Overlooked Savings from Single-Payer Healthcare

Mugsy

Mugsy's Rap Sheet

Monday, June 29, 2009

Ask any Republican, “If you could pass a tax cut that saved the average American $10-$30,000 a year and the average corporation millions of dollars a year, would you do it?” What do you think their answer would be?

It’s harder to argue against a “Single-Payer” healthcare system when you phrase it in those terms, and let’s be honest, “framing is everything“. Sadly, Democrats often allow the Republican minority and a handful of Conservative DINOs beholden to the insurance lobby to frame the debate against healthcare reform with fictitious horror stories of “Socialized Medicine”. They’ve been doing it for years:

I couldn’t help but notice that one of Reagan’s chief arguments was how the government could tell some doctors that they couldn’t practice in a town because they didn’t need any more doctors there. Funny, but I don’t remember a time when a medical degree was a guarantee of employment in the town of your choice. Then again, I wasn’t alive in the 1950’s. Maybe it was different back then .

The debate over Health Care is shaping up to be the most contentious battle in Washington since “Bush v. Gore” in 2000, except this time billions (trillions?) of dollars and thousands of American lives are at stake (arguably, in retrospect, it was in 2000 as well, we just didn’t know it). But sadly, just as in 2000, we see a dozen or so milquetoast Democrats conceding that “maybe the Republicans have a point”; unwilling to fight for their position as hard as the ideologues on the Right, watering down their position to try and please a bunch of WATB’s thateven a majority of Republicans don’t support on this particular issue. Following the absolute disaster of the Bush Administration, failing to prevent 9/11, attacking Iraq before completing Afghanistan, unable to end either war, the failure of Katrina, economic collapse, collapse of the U.S. auto industry, Wall Street run amok requiring a Trillion dollar bailout, record unemployment not seen since The Great Depression, all while adding another $5T to the National Debt… the American people SO rejected the Republican way of doing things, they voted in a Democratic president with a Super-Majority of Democrats in both houses of Congress. If the American people have ever spoken louder in one voice to reject the Republican way of doing things, I haven’t seen it in my lifetime (since LBJ). Yet STILL we have President Obama and Democrats in Congress concerned with “bipartisanship”, kowtowing to the Concerns of Republicans. We desperately need a National Healthcare System in this country if for no other reason than to pay for a spine transplant for all the gutless Democrats.

BY FAR, the most comprehensive, all-inclusive, most cost-efficient healthcare solution is a system known as“Single Payer”, where the Federal government pays the healthcare bills for each and every American (typically paid for with taxes). Denmark, Sweden, and Canada are example of countries with single payer financing of health care. England and France, where every doctor is a Federal employee and every hospital is owned by the government, are not (theirs is a true “Socialized” system). But the latter is what Republicans WANT you to believe “Single Payer” is. President Obama is advocating NEITHER. His is a third choice called “the public option”, where a government “health insurance company” competes for your business just like any other insurance company, but with lower overhead (such as advertising costs), no shareholders to pay dividends to or huge CEO bonuses to pay.

Republican arguments against “Single Payer” are truly absurd. They tell us a “government option” would simultaneously be a huge failure, cost a trillion dollars, provide worse care and still leave millions uninsured(warning: that last link is to Sen. Boehner’s homepage), WHILE SIMULTANEOUSLY threaten to put private insurance companies out of business because it would be SO GOOD and SO CHEAP that private insurance companies would be “unable to compete“, resulting in millions of Americans giving up their private insurance for the cheaper/better government option (which shows were their true loyalties lie).

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I can’t help but think of “FedEx” every time I hear this bizarre argument. Isn’t “the US Mail vs. FedEx” the perfect metaphor for the “Public Option”? I remember when people argued that a company like “Federal Express”, whose entire business revolved around simply “overnight mail delivery” would NEVER be able to compete with the USPS with its “unfair advantage” of being able to ship packages on any airline (not just their own planes) and delivered by their own postal carriers. And yet, FedEx is an enormously successful corporation competing against the government in the “Express mail” business.

UPS and their fleet of Big Brown Trucks was founded in 1907 and has successfully competed with government-run package delivery for over 100 years.

Now argue “private” insurance companies won’t be able to compete with the government. Funny how little faith “free market Republicans” truly have in “the free market”.

Currently, the popular “compromise” on Capitol Hill is something called a “co-op“, being put forth by DINO’s likeKent Conrad and DiFi (Sen. ”Diane Feinstein” of California). A “co-op” is basically a group of individuals that pool their money to cover each others healthcare costs. Of course, to have any leverage, you’re not going to control costs and/or be solvent enough to cover the extended hospital stays of very many members at once with just a few dozen… or even a few hundred members. No, to have that kind of leverage & security, were talking about a co-op with hundreds of thousands of members, like “Group Health” in Washington and Idaho, a co-op with some600,000 members. That’s not a “co-op”, that’s an insurance company! When you get that big, who’s going to Administrate it? We’re talking a full time job. Now you’ve got administrative costs, hiring bonuses to attract top talent, and (most importantly) a profit motive and plenty reason to deny coverage. This is their idea of acompromise???

Government-run “Single Payer” health insurance has numerous obvious advantages:

• Dramatically lower costs: With no profit motive, advertising costs, shareholders or bonuses to pay, single-payer would cost less. And if private insurance wants to compete, they’re going to have to cut those expenses or else lose customers.
• No “pre-existing condition” exemptions: No one can be denied coverage because of a “pre-existing condition”.
• See any doctor you like: Unlike an HMO or other closed system where you can only see “in-network” doctors, you can continue to see your current doctor or any other doctor of your choosing. (Excuse me, but doesn’t an HMO do EXACTLY what Republicans claim a government system would do… tell you “what doctor you may see” and “whether or not they’ll cover a particular procedure“? Apparently, “socialized medicine” is just fine when the private sector does it.)

