The recent article by Michael Tanner and Michael Cannon from the Cato Institute about “universal health care’s dirty little secrets” deserves comment. They make a number of claims, or, rather, state claims made by others, like some university research initiative study group that was unable to establish a “causal relationship” between health insurance and better health, or that “health insurance status was largely unrelated to the quality of care.” They went on to talk about “risk pools” and higher premiums for older people and health savings accounts and deregulation and so on. So the article attempts to establish that universal health insurance is not a viable solution.

I agree. Health insurance companies are the problem, not the solution. Making health insurance coverage for everyone mandatory just won’t work.

All health insurance policies have deductibles and co-pays and limits on whom you can and can’t see, what you can and can’t have for prescriptions and so on. Most insurance is provided by employers as part of a benefit package, but if you become unable to work because of accident or disease, the former employer no longer pays for health insurance. Granted, COBRA laws give you the option of purchasing the insurance for 18 months at group rates. I guess you pay for it with the paycheck you no longer have. But at the end of the 18 months, the insurance company is no longer obligated to sell you insurance. Sure, you can get a lawyer and fight it with the same funds that you buy the insurance with, right? At best, this will allow you to purchase insurance for another 18 months, with the same paycheck you no longer have.

Meanwhile, the medical bills pile up, along with the lawyer bills and the insurance company bills. And, of course, the usual bills such as rent, lights, heat, groceries, etc. This is the cause of the majority of bankruptcies filed in this country, but now that credit card companies get to write bankruptcy laws, that’s more difficult, too. Add that to the lawyer bills. It’s worth noting that the majority of those folks who had to file for bankruptcy because of medical bills had insurance when they got sick. People in these situations generally end up on Social Security, Medicare, SSDI, and a variety of other publicly funded safety net programs. And thank god for them!

Any “solution” that involves the insurance companies is not a solution. We need to think outside the box on this. Something most people don’t realize is that more than 60 percent of the health care in this country is already publicly financed. This figure includes all VA funding, Medicare, Medicaid, insurance for public employees including teachers, highway workers, elected officials, soldiers, firefighters, etc. Not to mention that prisoners get free health care, while many working people go without.

Perhaps some sort of publicly financed, privately delivered health care, such as enhanced Medicare for all, is a better solution. There is currently a bill before Congress (HR 676) that would establish just such a program. Write to your congressmen and senators if you support this idea. Democracy works best when people participate.

Insurance company overhead costs are generally between 30 percent and 40 percent. Medicare’s overhead costs are closer to 3 percent. Let’s just get rid of the insurance companies and provide enhanced Medicare for all. There are a number of ways to do this, all of which are less expensive than our current system. We’re already paying for this. We’re just not getting it!

Publicly financed, privately delivered health care would establish a relationship between better health and coverage as it would eliminate insurance company meddling and put doctors and patients back in control. It would encourage regular checkups that would detect problems at earlier, more treatable and less expensive points, and people wouldn’t go bankrupt fighting the system that we currently have.

The article also mentions that uninsured can get treatment in emergency rooms and that hospitals are obligated to provide care regardless of ability to pay. This is true, but it fails to mention a number of things. Emergency room care is the most expensive method of treatment, regardless of who is paying the tab. People go there as a last resort, and aren’t emergency rooms, by nature, for emergencies? When they discharge you from the ER, they tell you to go to your regular doctor for follow-up care. No insurance often means no regular doctor, and no paycheck often means no doctor as well.

I don’t think the folks at the Cato Institute would agree with this approach. They appear to be more of the Grover Norquist mind-set that government should be “small enough to drown in a bathtub.” I’m more of a believer in the Constitution, which states that government should “promote the general welfare, insure domestic tranquility and secure the blessings of liberty,” among other things. There are a number of things that we, as Americans, own in common, such as schools, highways, police, fire and military protection. I believe health care also should be in that class.

Steve Dunn of Bangor is a carpenter.