Healthy looking bunch. . .must have a great insurance plan
For probably the millionth time I have said it, I will say it again: we have not had health insurance in this country for a very long time; what we have is a pre-paid health plan.
Insurance protects against losses we cannot afford to cover out of pocket. House insurance and auto insurance are prime examples, and they have not changed. They do not cover routine maintenance and mechanical failures; they cover accidents, fires, and most acts of God.
When we had health insurance, it was much the same. This all started to change when Health Maintenance Organizations started to spread like kudzu. What seemed like a good idea made the actual cost of obtaining health services vanish from view—no one paid attention because all they had to do was pay into the HMO and that was that.
What happened is annual per-capita costs grew unchecked from about $400 in 1970 to over $10,000 now—it is now 25 times more expensive, while the minimum wage has gone from $1.60 to $7.25 per hour, or less than 5 times greater.
We can moan all we want to about premiums, but until we control costs, they have to go up. The only question is who pays the higher premiums? Everyone or just those the Republicans want to punish because of their pre-existing conditions or age or both?
In the bad old days to which Republicans want to return, the disparity in health care premiums was all over the map because insurance companies played a very nasty game with the public in the name of profit. Here’s how it worked:
Most large companies’ self-insured, which meant they collected premiums from employees and paid insurance companies to deal with payments to providers and pharmacies. Insurance companies made a percentage of the claims they paid, which is kind of what they do now.
For all other employer-provided plans, companies charged premiums based on sex, age and costs. The reason for this was they needed—and still do—make a profit. Younger, healthier people did not use as many heath services as people who are older, and as people age, they tend, often through no fault of their own, have more health conditions. Our bodies do suffer from something akin to planned obsolescence: people over age 65 comprise 13% of the population and consume 36% of health costs.
So, as a company’s employees naturally age and begin to incur more and more health care costs, their premiums increased continuously until, at some point, it became too expensive to buy. Profit motive—the free market—required this.
This is just what Republicans are doing by allowing older and sicker people to be put into high-risk pools and charged more.
They argue that lifestyle choice, like driving records, should affect the cost of insurance and why should people who make good choices have to subsidize people who make bad choices?
Sounds all well and good, but extremely myopic and just plain mean. And it is not how we cover other costs, like schooling. If we only charged people with kids for education costs, the public schools would crumble. We all pay because there is a greater good in having a well-educated populace. It is the same with health care. A healthy population misses less work and is more productive.
The elephant in the room, as alluded to above, is controlling costs. But no re-electable Republican would even breathe this.
In the bleak dystopian future exhibited in Logan’s Run, health care costs were minimal because everyone was killed when they turned 30. I don’t see this happening, but the Republican plan will accomplish control over costs by pricing the service beyond that which most people can afford. The rich will survive, the rest of us, well, don’t we exist just to increase their wealth anyway?