Why We Need Universal Healthcare
Jan 17th, 2008 at 7:13 am by Susie
Yes, I know that national health programs have their drawbacks (a Canadian reader wrote me with a bunch of horror stories just this week) but removing the profit motive should take care of many of the problems we have now:
Eric Simpson was strangely calm when the insurance company called last week, saying it was sending a man for his right arm.
The woman on the phone told him he should have known he had only $2,000 of coverage through Aetna for artificial limbs. And the arm, which he’d just received that week, cost more like $37,000.
But, he protested, he’d been preapproved.
Angelo Russello had the job of taking Simpson’s arm. He works for Allied Orthotics & Prosthetics in Northeast Philadelphia.
All week he’d been visiting Simpson at Moss Rehab in Elkins Park, fitting the device, teaching the 32-year-old Germantown man how to flex his muscles to move the thumb and fingers.
“I felt like a fool,” says Russello. “I’ve got to tell you, this has never happened before.”
Simpson read his face and said, “Just take it.”
And yet, in that odd way that often happens when major media calls an insurance company, it was all a big mistake!
“A miscommunication,” Aetna spokesman Walt Cherniak said yesterday.
Aetna officials had mistakenly considered his new arm medical equipment rather than a prosthetic, which is covered in full. They called Simpson to apologize.
And the next day, Friday, Russello returned the arm.
“Honestly, I didn’t think it would be back so soon,” Simpson said Tuesday in his room. The new arm will make it easier to dress himself, to support his weight, as he tries to recover from his spinal injury. Doctors give him hope he’ll walk again.
As we spoke, it was hard not to hear the man in the next bed talking with a rehab specialist.
“The wife just gave me the bad news,” he said. “The insurance company just called and said we don’t have approval for the procedure.”
Sounds like it’s going around.
The miscommunication apparently was that Aetna’s willingness to literally take the arm right off of one of the lucky duckies Who Have The Best Health Coverage In The Worruld somehow got communicated to a lot of people. That made Aetna look bad, and the Aetna people “mis” being left alone to take an arm (and next, a leg, yes?) from one of their “insured” victims with impunity.
Susie, this is a very complicated system and it is indeed out of balance. I agree that taking the “profit” out of healthcare and health insurance would help. The CEO would still be paid gazillions more than the phone operators, however, and there would be an incentive to bring in more money to pay annual “bonuses” or somesuch. So it’s not a perfect cure.
The point of insurance is to spread the risk. A single source of health insurance, such as Medicare for all, would throw everyone into the same pool. Right now insurance companies look at our little 10-person company and raise our rates through the roof because our “pool” is so small. We need to expand the pool to spread the risk. But like taxes, there are always going to be exceptions.
Some people will want to pay less for being healthier, for example. Smokers should pay more! The obese should pay more! Those with a family history of cancer should pay more! Where do you draw the line?
With regard to Canada, I have friends there who claim that they have never had any problems, including heart attack victims, pregnant women, and others with medical needs. In parts of Great Britain, however, other friends’ stories have been different — where the hospitals are owned by the government and doctors are paid by the government (single provider system which should be contrasted with the proposals for single-payer healthcare in the US) the service has been terrible.
A single-payer system in the US could face some of the same problems. Instead of an insurance-company minion deciding that the company shouldn’t pay for a procedure that would cut into the bottom line, we could end up with government bureaucrats (political appointees perhaps) deciding not to pay for certain procedures that they don’t like or consider to be too expensive. How do doctors like Medicare patients now? What kinds of hoops do they have to jump through to make a decent living? How much should doctors make?
Sometimes the problems seem endless.
Having said all that, having studied the candidates’ plans I think John Edwards’s plan would work best and would be an improvement over the current system. If Senator Obama wins the nomination, I hope he has enough humility to reconsider his plan and adopt Edwards’s. I don’t think Senator Clinton would.
I’m all for single payer, but can envision a specific political problem —
under a Repub regime, the likelihood of fundie zealots being appointed
to run the agency, and effectively preventing all abortions.
Better yet, appointing Jehovah’s Witnesses so that all care is denied,
except for members of the executive branch.
Part of the reason that single-payer works better is that there is a single risk pool, yes. But another reason is that the CEOs WON’T be making “gazillions” more.
Primarily, however, single-payer means we’ll have a coherent health care system that will focus on caring for sick people rather than the focus being on not caring for sick people. In our current system, caring for people is called the “loss ratio,” and insurance companies try to keep it as low as possible. Their responsibility, under law, is to their shareholders, not to sick people.
Look, I understand that private insurance companies do want to make money but the example of the prosthetic arm sounds like an honest mistake. I work for an insurance company in the claims department and people do make mistakes. Most times, the provider will simply call to clarify and the claim will be reconsidered. Many times, the error lies with the provider and how they filled out their claim form. By law, if a provider uses certain codes, we are required to process the claim as submitted. I cannot tell you how many claims I process that are filled out incorrectly by the provider. So don’t assume it’s the ‘big bad insurance company’, it could just be an honest mistake.
It could also have been paid for in full by Aetna’s CEO out of his 2006 pay. Would have only left him with $36-point-eight-three f’n million though.
You can see why the poor bastard couldn’t afford THAT.
We don’t need universal health care because universal health care is fatally flawed. It sounds good on paper however it is doomed to fail like any socialist idea. There are four main fallacies to universal health care: the first is that we need it. We don’t need it. There is nothing anywhere that says that everyone has the right to health care let alone free health care. Once government starts taking on roles it wasn’t designed to it stops doing things it was designed to.
Two, universal health care is free. It isn’t free. It just transfers the costs from one person to another. This is income redistribution and this idea always fails.
The third reason is that it stops people from assigning value. The minute someone else pays for something, we abuse that good or service. That is why there are incredibly long waits in any universal health care nation, because people go to the hospital for any malady.
The fourth is that universal health care has been successful elsewhere. It hasn’t. It is filled with horror stories.
here is how I wrote about it…
http://theeprovocateur.blogspot.com/2008/02/fallacy-of-socialized-medicine.html
I dont think that we should have universal healthcare since about half of our salery will go to the taxes of this