If there’s one good thing about the early onset of presidential electioneering it’s that health care is gaining traction in public discourse. Obama, Richardson, Edwards, among recently announced candidates, have joined state governors in advancing serious plans to reform our fractured medical system.
These brave pols are even using the adjective “universal,” previously stigmatized as a euphemism for “socialized.” We’ll probably have to wait awhile to see if Sen. Clinton has overcome the massive rejection of her ’90s health care reform plan. Maybe the country just wasn’t ready. Surely she’ll have to give it another go.
What we’re hearing sounds good so far. But it stops short of the fundamental power shift needed to break the stranglehold of insurance and pharmaceutical companies.
If the Governator has his way, California will follow Maine, Vermont and Massachusetts in offering universal coverage. That is, every citizen would be required to purchase health insurance, with state financial assistance if necessary.
Not to be outdone, President Bush unveiled his version of health care reform, not surprisingly based on a standard tax deduction for health insurance. Figuring out who would benefit, other than insurance companies, is complicated. According to CNNmoney.com, you would add up what you spend on health insurance every year, subtract that amount from the family or individual cap, multiply the difference by your tax rate and that’s your break. Got that? The problem is if your plan were to exceed the cap, you’d spend more in taxes because the amount over the limit wouldn’t be tax deductible. Huh?
According to another tax expert, a family of four in the 15 percent tax bracket would get a tax break of $2,500, but the cheapest family policy costs $3,360. And while a projected increase in competition might lower insurance rates, it won’t do anything to rein in skyrocketing health care costs.
Tying health insurance to employment may be a policy whose time is up. Some small companies get a pass. Some very large companies (think Wal-Mart) also get by insuring only a portion of employees. Some companies limit their insurance costs by hiring only younger workers. Others are refusing to hire those who smoke, are overweight or have other risk factors. Where will it end?
It’s already difficult for older workers to find new employment when their old jobs are lost to outsourcing, globalization or business consolidation. Take the case of one 40something woman who worked her way up to division manager in a publicly traded company. She has a family medical policy that covers her two children and self-employed husband. Last year, the company was bought by an international conglomerate, which then also bought a competing firm. Heads began to roll. Now her division may be rolled into the competitor’s East Coast facility. She, and her staff, will probably lose their jobs and their health insurance. The prognosis is poor.
Health insurance for the self-employed or unemployed is prohibitive. And insurance companies regularly refuse to issue policies to individuals or families citing pre-existing conditions or other risk factors. In a family of four, there is bound to be at least one pre-existing condition. Under our current system, people often are forced to take jobs they don’t want or move their families to take jobs that provide health coverage.
What I wish we would hear from the current crop of candidates is a plan that would do more than tweak the edges of the status quo. It’s not enough to include more people in a health care system that is dysfunctional at its core. As long as the insurance industry is calling the shots, the chances of true reform of health care are basically nil.