How do I Love Thee?
It appears that every time Elizabeth Warren or Bernie
Sanders bring up the idea of single payer insurance,
someone points out that people really love their private
insurance. Really? Let's take a good look at the object
of your affection, if you will. We'll start with a history
of the health industry:
Early 1900 - Doctors begin to coalesce into to organized
units and the American Medical Association is created
1912 - Teddy Roosevelt campaigns for mandatory
health insurance for all Americans, but the idea is
abandoned as World War I heats up.
1920s - After WWI, health care costs increase, and
the middle class is having difficulty affording it.
1930s - FDR signs into law the Social Security Act
without health insurance, due to opposition by the AMA.
They thought it would limit doctor's freedom to practice.
Blue Cross begins selling hospital insurance in some
states.
1940 - During World War II, employers began to offer
insurance to their workers to compensate for wage
controls. After the war, Truman proposed National Health
Insurance but it was again fought by the AMA who called
it 'socialized medicine'.
1950 - Tax incentives were offered to employers who
offered health insurance to the employees. The price of
hospitalization doubles.
1960 - LBJ signs the Medicare Insurance Act and Medicaid
Insurance for the poor and disabled. The number of
companies offering health insurance exploded. And by the
end of the 1960s, 69% of doctors were specializing.
1970s - The cost of health care exponentially increases after
Medicare and Medicaid. Nixon signs the Health Maintenance
Organization Act, creating everyone's favorite, the HMO, to
try and curb medical costs.
1980 - Health care providers move to privatize and consolidate
into ever larger hospital systems.
1990 - The cost of health care rises at double the inflation rate.
2000s - Medicare's sustainability comes into question as costs
rise. Direct-to-consumer advertising takes off, prescriptions are
being touted to consumers and not just to physicians.
2010 - Obama signs into law the Affordable Care Act, against
the opposition of most conservative legislators.
It has been a one-hundred-twenty-year long journey to get where
we are now, a game of 'which came first, the chicken or the egg'?
Did insurance evolve to help with the high cost of health care,
or did health care costs rise because now people had insurance?
Which ever it was this is where we are today. And thankfully,
because of the ACA, there are now some standards of minimum
coverage that insurance companies have to meet. It's how they
meet those standards that we will address next.
Let Me Count the Ways.....
* Finding a private plan that has coverage in your area and that
you can afford
* Or, understanding the plans offered by your employer
* Enrolling in the plan of your choice for yourself and your
family; forms, forms, and more forms
* Finding a doctor and hospital that accepts your insurance
*Getting second opinions
* Getting prior approval for a proceedure
* Making sure all medical providers are covered by your
plan, ER, OR, OT, oh my!
* Paying the co-pay for doctor's visit
* Paying the deductible for hospitals
* Calling the insurance company for an explanation of
denial of coverage
* Having to choose a new insurance company every year
because your insurance no longer services your area
* Getting laid off or fired and loosing your coverage
* Moving out of the coverage area
Select any or all that apply to you insurance coverage, this
is the world of private insurance. They are not here to make
life worry free for you, the insurance companies are here for
the bottom line, and when the actuaries tell them a certain
geographical area is not profitable, or a certain doctor is too
free with suggesting surgery, well then, the company moves on.
Too bad if you live in that area or that is your doctor,
I don't know about you, but I find it abhorrent that someone is
making money from the suffering of others. Perhaps Blue Cross,
when they started, had an altruistic motive when it was founded
by Justin Kimball in 1929. He was the Vice President of Baylor
University health care facilities and saw the need for assistance with
hospital costs. He offered 10 days free hospital care for a six-dollar-
a-year premium. That simple plan grew into Blue Cross/Blue Shield
and BCBS was tax exempt until 1986, operating as a 501c4, a social
welfare plan. Then in 1994, BCBS allowed its corporations to switch
to a for-profit status. And in 2010, Health Care Services Corp., the
parent company of BCBS, doubled its profit to $1,09 billion, and
the next four years have been billion-dollar profit years also. BCBS
is just one company, what the entire industry earns is staggering,
The latest figures available for 2017, show first quarter profits of
the top five insurance groups as $5,785 billion. That's profit folks,
not income, in the first quarter. These are companies that claimed
they would lose money under the ACA.
Now let's look at a single payer system, such as Medicare for all:
* Automatic enrollment with your Social Security card that you
receive when you are born
* Universal coverage at any hospital and doctor in the US and it's
territories
* All members of the family are covered
* No co-pays or deductibles
* No forms to fill out, providers collect directly from Medicare
* Never losing your insurance coverage by moving or losing
your job
* Supplemental coverage available for purchase to cover elective
procedures
How do we pay for this, you ask? The same way we pay for Social
Security, thru deductions in payroll taxes, shared by the employer and
employee. Right now, both pay for private insurance coverage, and you
also pay co-pays and deductibles, currently. Assign that money to
Medicare instead of the insurance companies.
OMG! What about government bureaucracy. Currently the cost of
administering Medicare is 3% of premiums collected. That is far
lower than the cost at private for-profits. And, think of the saving
in advertising.
The AMA says that doctors and hospitals can't operate on what
Medicare pays. That's a fair complaint, but let's look at the currrent
billing system of most doctor's offices and hospitals. In most cases,
there are more personnel working in the billing and collections
department than there are medical staff on duty. And what about
the savings from bad debt write-off?
And that $232 billion insurance profit? Well that might go a long
way to paying for prescription drugs.
I don't know about you, but I think I'm in love...I'm just sayin'.
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