Commentary —

Universal Health Insurance — The Only Answer

By William A. Collins

Dreamy health care,

Head to toe;

But only if,

You’ve got the dough.

Every American knows deep inside that the only solution to our health care crisis is government insurance. All other industrialized countries, save Australia, already use it. Some, like the United Kingdom, even provide the actual care. An ideal American system would likewise operate nationally, but one state could do it alone if necessary. HMOs would be reduced to a supplemental role and many would likely disappear.

Current federal policy, however, points in a very different direction. The president advocates, instead, an “Ownership Society.” His vision equates with what we once called when I was a lad, “Devil Take The Hindmost.” And indeed today the devil is taking poor souls lickety-split. Mostly the ones with faulty health coverage.

That number is growing fast as employers steadily jettison their historic responsibility for workers. There are a couple obvious reasons for that abdication. First is the explosive growth of insurance premiums; second is the comforting assurance from the White House that greed is OK. In Connecticut we have made the appalling discovery that many Wal-Mart employees are forced to get their coverage from the state Medicaid and Husky programs.

The solution to this abandonment of workers seems reasonably obvious. Building on America’s tradition of employer-based health care, the government would set up a Social Security-like system where employer, worker, and Congress would all pay into the universal health pot. Its administration would be much like Medicare, which is marvelously efficient. Enormous amounts of money would immediately be saved by eliminating existing duplication. Employers who care about their staffs would clearly be relieved, and every American would be covered.

As you might expect, the health insurance companies are not so thrilled with such proposals. Most would shrivel to a very secondary role. Doctors and nurses might not be too keen on them either. The thousands who staff HMO bureaucracies, working 9 to 5, would actually have to go back to serving patients in hospitals and clinics. Thus the upshot is that while the medical benefits of reform seem clear, the political opposition is likewise plain. But keep in mind that since other nations pay only 60 percent to 70 percent of our rate for health care, by emulating them we could eliminate, at least for a while, our current devastating medical cost increases.

In the meantime, earnest local politicians are seeking partial solutions. Some legislative leaders want a “play or pay” system. That would force those employers who don’t offer coverage to contribute to a health care kitty. Our state comptroller, in turn, wants to offer access to the state’s own medical policy to small employers currently priced out of the health market. Other folks are working to expand Medicaid, Medicare, or Husky. God bless them all, but what each proposes is largely palliative care, not a cure.

And while we maunder, the medical Gold Rush continues. Doctors install ever more sophisticated equipment in their offices, and then miraculously discover more patients who need to utilize it. Institutions do the same. Every day in our local paper the Norwalk and Stamford hospitals run competing ads, all at our expense, touting their new creative services. If they had gotten their way, both would now be doing heart surgery, following expensive lobbying campaigns. Danbury Hospital has already won that right and exuberantly reports grand new profits.

The bloated costs of all this to citizens are less well reported, but here’s how those costs get divided up. Recently my wife needed a sophisticated test to make sure she didn’t have cancer. She didn’t, but the bill was $3,500. Medicare paid $1,100 and we paid a couple hundred more. That was it. A younger, poorer patient, though, with no health insurance, would get no such discount. The hospital’s debt collectors would hound her ’til death for the whole $3,500. This is not a civilized way to provide health care.

 

(Columnist William A. Collins is a former state representative and a former mayor of Norwalk.)