Health care should be government's job
While having health insurance is crucial, U.S. corporations are paying more for benefits than they're earning in profits. Commentator Matt Miller says it would be better to get insurance from our country than from our jobs.
Commentator Matt Miller (Courtesy of Matt Miller)
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Tess Vigeland: If you're lucky enough to still have a job in this economy, it's not only where you're getting your paycheck, but also your health insurance. We heard earlier from John Dimsdale about the health industry's offer to cut $2 trillion in costs over the next 10 years. Commentator Matt Miller says that while health insurance is obviously essential to financial security, the uniquely American idea that employers should provide these benefits is an idea whose time has passed.
MATT MILLER: GM spends more on health care than on steel, and it's going broke. Starbucks spends more on health care than on coffee, and its business is reeling. Corporate America spends more on health care than it earns in profits. And health costs have soared from 5 percent of GDP in 1960 to 17 percent today. Is it any wonder companies are slashing health benefits? The press usually moans about this, as if firms were doing something awful. And the impact on families surely is. But the larger truth is this: while having health insurance is crucial, it's time we stopped looking to our companies instead of our country to help us obtain it.
No one else does, after all.
America is the only advanced nation that operates much of its welfare state through corporations. This may have made sense 50 years ago, when medicine was cheap, a single breadwinner worked at a big company for 35 years, and American business dominated the world economy so that companies could pass on, through higher prices, the cost of much of the country's safety net. But those days are gone. Today people switch jobs 10 times by the age of 40, and sky-high health costs make U.S. firms uncompetitive. Meanwhile, our archaic link between jobs and health care helps explain why 50 million people are uninsured, with millions more just a pink slip away from medical bankruptcy.
It's time we faced up to the fact that it would be better for business and for workers to shift the burden of health care from business to government. This doesn't mean we'll turn into France or Sweden or Canada. There are market-friendly ways to do this. Government could provide a voucher with which families could buy group coverage from among competing private plans. Lower income folks would get bigger subsidies. This is exactly how they do it in Switzerland and Holland; Massachusetts is pioneering such a system here.
None of this means business would be "walking away from the problem." But the capitalist mind will need a little rewiring. Linking health care to jobs is a dead idea, one of those old way of doing things that doesn't make sense in a 21st century economy.
VIGELAND: Matt Miller is a senior fellow at the Center for American Progress and author of the new book, "The Tyranny of Dead Ideas."
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From FL, 05/16/2009
Life expectancy and quality of life is lower in the United States than many other industrialized nations that have. On the average, the United States Citizen dies before citizens of other 30 (yes, thirty - we the USA are in the 30th place) Countries (See wikipedia list (http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy). While a very small (and shrinking) number of Americans have access to relative good health care, the grand majority has access to very poor quality.
Why not have a mixed system where a part is overseen by the government (not referring to medicare and madicaid) AND options for those that can afford to pay higher policies? This is similar to the current US higher education system. There are schools that are public, and schools that are private; if you can afford the private ones, then more power to you.
Another suggestion: LET THE CONGRESSMEN TASTE A BIT OF THE SOURNESS OF THE BROKEN HEALTHCARE SYSTEM: Yes, give them $5,000 bucks and let them get their own private insurance. Monitor them to see if any gets privileged treatment, and you will see how fast they fix our broken system. Currently congressmen have one of the best policies available, and we pay for them from our taxes.
From FL, 05/16/2009
Life expectancy and quality of life is lower in the United States than many other industrialized nations that have. On the average, the United States Citizen dies before citizens of other 30 (yes, thirty - we the USA are in the 30th place) Countries (See wikipedia list (http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy). While a very small (and shrinking) number of Americans have access to relative good health care, the grand majority has access to very poor quality.
Why not have a mixed system where a part is overseen by the government (not referring to medicare and madicaid) AND options for those that can afford to pay higher policies? This is similar to the current US higher education system. There are schools that are public, and schools that are private; if you can afford the private ones, then more power to you.
Another suggestion: LET THE CONGRESSMEN TASTE A BIT OF THE SOURNESS OF THE BROKEN HEALTHCARE SYSTEM: Yes, give them $5,000 bucks and let them get their own private insurance. Monitor them to see if any gets privileged treatment, and you will see how fast they fix our broken system. Currently congressmen have one of the best policies available, and we pay for them from our taxes.
From Kirkland, WA, 05/14/2009
I don't see how having every other country handle medical is a disadvantage to American companies. If an American company has employees in other countries, the other countries government pays for their medical expenses. If a foreign company has American empoyees the foreign company has to pay for medical expenses. The foreign companies still have to pay for medical expenses through taxes. So this doesn't really seem like a competative disadvantage at all to me.
