By Donald B. Ardell – May 03, 2009
Want to make someone groan? (Don't worry, this is not an x-rated joke or explicit set of
instructions for marital happiness.) Use the cliché, "I told you
so." Nobody wants to hear
that. It's off putting and it
sounds like gloating.
Well, sorry but I can't help myself - I told you so! I wrote
that the time had come to end employer-funded health insurance - years
ago. Now, it seems others are
joining my bandwagon. I'm tempted
to say, graciously of course, "What took you so long, people?" Of course
I won't say that.
"Stein's Law" is an economic rule, seemingly
obvious, to the effect that when something can't go on forever, it will
stop. Stein's Law has been invoked
recently by several politicians to describe our broken, bloated medical
system.
I have been vindicated. Others are urging the same fundamental change I advanced at
my website and weekly newsletter.
One prominent champion for a single-payer system that removes employers from
the burden of providing health insurance in the physician brother of the
president's chief of staff, Dr. Ezekiel J. Emanuel. Dr. Emanuel is an oncologist and medical ethicist, brother
of Rahm Emanuel and the "first doctor" on the president's health
policy team. In a recent book and
in articles and lectures, Dr. Emanuel urges "a guaranteed health care
access plan." Instead of
employer plans, all Americans would receive vouchers to enroll in health
plans.
In addition, Democratic Congressman John Conyers has
introduced a universal healthcare bill (H.R. 676). This bill would establish a single-payer system akin to
Medicare, but under a new National Health Insurance Program (NHIP). In this bill, employer-funded health
insurance would end.
Which brings us back to "I told you so." Here is my prescient rant from January
30, 2006.
As medical treatment costs rise and several once great
American companies fail, in good part due to bloated employee entitlements, the
popular post WW II benefit of subsidized health insurance has come under
scrutiny. Scrutiny is fine and well justified. However, what is needed now is
an end to scrutiny. No more time-wasting scrutiny is needed or justified. What
seems abundantly clear is that employer-based health insurance, the payee for
the health care of 64 percent of Americans under 65, must be eliminated. In its
place, America needs a universal coverage plan. The latter should be designed
to provide basic medical benefits for all, with compelling incentives for
citizens to stay well in the first place.
General Motors faces a one billion dollar increase in
medical costs (for a total of $7 billion) in 2006. Currently saddled with the
medical bills for 1.1 million workers, retirees and family members, GM paid
just under six ($5.8) billion last year for this devastating entitlement. How
can GM carry such a load and still compete with Toyota and other foreign
automakers with no such burden? The answer, of course, is that it can't.
Neither can other US companies facing similar if less spectacular medical
entitlement burdens compete globally with firms located in countries that offer
universal medical care.
There is also the fairness question, though what seems fair,
of course, depends on where you stand. Few of us can be objective about
fairness if our interests are affected by the choices. Still, many might see a
problem in the fact that half the tax subsidy for company-paid health insurance
goes to families earning in excess of $75,000 a year; a quarter of that accrues
to families with incomes over $100,000. annually. As you might expect, most
(two-thirds) of the 45 million without health insurance last year (or 18
percent of the 65 and under population) made little more than the amount the
federal poverty level, according to a report by the Kaiser Family
Foundation.
Here are some additional facts to consider when pondering
the idea that company-sponsored health insurance (in fact, medical benefit
payment plans) should be eliminated by the creation of nationalized health care
for all.
* 45 million Americans lack health insurance. Not everyone
works a company that subsidizes all or even part of the costs of medical
care.
* Employee health insurance is subsidized by all taxpayers
via tax policies. How much is this subsidy? About $130 billion--enough to buy
everyone in this country a basic level of care via universal coverage.
* Medicare and Medicaid spending could also be eliminated.
This would provide another $180 billion in 2010 that could be applied to an
even more generous but still basic level of care for all citizens.
Of course, my idea to phase out employer-based health
coverage will encounter stiff resistance from the health insurance and
pharmaceutical industries. After all, these industries currently rake in
billions as middlemen and middlewomen between patients and caregivers, a
"service" that contributes nothing to overall care or better health
status. The drug industry gave us the "Harry and Louise" campaign in
1993 - 1994. These attack ads helped sink Hillary's health reform plan. I can
imagine the awful things that Harry and Louse would say about me, but
somebody's got to speak up. (By the way, while Hillary's plan was pretty awful,
its shortcomings were not addressed in the scare-tactic
"conversations" dramatized by actors who played Harry and Louise.)
Another problem with employer - sponsored medical insurance
is that the subsidy promotes wasteful medical spending. The well-to-do gain low
cost coverage in such high amounts that they feel entitled to a "more is
better" way of thinking. This, in turn, leads to more use of the system
than is usually appropriate, which, naturally, adds to the unstoppable inflation
of medical costs. As often noted here and elsewhere, no nation spends as much
for medical care -- $5,400 per person per year a few years ago, undoubtedly
much higher now.
Well, what do YOU think? Do you believe the country would be
better off without employer-based health insurance for a privileged few in
favor of a restructuring that grants basic medical access for all? I'd be
delighted to hear from you. 