Universal Healthcare a moral and fiscal imperative

by Kathi Thomas

At the Wednesday Night Speaker's Series at Austin's Central Presbyterian, Gaye Kopas of Health Care for All Texans (http://healthcareforalltexas.org/) spoke about "The Problem with Healthcare in the US and Texas." When I woke up this morning, I told my husband that, especially after seeing that program, I cannot imagine anyone being against universal health care, if they have any concern about moral or fiscal imperatives.

Here are some cold, hard facts:

1. 46-50 million people in the U. S. are UNinsured and another 50 million are UNDERinsured. In 2006, 22,000 people died prematurely due to no insurance. Texas has the highest rate of uninsured at 25% (even BEFORE all the layoffs, so that number is no doubt higher now.)
2. 80% of the uninsured in Texas work full or part time.
3. 75-80% of the uninsured are U. S. Citizens.
4. In Texas, a working parent who earns more than $4,634 per year makes TOO MUCH money to qualify for Medicaid!
5. Texas is among the states with the strictest criteria for adults to qualify for Medicaid. Yet, for the average family of four, decent health care insurance costs approximately $12,000 per year. A bit of a gap, I'd say!
6. The U. S. has the lowest life expectancy and the highest infant mortality of the industrialized nations, yet spends more than twice as much as most other developed countries spend on health care. The U. S., (including private and government spending) spent $7,900 per person in 2007, or 17% of GDP. Healthcare spending in Switzerland accounted for 10.9% GDP, 10.7% in Germany, 9.7% in Canada and 9.5% in France. (www.nchc.org)
7. Insurance companies' administrative costs and profits take 31¢ of every dollar they spend on healthcare, while Medicare spends only three cents (3¢) per dollar on administrative costs.
8. Taxes already pay for more than 60% of U. S health spending with tax subsidies, public plans and public employees. (This includes counties and cities footing the bills for indigent health care services for those who make "too much" to qualify for Medicaid, but too little to afford health care.)
9. More than half of all bankruptcies are triggered by medical bills, yet 75% of those filing for bankruptcy protection had health insurance at the time they became ill or were injured.
10. From 2000-2007, health insurance premiums jumped 87% for Family coverage, yet median income in Texas only rose 15.6%.
11. According to Consumer Reports, reported 2006 profits for the six largest U. S insurers totaled $11 billion.
12. Health care industry lobbying totaled almost $1 billion in 2007-2008, and the industry gave $162 million to candidates of both parties.
13. In 2007, the top 10 drug companies in the U. S spent 15% of their revenues on Research & Development and 32% on Marketing/Administration and still notched a gaudy 17.5% net profit.

One of President Obama's goals is to ensure more affordable healthcare for all of us. Unfortunately, the Healthcare Cartel (insurance and pharmaceutical companies) is hard at work, with its high-priced lobbyists and its strategic campaign contributions, working to keep the biggest piece of the pie on its own plate, regardless of the dilemma in which the rest of us find ourselves.

Currently, there are three plans being touted:

1. The Healthcare Cartel's plan keeps it right in the thick of things, with the government as Payer and the industry as Payee, still raking in monstrous profits. While this would mean healthcare for more people, it would be at a prohibitively high cost. I don't see how we can conceivably come up with the money for this.
2. The hybrid. One can keep one's private plan OR enroll in a Single Payer Plan, much like Medicare. Doctors would be able to renegotiate fee structures every 2 or 3 years, so they would not be burned by low rates that didn't keep pace with inflation. Private insurance companies would take the healthiest people to insure, leaving the less healthy to the government plan, which would drive up costs, so this isn't a great alternative.
3. Single Payer health insurance for all, (with same negotiations for fees as #2) financed by:
• Payroll tax. A modest and progressive excise tax on payroll and self-employment income;
• Health tax. An additional tax placed on the wealthiest 5% of taxpayers;
• There will be a .25% tax per transaction on stock and bond transfers.
  

Given that my husband's small business now pays a LOT for the 75% of costs he pays for his company's employees' healthcare costs, the new payroll tax would reduce his cost per person and finance insurance for everyone. Under the current system, the younger and healthier employees often opt out of employer-paid insurance, which drives up the costs for the older workers. If one of these younger people is involved in an accident requiring medical care, or if they contract some awful disease, like cancer, the public picks up their tab anyway, because they have no insurance.

HR 676 is a Single Payer, Universal Coverage health plan. It is publicly financed, but privately delivered. (Individuals still select their own doctor, but their insurance is paid by all of us who are taxpayers.)

