It Ain’t Rocket Science

Space Shuttle Launch

Let’s try to cut through all the BS, double-talk, flummoxing, and fear-mongering over how we might implement a health care plan in this country that addresses the needs of those in our society unable to afford the high-priced medical premiums offered by insurance companies, thus lacking the means to pay for medical care.

The answers exists in one word – Medicare. We already have a tried and proven program for providing senior citizens with the medical care they need without driving them into bankruptcy, most of whom are on a fixed income.

Medicare serves almost 45 million senior and disabled Americans. The program has been in place over 40 years, has a mature process in place, and provides payment to providers with a miniscule 3% administrative costs, compared to as high as 30% for private insurance companies.

Extending Medicare to the estimated 60 million-plus Americans who are either uninsured or under-insured, is the simplest approach to this problem — we don’t need an all new plan with its own bureaucracy and added costs to run the program.

As for how to pay for the plan, the premiums would be paid based on the recipients ability to pay. There would be a sliding scale established by what the individual(s) earned in the prior year based on tax returns.

Those in the lowest income brackets would pay the least — at some level, possibly nothing. The premiums would increase with earnings, and at some point, the premium for Medicare would be equivalent to the cost of a private policy.

This would reduce or eliminate the concern that people would drop their private policies in favor of the public plan. Medicare does not now, nor will it ever offer as much as private insurance. No one in their right mind who can afford private insurance would give up the benefits for Medicare if the out-of-pocket costs are going to be the same. I can tell you that, as well as Medicare works, if we could have back the private coverage we had when I was employed by Boeing, that’s what we’d have.

As for the unfounded fear that large companies will suddenly dump their employees insurance plans and tell them to move to Medicare, you simply put in place a provision that says if they do that, they will pay the Medicare premiums based on their employees earnings. They don’t get a free ride, either. That will have the affect of deterring large corporations from dumping their people into the public program. If a company tries to give the employees inferior insurance, but the cost will be the same as private insurance, both the employees and the company will object.

On top of that, insurance companies are not going to lose the billions of dollars they’re making off of premiums for the largest corporations in the land, so they will make sure that both their premium structure, and the benefits of their plan are superior to anything that Medicare might offer.

Small businesses that can’t afford the high cost of private premiums would have the option of signing their employees up for Medicare. If the insurance companies want their business, it will be up to them to offer plans that are affordable for small business.

For the record, Medicare recipients today do not get a free ride. My wife and I pay $182 for our Medicare every month — it’s deducted from our Social Security payments. In addition, we pay for a supplemental plan that covers the costs not covered by Medicare, giving us a total of right around $500 a month in medical premiums.

Finally, the ceiling for paying into the Social Security/Medicare system has to be raised from the $106,800 level for 2009. This will cause a lot of high-end earners, and anti-government/tax people to whine, but the fact is that if you’re pulling down $120,000 a year, your taxes will go up $1,009, less than the cost of a daily latte at a local coffee shop.

By raising the limits on salary ceilings we address the current forecasted short-fall for the program, and by having the new people pay on an ability scheme, we pump more money into the system.

Why is public access to medical treatment so critical, not only to the people who are sick and dying, but to the overall health of our country? Simply because the cost will go down, not up. If we do nothing, the costs will continue to skyrocket. Right now, there are people who avoid going to the doctor for a checkup, or to get treatment for an ailment because they can’t afford the medical bills.

As some of these people get sicker and sicker, they end up in the emergency room, and often require a hospital stay of possibly a week or more. At around $500 to as high as $3,000 for a typical emergency room visit, and another $3,000 — $5,000 a day for a hospital stay, you can easily run up $15,000 for a 5-day stay. This might all be avoided if the people in question know they can go to their family doctor, or a local clinic for $60 — $100 for preventive care, with their only cost being a $10 co-pay, if that.

It’s time for some straight talk about this issue, not the name-calling and fear-mongering that the conservatives have tried to pass off as public discourse. Adequate and affordable health care should be a right, not a privilege for only the affluent in our country.