From Fairfax, VA, 05/14/2009
I have employer-paid healthcare insurance. My friend Sue does not.
Last year I was diagnosed with CAD with significant blockage in three arteries. At the same time I was also diagnosed with another chronic disease. Under my insurance plan I underwent CABG surgery and have received ongoing treatment for my chronic illness and other risk factors.
Six months behind me, my friends had a nearly identical diagnosis of CAD and the same chronic disease, with the addition of kidney stones. Under the public health care system she underwent angioplasty instead of CABG, which is the gold standard for people with CAD and the chronic disease she also has because of the high risk of blood clots and plaque debris. Unfortunately, because public health care operates on a shoestring, .she subsequently suffered a stroke because they applied the cheaper fix with costly consequences.
If this is a sample of what we can expect from a government-run national healthcare plan, I fear we are all doomed. I don't know what the answer is, but it is not letting the government run such a vital function as national health care.
05/13/2009
As Susie Kjell pointed out, some of the high cost of medical care, is Americans trying to get a "pill for every ill". But, where have Americans, even the recent immigrants, learned this behavior?
Well, of course, from the advertising of the pharmaceuticals, telling watchers of TV and readers of magazines to go ask their doctor for the newest drug that solves a problem. That advertising needs to be paid for, and how does that happen?
We have been taught, a better life thru chemistry. Our Congressional representatives tell us, single payer is off the table. Unless you work for Congress, or are in the military. Yes, our troops are not asked for insurance when they go to the hospital.
So, if we can do it in some parts of American society, we can do it elsewhere. The only problem I have, is the politicalization of socialized medicine. How did the victims of Agent Orange get treated? What would another Bush administration--say, Jeb's, or someone along a similar vein--do with family planning at the doctor's office?
From FL, 05/12/2009
Mr. Miller does a very good job at stating how the broken (and exploited) health care system effectively destroys value by making the US less competitive and employment in the US a liability. However, he very quickly jumps to a "solution". The truth is that using ANY OTHER industrialized heatlhcare system as a model for healthcare would be an improvement. You name it, any other industrialized nation health care system IS better... even in performance AND life expectancy!!!.
I have heard people crying about a socialized health care system and how bad that would be. The case is that the US healthcare system IS socialized... WE ALL pay for those who can't pay, YES. Is a hospital let someone just Die because they don't have insurance or medicare or medicaid ? The answer is NO. We all end up paying for those who don't, in one way or another... whether it is higher taxes, higher insurance premiums, higher healthcare bills, or a more expensive cup of coffee.
If health care costs were a net-zero end game, we would be alright, we would be in fact paying what Canadians pay; 11% of GDP, but that is NOT the case, we end up paying 19% of GDP. And where goes that extra 8% ? The answer is that in the confusion of billing, hidden costs, insurance companies, and hospitals (not necessarily doctors unless they own the clinic) get away with looting the spoils (an extra 8% GDP!).
Have you ever gotten bills from a hospital? For a simple procedure, you could get 10 different bills. Have you ever wondered how much the insurance company pays? They pay about 1/3 of what the hospital charges you. But YOU have to pay the remainder at a 100% rate. If you can't pay, your credit is ruined, and the hospital gets to discount for tax purposes at 100% not the 1/3 the insurance company would have paid.
ALL the typical given reasons for high healthcare costs in the USA are lies we've come to believe.
Those who say that the high health care costs are due to malpractice lawsuits, that is a lie. The TOTAL direct costs of malpractice (that is all that was settled, spent in courts, and paid) was 1.5% of the total healcare costs in 2006 ($30B of $2 Trillion). In a free market economy, the cost of insurance for doctors would be just slightly bigger than that 1.5%.
Are Americans just less healthy than other cultures? NOT true, there is NO genetic reason, NO diet reason. Probably except for the Japanese, our diets are *in average* similar to other industrialized nation's diets. Compare to French and German. Another fallacy we are made to believe.
Some say American health care system provides better health care... by standards, we have the second to worse health care in comparison with 32 industrialized nations... we only did slightly better than Hungary. We have 22% uninsured, and probably 40% under-insured on top of that. The MRI's and the CAT-scan equipments in US hospitals are not really better than those in other industrialized nations. Yes, others ALSO have the same quality equipment, AND get charged MUCH less for the same service.