All residents of the U. S. and its territories are covered, regardless of employment, income level or pre-existing conditions. There are no co-pays, no deductibles and no insurance premiums. There are no upper limits of coverage.

Benefits include primary care, inpatient care, mental health treatment, emergency care, specialists, long-term care, substance abuse treatment, chiropractic therapy, vision and dental care, prescription drugs reimbursement and durable medical equipment.
A National Advisory Board will determine medically necessary services.

Patients can use this from coast to coast, when one travels between states. Each of us will have electronic medical record cards, already in use in many countries, which cuts down on mistakes and billing time. All this is managed electronically.

What Opponents of the Single Payer plan allege:

• It amounts to SOCIALIZED healthcare!
• It inexorably leads to Rationing.
• It will cost too much.
• Doctors won't like it, because they will make less.
• Many people will lose jobs in the insurance industry.

Some answers to the cited objections:

Medicare recipients report higher rates of satisfaction with their healthcare than people with privately paid health insurance.
Medicare was also called "socialized medicine" when it was passed over the determined opposition of the Republicans and of the healthcare Establishment.

We already ration healthcare, based on ability to pay. In most countries with single payer systems, one can see one's primary care doctor as expeditiously as in the U. S. It might take a month or two to see a specialist, but it takes that long now. (I made an appointment for Lettie with a specialist, calling on April 15. The earliest available appointment is May 18. To see a dermatologist, it is a 3-4 months' wait and for a routine dental appointment (with insurance), a 2-3 months' wait!

Refer to Fact #6: Given that we're already paying more than double what other developed countries pay, AND getting a lower standard of healthcare services, AND carrying the enormous profits of private health insurers, how can anyone say this would cost too much? It will, in fact, cost dramatically less than the 17% of GDP we pay now! Dramatically less.

Doctors in many of the countries with the single-payer approach are paid to keep their patients well, meaning doctors work with patients to adopt healthier lifestyles, because that is to everyone's advantage. In England, doctors earn a bonus for keeping patients healthy. A doctor interviewed on a PBS special said he made an additional $190k a year for keeping patients healthy. Remember, too, they won't need huge administrative staffs to deal with insurance companies, and they won't be "floated" by insurance companies, or denied payments on the basis of stylish whims!

There is a provision in HR676 for those who lose jobs. The bill's sponsors believe many medical professionals who are now working for insurance companies will return to caring for human beings, because the 50 million people who currently don't have insurance will need primary care doctors, and those doctors will need nurses, Physicians' Assistants and Nurse Practitioners. For those who actually lose their jobs, there is a two-year severance plan, up to $100,000. (And we'll STILL save money!) It won't help CEOs of insurance companies, some of whom actually make MORE than Wall Street Bankers, but if one has been making $100 million per year, she or he SHOULD be able to squeak by for a few years at least! The CEO of one of the largest healthcare insurance outfits made well over $100 million in 2008. That strikes me as inappropriate. That individual made that enormous amount within a system based on denying healthcare to large groups of people. In my book, that's Blood Money.

With all arguments now answered, what can each of us, including YOU, do about it?

I urge you to write to your U.S. Congressperson and your two U.S. Senators. Even though Kay Bailey Hutchinson and John Cornyn are Republicans, MAYBE, if they hear from enough of us, they'll at least consider doing what's right, because it IS morally and fiscally the right thing for the country. Bringing down our healthcare costs while covering more people shouldn't be a Democratic OR a Republican issue, it SHOULD BE simply the RIGHT thing to do for our country. The question is, will they do it at the expense of THEIR campaign war chests, which have been lavishly stuffed with money from this industry?

My Congressman, Lloyd Doggett, has not yet signed on as a sponsor, so he needs to hear from every one of us in his district. His office says he is "looking at the bill," which isn't the same as "Yes, he'll co-sponsor it." We need Congressman Doggett to lend his voice and influence as a sponsor. Currently, Rep. John Conyers' HR676 has 74 sponsors of the needed 150 in the House.

Sen. Hutchison's contact information:

Sen. Cornyn's contact information:

To contact your Congressperson by e-mail:
http://www.house.gov/house/MemberWWW.shtml

Please, do this important thing right now.
Ask where your Congressperson stands, and if she/he will not sign on as a sponsor, insist she/he tell you why. They need to take responsibility for their decisions, and we need to know why they won't support this, if they refuse to do so. Call AND write today!

NOTE: Thanks to Healthcare for all Texans for the facts and figures cited in this article, which they gleaned from a variety of sources.