“Universal” vs. “Affordable” Health Care

42-15614510This morning, President Obama will be hearing from a variety of viewpoints on the state of health care in this country. From the Washington Post:

President Barack Obama has invited to the White House more than 120 people who hold a wide range of views on how to fix the world’s costliest health care system, one that still leaves millions uninsured.

A broad group of doctors, patients, business owners and insurers were to gather for a forum Thursday in hopes of building support for big changes in health care. Republicans are invited, and they’re expected to speak up.

It’s been years since we’ve had a serious discussion on how to fix our health care system. Oh, sure, it comes up during every election cycle. But the candidates get elected, and this issue gets pushed aside by other “more pressing” issues. You may wonder how this can happen over and over again. I mean, we hear the figure “48 million uninsured in this country” and we are shamed that this can happen in a wealthy nation such as the U.S.

And then we move on.

Because here’s the thing: if you have health insurance, you really only care about … the cost of health insurance. You can’t even get your head around the fact of life without health insurance. But one day, I’m afraid it could all come crashing down for all of us, even the ones with health insurance.

Consider for a moment: employment. In our current model, of course, most people get their health insurance through their employer. This puts us in a pool of insured, with the idea being that this keeps the cost down. It sure does for me, because I am a state employee so I’m swimming in a huge pool.  But there are a couple of problems with this pool-model.  First of all, what happens if I get laid off? Guess what — you know those rising unemployment figures? That is going to translate into a lot of people who lose their employer-sponsored health insurance.

Secondly, there is COBRA, which is supposed to be a solution, but is one of the most non-viable solutions I have ever been given for a problem. Twice in my lifetime I have been face with using COBRA. Once, I tried it. I had left my full-time job to attend graduate school full-time, and I had never been without health insurance in my life, so it just seemed logical. Until the bill came. I think I lasted about 2 months when I realized there was no way I could pay the full premium on my own. My monthly premium was as much as my rent. The other time was when I switched jobs and the benefits at my new job didn’t kick in for 90 days. I made the decision to gamble for 90 days and be very, very careful.

But apparently the American public and our elected officials don’t care. I’m sure my stories above are not unusual, but it seems that they are irrelevant. Fortunately, it appears that the White House and Congress are going to take a new tactic in this effort to reform health care in America. Instead of telling stories of people who don’t have health insurance, they’re going to appeal to us where we really care:

The “appeal” of this push, [Speaker of the House Nancy Pelosi]  said, will not be that 48 million people don’t have health care insurance. “What is important to the bigger population,” she explained, “is their own health care.” She noted that with health care costs rising faster than any other costs, the key issues these days are the impact of these increasing costs on the economy, on the quality of the care delivered, and on federal entitlements (meaning the costs of Medicare and Medicaid).

Pelosi was signaling how congressional Democrats will be selling their drive for health care reform. She said that the package will focus on science and technology and include major investments in biomedical research, preventative health care, and electronic medical records. She noted that when technological improvements in maintaining medical records render it easy for health care providers to compare the medical treatment of a low-income person with a certain disease with a wealthy person with the same illness, both patients will benefit. That is, the more patients in the information pool, the better for all, including those who already have coverage.

So health care reform will be pitched not primarily as a benefit (or handout) for the uninsured, but as a way to deliver higher quality health care at a lower cost with fewer errors to those who posses some degree of coverage, especially those in the anxious middle class.



  1. I cannot believe that this nation can’t get its act together about health care. I hope that people will understand that we need to get away from this attachment to employment. It’s full of problems, as you pointed out.

    I also can’t understand why corporate America hasn’t screamed to be off the hook for providing health care to its employees. It makes no sense.

    I guess the money flowing into Congress from the health insurance lobby has much to do with it…..

    Thanks for addressing this incredibly important issue.

  2. I compare health insurance to auto insurance, and I don’t understand why we have 2 different models. I mean, I do understand, and I don’t. Because on the one hand, they insure very different things, of course. But on the other hand, you are required to have auto insurance in most states, and your premiums are based on your demographics. So it’s not an ideal model for health insurance in that if someone is ill, they would have a much higher premium (like someone who has been in a lot of accidents or gotten a lot of tickets). But if the others who are healthy had low premiums then wouldn’t the overall cost of health insurance go down, meaning it would go down for ill people, too?

    We’ve got to get away from this “it’s a right”/ “it’s a privilege” debate. It’s just a fact of life, the way auto insurance is …. (or it should be, anyway!

  3. Stacy, I can tell you feel strongly about this issue because of the all caps and excessive use exclamation points.

    Many things in our country are federally mandated, and I have no problem with that. I do not subscribe to the “government is evil” school of thought. I understand that government laws and mandates are the reason why we as a society have:
    police officers
    seat belts
    trash pickup
    food safety inspectors
    building codes
    speed limits
    child labor laws

    and personally I see no problem with adding health care to that list.

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