Do you think the health companies will willingly give up the golden goose that makes them rich as it destroys our ability to compete in the Global market place?
William Chirolas -- World News Trust
March 13, 2007 -- There are times when one must disagree with allies in the fight for health care reform, and this is one of them. Andrew Stern, president of the Service Employees International Union, has been a friend of progressives and now wants to move beyond the employer-based health coverage that currently covers 60 percent of us, noting that by 2012 25 percent of the American workforce will be contingent workers (temps) with no coverage.
Stern notes that the debate has moved from 1993's "Health care is a right vs. Health care is a privilege" to a corporate competitive need, as we can not export or compete if we are the only country to build into our product and service pricing the cost of the employers' health care coverage policy -- and a corporate concern is a place where Congress seems more able to pass legislation to solve the problem. Logical -- and indeed one would say the union president is on the right path so far.
But Stern appears to be afraid of giving Insurance company management a hook to use to scare their workers away from joining his union. It is impossible to develop an insurance company approach that keeps you covered at a flat cost, because in a job-changing world, the insurance companies still want to be able to deny standard coverage if you had been sick, out of work and therefore not covered, and were now going to work for another employer.
And Stern has drunk the GOP/Insurance Company Kool Aid about the need to worry about reining in costs. He hasn't worked out the fact that reining in costs equates to denying coverage -- directly by way of insurance company rules on what is covered, or indirectly by way of making something more expensive than something else a person wants to spend their money on. He misses the public health need to get preventive care to everyone, even the ones so cheap that they'd deny that care to themselves if given the choice -- and given an incentive that was greater than a few dollars.
Someone should point out that Canadians with a state-provided health care payment system live 2.5 years longer than we do, or that our children's health outcomes is down there at the Third World level of a country like Malaysia.
Stern appears to have not absorbed what Physicians for a National Health Plan have been saying about ideas like extending Medicare for all. Andrew thinks Americans will reject a government-run system like Canada's a single-payer system: "I don't think Americans have a great trust of government in general. I think things like Katrina and Walter Reed don't make people feel comfortable that government's going to solve their problems. I think single-payer would be the most efficient system, but I think Americans want to have an American solution, not a Canadian solution." He seems not to understand we are talking about a better health payment system -- not a government bureaucracy -- and that any Insurance company-based cost containment will include the same type of rules about what is covered and what is not covered that he seems to be trying to avoid coming from government.
Indeed someone should tell Stern that our states already impose "What is covered rules" on their Medicaid programs. The only question is who would make that decision with an eye on making the nation as a whole healthier and living longer. While he has kind words for Sen. Ron Wyden, saying: "Why shouldn't every American have the same health plan as his member of Congress?", he suggests that the decision be left to each state -- perhaps with more Federal resources sent to the states.
Asked if there is a role for the health insurance industry in a future health care system, he does not respond by pointing out the fact that that health care industry does an excellent, profitable and low cost job already in being administrative services-only providers to the Medicare Part B (doctors bills) system, but instead says, "I think there will be (a role for insurance companies), but it's got to play a different role, and it's got to add more value to the system. There's too much administrative cost, too much advertising, too much money that's not spent at the bedside. Insurance companies are going to have to find new ways to deal with prevention and chronic disease management, not just processing claims."
All true -- and all solved with the approach we now use in Medicare Part B administration. Well Stern, you should know that what you just described as needing to occur with Health insurance companies adopting a different role was getting to the equivalent of single-payer universal health through regulation of health companies' pricing and coverage -- or do you think the health companies will willingly give up the golden goose that makes them rich as it destroys our ability to compete in the Global market place?
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William Chirolas brings 40 years of real-world business experience in local, state, national, and international tax, pensions, and finance to the world of blogging. A graduate of MIT, he calls the Boston area home, except when visiting kids and grandkids. He can be reached at: \n This email address is being protected from spambots. You need JavaScript enabled to view it.