Tuesday, December 29, 2009

In defense of the Public Option

This is it, folks.  The house bill includes the public option, the senate bill does not, and as soon as they're back from Christmas break, they will be working on a compromise version.
For a million people with CFS, as well as millions of other people with pre-existing conditions, that public option is a vital necessity.  Insurance companies won't insure us now, they're not going to want to insure us later, either.
If you do nothing else this week, go to house.gov and senate.gov and contact your congressperson and 2 senators about keeping the public option in the compromise bill.  It may be life-or-death for some of us.
Here are Dr. Mary Schweitzer's defenses, which you are welcome to crib for your letters.
Tell them when you first got sick, when you stopped working (were you fired, put on leave, or did you quit?), what symptoms make it impossible for you to work.  If you're paying for health insurance, tell them what percentage of your income goes to the premiums (one proposal is for subsidies for anyone paying more than 10% ... I pay about 40% of what I earn, and get essentially nothing in return).  If your policy was stripped down after you used it, tell them how unfairly you're treated.  If you were refused insurance entirely, tell them that.  If you've gotten sicker because you can't get treatment due to finances, tell them! 
They have to hear all the horror stories from our side, and not just the claims of the other side that we're simply too cheap to pay for insurance or too lazy to get jobs -- recent statistic, 20% of Californians have no insurance and more than half of those have full-time jobs.  I know someone who had a full-time job, whose employer spent a year looking for someone willing to insure -- at any price -- an employee with multiple pre-existing conditions.  Every insurance company turned him down.  The other side won't tell that story; they've argued he should've gone to a different insurance company (turned down by all the ones they named) or that he just has to cough up the price quoted (no price was quoted because no one wanted to sell him a policy).  They can't (or won't) get their heads around it that some people are flat-out uninsurable under the current system.
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It's all well and good to say you don't want the government running anything, but right now we have way too many people with no health care options at all - the burden is much greater on young people, who increasingly can't get paid through their employment, and don't make enough to afford private health insurance on their own.

If you get sick in your twenties you're really fried, because you won't have enough quarters of work to qualify for Social Security Disability, and you're too old to be carried on your parents' insurance.

That's because the wealthy and very upper class are increasingly buying boutique plans that treat you like a prince - at the same time companies are scaling back on benefits, and small businesses are totally on the ropes over this.

I think that bears repeating - this current system is really tough on small businesses, because of the economies of scale.

Study after study, going back decades, comes to the same conclusion: The higher your income, the better your benefits package. The lower your income today, the greater the chances you have no employer-based benefits at all - and if so, you can't afford an individual plan.

Without a public option, these people will have no place to turn.

Medicare definitely has its problems, but try to take it away from old geezers. They know what their lives would be like without it.

My daughter-in-law is tied to a job she hates because it has the family's health insurance package, and both she and my son have significant pre-existing conditions. So employer-tied insurance has left labor immobile at a time when we badly need labor mobility.

No, I wouldn't want England's system either - although except for ME/CFS, which is done poorly over here too, they tell me it's not so bad. But those so-called "NICE" guidelines were developed with the help of American insurance companies, which are already trying them out here - that's how the catastrophe with Lyme Disease happened.

We already are paying for a very overpriced health care system for the uninsured - have you been to an Emergency Room in the past decade? The one I am supposed to go to, geographically, is a total mess - every day is like Saturday night used to be.

Treating colds and ear infections in an ER is just stupid, because it's a lot more expensive than a clinic would be. And it interferes with the treatment of the people who come to the ER because of a real medical emergency.

These people can't pay ER prices, so WE end up paying - through higher "hospital costs" and through higher premiums. But that ends up taxing the middle class who get sick - wouldn't it be better to spread the cost around?

Plus people with no insurance put off care until their condition is really bad - and therefore really expensive to treat - and we pick up the tab on that, too.

In 1993, when we were sparring over whether the First Lady should also be the First Lobbyist (my own vote was "no"), both Taiwan and Switzerland had decided they, too, needed to overhaul their health systems. But they both commissioned studies, which were very revealing on the strengths and weaknesses of those of different countries. Only after examining the different options - and publicly debating them - did they make their choices. Switzerland seems more pleased with the results - Taiwan underestimated their costs - but under both systems, nobody goes without coverage, and they both rank higher than we do in terms of results.

Our media should have been doing that - showing us ALL the options, not just Canada - instead of interviewing each other, and keeping score with the polls as if they were playing the spread on a football game.

Because the real problem here is we pay far more per person for health care than any other country, yet we rank 39th.

I think a system like Germany's would have been best for us - It is dual, public/private (you can buy a better plan if you want).

They have a lot of problems - they inherited a huge mess when they had to reabsorb East Germany into their country, and their constitution (which we pretty much wrote after WWII), says they can't deny immigration, and they have a lot of Turkish immigrants. That mirrors many of our problems. And interns in Germany have to spend a year doing home visits - imagine that! Home visits! - so they have a better understanding of the relationship between illness and environment.

How could we pay for this? Well, first of all, FICA does not just cost 7 1/2% - employers have to match it. It's really 15% off the top of labor costs, and the burden is greater the lower your income and the smaller the business (because there are economies of scale).

Then I assume you know that after you make roughly $150,000, the rest you make doesn't go into FICA or Medicare (the Medicare cut-off is a bit higher, but it's the same range).So Paris Hilton pays less than 1% of her income to FICA, whereas my West Virginia relatives who make ends meet only by hunting and otherwise doing a lot of economic activities outside the market - the full freight of 15% is taken off their income.

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