Have you noticed that “solutions” to the health care crisis rarely mention health? It would appear we only care about the health of our pocketbooks. I don’t believe that. With the lack of sufficient health insurance as the leading cause of bankruptcy in America, I can understand the emphasis on money. But it’s also the sixth leading cause of death in the United States.
The crisis affects everyone of us; 121 million Americans (more than 40 percent), most of whom are employed (more than 70 percent), are either uninsured or underinsured. Add the effect of the untold millions who are suffering, but not dead, and those devastated, but not bankrupt and everyone is affected. The health care crisis is both a cancer in our marketplace and a plague to our people. No proposal which fails to address this dual threat can be considered a solution at all.
The monetary considerations are certainly staggering. The cost of health services is escalating. New drugs and medical technologies, the aging population, malpractice insurance, the rising incidence of preventable illnesses, and our own behavior significantly drive costs up. Abuse is the least concern. We have huge, public, private, and personal decisions to make in order to truly solve this complex crisis. This is not a simple problem with any simple solution. At best, it’s a multitude of problems with disturbing connections to most of what we hold dear. Nonetheless, we either bite the bullet in this, very soon, or we lose far more than our money.
The leading cause of increasing local taxes is school taxes. The leading cause of increasing school taxes is escalating health care costs. This relationship holds true for virtually all public and private goods and services. Shifting costs from employers to employees, and limiting coverage, are short-sighted nonsolutions. However one splits it, the money still has to come through the front door in order to pay for it. We have a systematic problem. Nothing short of providing affordable, excellent, preventative, and comprehensive coverage to all citizens, regardless of employment status, will correct it. How do we accomplish that?
Americans already spend twice as much, per capita, as anyone else on earth for healthcare, and we’re one of only four industrialized nations (India, Mexico, Turkey, United States) which fail to provide universal coverage. We rank 37th in overall health care system performance, in largest part due to this failure. Where’s our money going?
We even pay more than most for the drugs and technologies which we produce. And make no mistake about it; it is we, through our federal taxes, who significantly underwrite the cost of research and development of these new drugs and medical technologies.
While no one can accurately predict what an individual will use in healthcare dollars, put that individual into a very large group, and, counter-intuitively, an actuary can, very precisely, predict the dollars the group will use. This is one of the founding principles of all insurance. As long as we permit absurd divisions of the group our health care dollars can’t be fully maximized. Divisions result in inequitable distribution of the charges. My own small business health insurance rates have doubled in the last two years, with no end in sight. Does anyone actually expect me to believe that any combination of legitimate cost drivers is responsible for this?
How much worse does this problem have to become before we recognize the mortal threat it is to our common good, and address it accordingly? Health care is at least as definitive of our health, safety and well-being as roads, schools, police and fire protection. I’m sick of the rhetoric which seeks to divert our attention away from the gross inefficiencies and profit-taking which are costing lives and livelihoods. I reject all “solutions” which require more money and less coverage to sustain this demented system. We must demand that health coverage be valued at least as much as monetary considerations, and included in all viable solutions to the health care crisis.
I support Gov. Baldacci’s health care proposal. His bold initiative to create a public-private, nonprofit insurance company to collect premiums, and to leverage those which qualify with federal monies, is a marvelous beginning to maximizing the value of our health care dollars. A moderated company providing affordable, excellent, preventative and comprehensive health coverage represents significant relief for Maine’s health care crisis. When considering all that will be said about the governor’s plan in the coming weeks, I urge you to weigh the facts, not the rhetoric.
David A. White is a small business owner in Bar Harbor, a board member of the Small Businesses for Universal Single Payer group, an arm of the Maine People’s Alliance, and a member of the benefits subcommittee of the Health Action Team which helped to design Gov. Baldacci’s Dirigo Health plan.
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