Do we (as Americans) spend more in R&D? Probably YES, but most of it most likely comes from your tax Dollars and through NIH (national health institutes)... That goes indirectly (and sometimes directly through grants) to benefit companies developing new technologies in the US.
So what is the solution?
I don't know, but insurance companies AND hospitals should start with TRANSPARENCY and TOTAL disclosure of what is in your bill. They should also give you ONE bill for EVERYTHING you had done for a single hospital visit. The information SHOULD NOT BE HIDDEN FROM PATIENTS. WE DESERVE BETTER.
From Phoenix, AZ, 05/12/2009
As I heard Matt talk about what made sense in America's health care 50 years ago, I thought back to a time when common sense was commoner. In the 50's I was a little girl who was diagnosed with an inner ear problem. The doctor told my father it would cost $2000 for surgery to fix it or I would have a permanent hearing loss. And most of it would not be paid by insurance. My father's reaction? No, surgery for Susie. And I've lived with my slight hearing loss happily ever since. Not everything needs to be fixed and that mentality is the first thing that will need to change under any form of government health care. We all run to the doctor too often for too many trivial reasons. Let's all try to have some common sense about our common health problems as we work to make this change.
05/12/2009
Alex villifies Ed for being against a proposal that will increase his own taxes. Why should he be for that when he doesn't get any benefit? It is not his responsibility, or the government's, to provide health care for others. Who can best determine what I need and what I'm willing to pay for it? Me. Then I can donate my extra money to free clinics.
05/12/2009
If you are uninsured and does not have insurance, you should check out the website www.UninsuredAmerica.blogspot.com - John Mayer, California
From CA, 05/11/2009
If businesses stop providing health insurance to their employees, the collective bargaining capacity of the employees is gone.
Proponents of this plan, tout choice. That is utopia. Try shopping for an individual insurance plan and you will know how difficult they make it for you not to understand what you get. The devil is in the details.
Here is what I propose.
1. There should be two government plans. Lets assume they are called UniCare Basic and UniCare Premium. The terms and conditions, premium, cost of services are determined by the government(Congress).
2. All insurance companies must offer these plans. They are free to offer other competing plans.
3. The premiums collected for these plans are passed onto a government corporation like the FDIC. Lets say Federal Health Insurance Corporation (FHIC). The insurance companies get a flat price for each person insured to defray costs of administering the government plans.
From CA, 05/11/2009
As Mister Miller began his commentary, my spirit was quickly raised as he said it was time to end the outdated idea of employees providing health care but my spirit plunged when he instead thought that government should do it. I had hoped that he was going to say that each person should be responsible for their own health. I suppose APM/NPR will always come up with that sort of opinion. Maybe because they receive government funding and hope for more in the future. Mr. Miller wants the same government that lies us into wars with great regularity, the same government that is untold trillions of dollars in debt (and growing), the same government that incarcerates more people than any other country, the same government that misplaces billions of dollars every year and which has devastated our economy. I don't know what Mr. Miller was smoking to come up with that plan. I think the only way to bring health care cost down is to let every person negotiate their own health plans. Government. Talk about a tired idea.
From Northville, MI, 05/11/2009
While I respect Ed's opinion, I think the truth of the matter is businesses with a direct stake in costs don't focus as much on negotiation for health cost control as they do on managing costs through claim denial, focusing their business on the young and healthy, and when all else fails raising rates. That is the path of least resistance for a for-profit institution.
05/11/2009
It seems Ed is about to reject any proposal that will increase his personal taxes. That is not necessarily a downside if the plan succeeds in achieving the stated goals of (a) reducing the total cost of healthcare as a percent of GDP, and (b) providing healthcare coverage to as many individuals as possible. The current system clearly fails at both.
From Silver Spring, MD, 05/11/2009
It seems Matt considers the best argument for his unnamed proposal which I'll refer to as "National Healthcare", is that it is common in other countries. That is an important point for such a drastic change but irrelevant if the change is not substantiated by its own merits. His proposal is not.
He acknowledges that businesses will continue to share the burdon (as taxpayers) but omits the additional burdon to individual taxpayers. When all the dust settles, the most significant change is coverage for those who do not work, paid for by taxpaying individuals and profitable companies. The change of secondary substance is negotiation for health cost control moving from business with a direct stake in costs bargaining collectively on behalf of their employees to negotiation by a government without a profit motive or individuals without bargaining power.
I find commentaries that ignore such substantial cons of their point to be worthless and below the standards of airtime on Marketplace.
Although I disagree with Matt's viewpoint, I would respect an opinion that discusses the pros and cons without bias, confident that the listener will arrive at the appropriate conclusion.
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