Health Insurance in a Sickening State
by Trude DiamondLink to article
Health insurance in the United States is certainly neither “united” in our best interests, nor in a “state” that gives us peace of mind. Now, don’t get sick over the situation. Your insurance, if you have any, probably wouldn’t pay for your treatment. You’re not upset enough to be a danger to yourself or others, are you? No? Well, our healthcare system seems to be just such a danger.
The good news is that consensus on that point appears to be building on both sides of the aisle in both houses of Congress. But since we don’t yet have peace of mind, we can write to our representatives to give them a piece of our minds. And when we do write to them, we can throw in some facts to prove we’ve done our homework. In chronological order:
Point 1: In 2003, HealthAffairs.org titled a white paper “Employment-based Health Insurance Is Failing – Now What?” We still don’t know “what,” but analyst Alain C. Enthoven makes the point that corporate purchasing policies contribute to rising costs and inhibit economical approaches. It’s been four years. Let’s think up something better.
Point 2: The California HealthCare Foundation provides a 2002 (but not out-dated) study by the Georgetown University Health Privacy Project: “Purchasing Health Insurance Online.” From the overview page, the Tips for Consumers document will give you general guidelines, tips and resources for comparison shopping, and a list of health plan and broker sites to visit first. Hint: “Quality” is the top consideration. Too bad quality is so unevenly provided by the various plans in different geographical areas.
Point 3: A 2005 Georgia State University study found that differences in employers’ likelihood of offering coverage may be due to differences in plan supply or distribution, or differences in availability of coverage alternatives, such as safety net care. Maybe we can conclude that national universal health coverage would even the playing field.
Point 4: The Employment Policies Institute offers a May 2007 comparison of health insurance reform proposals. This study’s authors consider employer mandate (most expensive), expanded access to Medicaid, and a tax credit for low income individuals to offset some of the cost of private insurance (least effective). The Institute’s 2006 studies on The Dynamics of Health Insurance Coverage and Implications for Employer-Mandated Insurance and The Effect of Increases in Health Insurance Premiums on Labor Market Outcomes present stultifying arrays of metrics in support of conclusions that are no surprise. The “dynamics” study finds that people who work for small companies and lose their health insurance have the lowest likelihood of finding new insurance they can afford within a year, but enforcing employer mandates for insurance on small companies would likely have a negative effect on employment. The “premium increases” study tells you something else you already know – if you’re among the lucky two-thirds of the non-elderly population covered by employer-provided health insurance, the cost of your insurance has increased by over 59 percent since 2000, without an increase in the scale or scope of benefits. Not only that, but you’re increasingly likely to lose your job entirely (or be shifted to part-time work with no benefits) as your employer’s cost of health benefits rises. With every solution considered, we have the Devil here and the Deep Blue Sea there, and our only choices are to burn or drown. I hope we’re smarter than that as a nation. Thinking outside the box of these studies, the further conclusion is that universal health care is the only feasible solution.
Point 5: The Commonwealth Fund (whose mission is to create “a high-performance health system”) offers a 2007 study, “Congressional Health Care Bills, 2005-2007: Part I Insurance Coverage.” The study “considers whether the proposals would improve access to care, increase health system efficiency, make the system more equitable, and improve quality of care.” Among its observations on the question of quality, the report finds that “proposals that would organize coverage through a central mechanism, such as the Medicare program in Representative Stark’s proposal and Health Help Agencies under Senator Wyden’s bill, have the potential to improve quality in a number of ways.” And AARP’s July 9, 2007 Policy and Research Newsletter’s Divided We Fail section reports that the recent presidential debates addressed healthcare and financial security in only 6.4 percent of questions. Yet the candidates (and the media asking the questions) know that AARP’s demographic are highly motivated and highly likely to actually vote. What part of “keep your customer satisfied” don’t they understand?
Points, ad infinitum: If you want to bludgeon your national representatives with an ongoing barrage of healthcare suggestions, demands and peasant uprisings, The Commonwealth Fund’s website also offers “DC Policy Updates,” reports from the “Commission on a High Performance Health System,” and a “Newsletter Spotlight.” Current articles include “Why Well-Designed Universal Health Insurance Is Essential to a High Performing Health System,” “Health Care Disparities Linked to Where Patients Get Care,” and “Measuring Health System Performance: The State Scorecard.”