But there is a plethora of “hidden” benefits from insuring every single American that are not immediately obvious and go unmentioned on the Network News (I know, big surprise):

• No more need for Workman’s Comp - with every single American receiving guaranteed injury protection coverage that can not be denied for any reason, companies will no longer have to carry costly “injury-protection” on their policies (though they may still need coverage for “negligence”), thus saving businesses billions each year.
• Ditto on your car insurance. No more need for injury liability coverage on your car insurance. - I have a minimal policy that covers only around “$25,000 per person, one driver and up to two passengers” if someone I hit is injured in a car accident. At today’s healthcare prices, a ride in an ambulance for a trip to the ER could burn through that $25,000 maximum in minutes. I would then have to make up the differenceout-of-pocket. But with every person having full medical coverage, you won’t need “injury protection” on your car insurance any more, and rates should drop considerably (but before you shed tears for the insurance companies losing all that money in premiums, I’ve had to sacrifice better “collision” coverage, and have a high deductible, to cover those injury costs. I’d likely increase the coverage of my car so that my insurance pays for more of the damage, rather than take the savings and run if my rates were to go down significantly.
• More people would be able to afford health insurance while unemployed or under-employed. - While hard numbers are difficult to come by, it is not uncommon for health insurance to cost between $800 and $2000 (or more) a month per person, an amount extremely difficult to afford even in the best of times with a well-paying job. With lower rates under a national program, many people who suddenly find themselves without a job (or a low-paying job) won’t necessarily have to give up their health insurance because it is too costly. This means fewer people relying on the costly Emergency Room for their medical needs… an expense that explodes insurance costs for all Americans.
• According to a Harvard Medical School study earlier this month, over 60% of all bankruptcies in the U.S. are due to medical bills either because their illness/disability exceeded their coverage or disallowed by their insurer. With “Single Payer” public health coverage, as long as a treatment is ruled “medically necessary”, it must be covered. And if private insurance companies expect to survive, they’re going to have to do the same or else risk losing that customer to the Public Option.
• Malpractice insurance would no longer need to cover the expense of a lifetime of medical care resulting from negligence, thus driving down malpractice insurance rates that then get passed on to the patient. (Some Republicans think the healthcare crisis can be solved through tort reform. Not only do malpractice lawsuits account for only two percent of healthcare costs (according to an April, 2006 AARP report), tort reform would result in a savings of just 0.4 to 0.5 percent, while limiting the jury award to the victim, possibly disabled for life, by some arbitrary cap pulled out of the air by some Conservative bureaucrat. A reduction in malpractice insurance rates would do far more to reduce costs across-the-board than tort reform.)
• I am presently unable to find figures on the costs associated with “lost productivity” for the time employees are out sick or function at less than full capacity if they come to work sick because they can’t afford to take time off, but I’ve sure it is significant.

In January, The National Coalition on Healthcare issued a report that (among other things) listed some of the costs created by the uninsured population:

• The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.
• Hospitals provide about $34 billion worth of uncompensated care a year.
• Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.
• The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stay estimated to be about $3,300.
• The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.
• A study found that 29 percent of people who had health insurance were “underinsured” with coverage so meager they often postponed medical care because of costs.
• Nearly 50 percent overall, and 43 percent of people with health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.

We don’t have a “HEALTH CARE” System in America, we have a “DISEASE TREATMENT” System. We don’t treat people when they are healthy to keep them that way for low cost, we have a “Wellness” system where people put off going to the doctor until they’re already symptomatic, needing treatment at a far greater expense.

The need for “extreme profits” (along with uncontrolled hospital and prescription costs) has caused insurance premiums to rise at twice the rate of inflation (according to the same NCHC report referenced above). Removing the “extreme profit motive” to payoff shareholders and award exorbitant bonuses will encourage researchers to focus on REAL cures for serious illnesses and not just the next high-profit diet pill or (no joke) a drug to grow longer eyelashes (and, perhaps the perfect metaphor for the big money to be made from such inane cosmeceuticals: the preceding link pulls up a slick, professionally done, big-budget website).

I know I’ve barely scratched the surface of benefits we can expect from Universal heath insurance that guarantees coverage for each & every American, but I think I’ve hit many of the most significant points, as well as highlight some of the stupidity, cluelessness and rank hypocrisy on the Right… people claiming to be concerned over making healthcare affordable for everyone, while proposing “solutions” that do little or nothing to actually fix the problem.

Some light reading for those looking for more “meat”:

Read “Hidden Costs, Value Lost: Uninsurance in America“, entire book is online.

The Obama Healthcare Plan was posted online (pre-election) and worth a read. It hasn’t changed as much as you might think, at at only 9 pages (8 plus appendix), it’s worth a look.

Postscript: Tuesday is the big handover of Iraqi security to the people of Iraq, and the removal of thousands of American troops from the streets of some of Iraq’s biggest cities. While tens of thousands of American soldiers will remain in the country for months to come, it will be mostly in an “advisory roll” with the Iraqi government in charge and U.S. forces no longer calling the shots (no more American-led missions inside Iraq unless specifically requested by the Iraqi government). This will be a historic shift in the Iraq War and (I hope), will reveal that a quicker exit than “the end of 2010″ is possible. A recent uptick in violence in just the past few weeks appears to be… not a sense of what’s to come after we leave… but a pitiful attempt by groups like alQaeda that hope to “trick” America into reneging on its pledge to leave so they can say, “Look! We told you they’d never leave!” They also know Iraq is a distraction from Afghanistan/Pakistan and is costing the hurting U.S. economy billions of dollars a month.

Copyright © 2009 “Mugsy’s Rap Sheet”