an established rate. For several years the rate of premium growth has been in the 15% range. Take that 15% and divide it into 72. The result is 4.8 years. In other words, that $10,000 annual premium will be $20,000 in less than five years! You’re the employer, what would you do? Now, how will you define “too expensive,” when it’s your job and benefits that are on the line? Never forget this turn on Newton’s First Law of Motion: If nothing is changed, nothing is going to change.
Just because we may choose to do nothing does not mean healthcare costs will remain static. They won’t. As I just observed, although you’ll have to do some extrapolating, the costs of continuing on the current course will bring the US, as we now define it, to a tragic end. That’s expensive, no matter who you are. If by investing that $1.6 trillion (over the next decade) we can cut the rate of growth to today’s average rate of inflation, or even just slightly above, then we will enjoy a “net” savings. Our total expenditures for healthcare will go down, not up, relative to what we’re experiencing today.
Arguments rebutting “it will turn into socialism”:
From the outset, understand that at no time has the United States been a pure free-market economy. From Day-One, private enterprise has sought to hedge its bets via government subsidies, to privatize wealth while socializing loss. The transcontinental railroad, for example was financed with government bonds. In addition to funding, the Union Pacific was granted a checkerboard of sections (A section is a 640 acre parcel, one mile along each side.) along the route that has made of the corporation the single-largest landowner west of the Mississippi, and second only to the US government, throughout the country. (http://en.wikipedia.org/wiki/Union_Pacific_Railroad) With relatively little of their own money at risk, already extraordinarily wealthy Leland Stanford, Charles Crocker, Mark Hopkins, and Collis Huntington became wealthy beyond anyone’s ability to measure the adjective. The last several months have only served to amplify the fact that American private business has always sought to be private only when it is to its advantage.
Whether some thing falls under a given –ism — socialism, capitalism, etc. — rubric is not at all the best test. Some services serve the society best when they are socialized; the Departments of Defense, Interior, etc. Or would you prefer to see 100% of our defense in the hands of an Enron, or a Halliburton, for example? No, the only test that ought to count is which organizing model will provide the most effective and efficient service, to the most people, at the lowest cost. I challenge anyone to suggest that it’s the for-profit, private enterprise health insurance industry model.
Besides . . . Everyone knows that baseball enjoys an anti-trust exemption. Can you name the only other industry that does?
And to the extent that US healthcare delivery becomes a socialistic enterprise will depend absolutely on the free market making a free decision that that is the model it prefers. Whatever other details of Obama’s plan may be fuzzy, one is high-def clear: The choice, whether to remain in the for-profit, private insurance industry system, or to opt to a model that closely replicates what all federal employees have right now will be to the individual or the individual’s employer to decide. Per Obama, “I don’t know how I can make it any more clear: If you like the insurance you have now, you can keep it, the only thing that will change is that your premiums will be lower.” (You got a problem with people acting freely?)
Arguments rebutting “we’ll get rationed care”:
At least 47 million Americans have no healthcare coverage now. That’s roughly one out of six! Half again as many have coverage so inadequate that they simply cannot afford to visit a doctor for annual checkups, or even the Emergency Room, so long as they perceive the condition is not absolutely life threatening. That, my friends, is rationing, by economic ability. Could anything be more morally indefensible?
Once hospitalized, the care received under the present regime is not the sole discretion of the physician and the patient. Smack right between the doctor and the patient is the highly anonymous, non-professional insurance clerk. Located often thousands of miles from the scene, the clerk is verifying via a computer-monitor display whether the treatments and procedures recommended by the physician match what is on that screen. If they do not, it is that invisible clerk who informs the physician that the treatments and procedures will not be paid for by the insurance company.
The ONLY genuine differences between the two models will be the name of the payor on that clerk’s paycheck, and the leverage the physician has to amend the clerk’s decision. The sole function of the insurance company clerk is to enhance the insurance company’s financial statement. That’s accomplished by denying coverage whenever it can be legally defensible to do so. The insurance company is not your friend. As noted above, given the preference whether you live or you die, if the claim will likely be high, the insurance company prefers that you die.
At least under government auspices, there’s a representative or senator who depends on the votes — the good will, if you will — of his or her constituents to remain in office. That may be modest consolation, but, on the face of it, it seems that the odds are improved in the government option, as compared with the private one, where the interests are antithetical to those of the patient. The representative and senator loses a constituent, if you die. The insurance company saves money.
I think it’s to you to decide, who you really want on your side, and why. It’s also your responsibility to present the issue(s) to those who say they’re initially opposed to any change, or to the president’s proposals. The insurance companies want to flip the coin so that it’s “heads they win, tails you lose.” Or, you can keep the peace in the family by suggesting perhaps you enjoy one of the summer reruns on television together.
— Ed Tubbs
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