Universal Health Care

Reader John in comments questioned one of my posts about how Vermont towns voted on, among other things, the issue of universal health care. So let me address this now.

I actually share a good deal of healthy skepticism about allowing "the government" to handle American health care. Talk to seniors and others who have had to depend at least in part on the feds or "the state" to do this and they'll tell you it's often a nightmare. Almost anything you involve bureaucracy in becomes much worse because of that bureaucracy's involvement.

But first, within Vermont at least, we're not looking to the feds but trying to find a way for ourselves, much as Maine has already done. Maine's plan is still too new to know how well it will fare but congratulations to them for forging ahead.

Second, the dynamic of health care in this country is changing a great deal, largely represented by how the health care industry and employers' benefits are changing. More and more people work at jobs that either a) don't offer benefits to them at all or b) have severely curtailed the coverage or c) make employees pay higher and higher premiums out of their own pockets. We're quickly reaching a point where the only people assured of relatively excellent care are a) politicians and serious bureaucrats b) the wealthy and c) CEOs only.

This means that more of us are either picking up health insurance ourselves or going without it. Having more than 50 million Americans (and I've read in some places this only represents adults without health insurance because children of the poor are often picked up at least in part by state programs) without health insurance is not only bad for these people, it's bad for the entire nation. See my book "Buying Rx Drugs Online: Avoiding a Prescription for Disaster" for more details on what I think about this. Uninsured Americans threaten our society as a whole, even if you don't happen to subscribe to my theory that people should have access to health care, period, end of sentence.

I don't think anyone is seriously talking about a state or federal initiative that would amount to free health care. Certainly not during these Bush years. Ironically, when Bush was trying to sell the new Medicare drug benefit plan, he said that seniors should have access to the same great care that government officials did.. then turned around afterwards and said that couldn't happen because it's too costly. Agreed. If we cut back on benefits for Congress, we could each pocket a check that would at least help us pay those high premiums.

What is on the table by some intelligent folks is a plan that allows everyone to buy into health care at a price that would be far less (because of the massive number of people involved) than paying individual premiums. Rather than you, me, Joe Blow, Aunt Flo, and John Doe each paying as individuals or individual families, we would go into one huge GROUP over which the overall costs would be spread and the premiums would be lower. It's not so much federally or state financed like a welfare system, but one that brings us together to be treated as a group rather than as individual payees.

I'll use myself as an example. Right now, I pay close to $450 per month as an individual Blue Cross of Vermont subscriber. WOW! I've never had a car payment that high. I would normally never take on a debt that requires such a high monthly cost and this comes close to half the cost of my mortgage payment each month. For health care I don't regularly use (I see a doctor every few months and have a couple of prescriptions), that's awfully high. And I'm someone who has only had one major hospitalization in her entire life. I'm also someone who has taken several proactive steps to improve her overall health (more exercise, watching what I eat, no smoking, working with my doctor on solutions that don't require prescription/medical care) so to reduce the risk that I'll have another catastrophic illness (I got hit by a super-bug a few years ago that sent this otherwise fairly healthy person into three weeks of ICU).

An acquaintance of mine who does employee benefits for a company figures that between the company and employee contributions, very similar coverage to mine costs about $287 per month for coverage that extends beyond the employee him/herself to cover a spouse.

The $160+ difference is the power of a group. The larger that group becomes and the more spread you have between relatively healthy and less healthy people, the more cost reduction you see (at least in theory).

I don't want Big Brother to pay my premium. I just want the power and cost effectiveness of a group to make my premium more reasonable. I think a lot of people feel similarly.