PrintAugust 17, 2009
The Big Lie About Health Care
We already have national health care in the United States. It is disingenuous and meretricious for the Left and the media to insinuate that we are a cruel and heartless people by incessantly bellowing that 40 million citizens do not have health insurance, implying they are denied care. This big lie is fomenting the Obama health care initiative under false pretenses. By starting with the truth and de-politicizing the argument, it is possible to streamline health care delivery.
If free care for those who cannot afford it is provided by health insurance policy holders and tax dollars, then why is this basic fact kept out of the argument on health care now raging across the country? And how did we arrive at this waypoint? Are we really going to toss away the most excellent health care system in the world based on a politically motivated lie?
I commissioned an investigation in 1986 in the business journal I operated then to find out why the group health insurance premiums for our company were rising 30% to 50% a year, requiring the ordeal of enduring tedious presentations from new providers offering a better price. The next year, the reduced costs in yet another new plan would skyrocket and the process continued. Running a company became more like managing a day care center for over-sized children; reading the Tax Code was a break from the tedium of reviewing complicated clauses in health plans. But worse, management became intertwined personally with each employee's personal life.
The problem began with two arms of the federal government that regulate hospitals. One department mandated that hospitals must break-even or show a profit to keep their charter. This was instigated because of money-losing hospitals duplicating services and equipment, endangering the solvency of profitable facilities. Another set of federal regulators ordered that all hospitals in the US must provide indigent care to any person who arrives at their door. Any American without the ability to pay -- or lacking health insurance -- can visit any hospital in the US and receive cradle-to-grave care free of charge. The services range from dental care to maternity to heart surgery.
These requirements at first led to cost increases where the hospital had total control: room rates rose seemingly overnight from $75 to $90 a night to $400 to $600. This move, augmented by rising costs in every aspect of health care delivery -- combined with the spiraling price of new technology and expanding longevity -- created a bubble in health expenses that continues to expand 25 years later.
Going back 30 years before the mandates, health insurance was prohibitively expensive for an individual. Companies, allowed to pay for health plans out of pre-tax dollars, offered group plans to provide cost efficient coverage as an employee benefit, paid for by the employee. As the 1980s wore on, employee rights became the issue du jour, mostly caused by the huge influx of women into the work force. New laws and regulations spewed forth monthly to sanitize the workplace from the provenance of males. Sexual harassment led the way, but the problem of dealing with pregnancy was one of the key drivers in the need to expand the parameters of health insurance. Under federal law, pregnancy was deemed a disability, and woe to the company that did not accommodate maternity needs in company policy.
The rise of hip tech firms, coupled with a booming economy, transformed health insurance from simple access to affordable care to the jewel in the crown of employee benefits. Led by government agencies and universities, the bells and whistles attached to a group plan became multi-faceted and complex. Insurance purveyors made huge commissions selling the latest model, knowing they had ensnared a captive customer since businesses were the key option for affordable plans.
Soon the health plans took on a life of their own, requiring a management component that competed for resources with the core product of a company. Plans offered an array of options, including doctor visits, check-ups, prescription discounts, mental illness care, scores of co-pay options and advanced maternity care. The elemental definition of health insurance -- major medical in case of a catastrophic event -- became obscured. Employees began to view their health plan and all the attendant services as a right.
Until the early 1990s this seemed to work. Then thousands of firms closed their doors due to the burdensome cost of health insurance during the worst recession on record since the Depression. By the end of the 90s, only a very few private sector workers -- and of course government employees and educators - received fully funded plans. Today, employees pay a large proportion of the premium, and free dependent care is a relic of the past --even for teachers. The salad days of corporate sponsored health care were nearly over. In today's horrific economy, the health care crisis is the top priority of the Obama administration, but action by the administration is not driven by the economy. Their plan is focused on political and social engineering.
That's why Obama's plan is centered on the corporate model. Businesses will be forced to provide group health care or pay a penalty. This punitive concept is driven by the anti-business attitude of the President's elitist advisors who are dedicated to leveling society and the marketplace. And they miss the point history has demonstrated: group plans are a cumbersome and inefficient burden, especially to the small businesses that comprise 90% of the employment and productivity of the GDP.
There is proof this imposition on business is punitive and directed against a defined group. Today, citizens no longer need to join a group to obtain affordable health insurance. Health providers now extend lower rates to applicants by placing them in an existing group.
It's time to end the madness. First, government and media must admit we already have national health care, and indigent services should be covered by an assigned risk policy guaranteed by the government; secondly, health insurance must be made tax-deductible for individuals. This construct allows the government to assist all its citizens and refrain from punishing the few to please the many. Better, this method revolves around the options of the individual operating in an open marketplace for services - a concept fading into the past under Obama's world view.
Bernie Reeves is editor & publisher, Raleigh Metro Magazine
