Candace

Talmadge

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March 11, 2008

More Private Health Insurance: The Worst Possible Solution

Our current health care reform debate frames the issue as merely a matter of expanding the numbers of those who pay for private health insurance.

As previous columns have outlined, health insurance is no guarantee of good health care or even access to any kind of health care. We’re making a major assumption about the problem that simply does not hold up under any kind of close examination of what actually takes place when those who pay for private health insurance have cause to use it.

According to a recent nationwide poll conducted by National Public Radio, the Henry J. Kaiser Family Foundation and the Harvard School of Public Health, the public supports a broad approach to make sure that everyone has private health care coverage. The poll shows 59 percent in favor and 33 percent opposed. Do note, however, that this level of support comes with caveats that include requiring businesses to provide health insurance to their employees and insurance companies to take anyone who applies, even those with pre-existing conditions.

But that’s not what happened in Massachusetts, the first state to mandate that individuals living in the state buy private insurance. The Bay State made the fine on employers for not providing health care coverage a trifling $295 per employee per year (maximum), and on top of that has been lax about collecting said fines. This is an open invitation for employers to ditch health care coverage altogether, since paying the fines is far cheaper than the cost of offering coverage (provided they actually do pay).

What happened to the other caveat? There is no legal requirement that health insurance carriers in Massachusetts take people with pre-existing conditions, and no law that prevents double-digit insurance premium hikes. “Patients end up with the worst of both worlds,” says Carmen Balber, a consumer advocate with the Foundation for Consumer and Taxpayer Rights. “They are forced to buy unaffordable insurance or junk insurance with no real benefits” due to extremely high deductibles and co-pays.

The special interests that gutted the Bay State’s insurance mandate of any real value to the public will be at work again many times over if/when Congress ever gets round to drafting a national health insurance mandate. The public interest simply doesn’t stand a chance against hefty campaign contributions and other “perks” lavished out to Capitol Hill legislators by deep-pocketed business groups, insurance carriers and professional medical organizations like the AMA.

Enough already. All the hot air over whether or not to require private health insurance prevents us from asking other, much more pertinent questions about healing our broken health care system.

Basic questions, such as: Does the United States, as a nation, value healthy profits over healthy citizens?

We demonstrate that we value the former far more than the latter by framing health care reform solely as a matter of expanding private insurance coverage, by force of law if required.

Yet the health of the U.S. public is a matter of national security and our ability to compete in the global economy. Some of us, at least, think of public education as an investment. Why not public health care? Why is the best health care this country has to offer limited solely to those with deep pockets and/or those in high political office?

Another question we haven’t yet asked: Is insisting that we must select between universal health care or health care for profit perhaps a false choice? Is there some way to combine the best of both? We haven’t even done some basic thinking about this possibility because we’ve been too deep in the red herring debate over requiring health insurance.

Last, but by no means least, my favorite query: Is the western science medical model the best and only way to approach health care? According to the U.S. Centers for Disease Control, in 2002, the latest year for which numbers are available, 62 percent of U.S. adults used complementary and alternative (CAM) medicine over the past 12 months.

The most telling phrase in the CDC’s 2002 report: “Rates of CAM use are also exceptionally high among individuals with life-threatening illnesses such as cancer or HIV.”

Maybe, instead of making CAM a last resort, we start talking about integrating low-tech, lower-cost CAM approaches into our national health care. The main complaint, of course, is that many CAM methods haven’t been rigorously tested to discover if and how they work.

Not knowing how something works has never stopped the medical establishment from pushing flu shots. In their more candid moments, doctors and medical researchers will admit they haven’t a clue why vaccinations – if prepared for the right flu strain – help prevent people from catching that season’s virus. They just do, based on clinical observations. The same with CAM, varieties of which have been used for thousands of years to promote health in China, India and other places.

It’s long past time to ditch the rubbish rhetoric about insurance mandates and start discussing real solutions for our health care system. They’re available, but invisible unless and until we open our minds and think way outside of the western medical model. What do we have to lose?

Read Previous Installments of This Series

Horror Tales from the Health Insurance Trenches - March 10, 2008

Health Insurance Mandates: Great for Insurers, And That’s About It - March 3, 2008

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