Follow the health care money
By Susanne L. King, M.D.
Berkshire Eagle,
Thursday, August 31
POWERFUL FORCES have been shaping the new mandated health care insurance bill being developed in the Statehouse in Massachusetts. I was reading a news article this week about health care lobbying in our state legislature, and was astounded by the sums of money being spent by special interest groups to ensure that the new bill will protect their specific interests; i.e. their profits.
For example, Blue Cross Blue Shield of Massachusetts spent $507,056 this year on lobbying, and the Harvard Pilgrim health insurance company was not far behind with $392,631. Other big spenders included Associated Industries of Massachusetts, and Partners Healthcare, the Boston hospital conglomerate.
But who lobbies for patients? Who lobbies for the policemen, firemen, and other essential city employees who are paying more and more for their health care, so that cost of living wage increases are being canceled out? Who lobbies for the increasing numbers of workers who pay for their own insurance premiums, as fewer employers offer health care benefits (down to 60 percent of employers in 2005, from 69 percent in 2000)? And who lobbies for those of us who pay our own health insurance premiums, and have watched them rise by double digits each year for the past five years?
The new mandated health insurance bill will be helpful to those who earn the least — $9,800 per year for an individual and $13,200 for a family, the federal poverty line. And if you earn up to three times the poverty line, you will qualify for a sliding scale subsidy from the government. However, whether the payments will be affordable for poor families, and what will be affordable for Massachusetts, is now the focus of intense debate within the Commonwealth Health Connector Authority board (a new state agency that will add yet more administrative cost to the health care system).
The state has budgeted $160 million for this mandated health care plan. Tapping into the free care pool fund has been suggested when this budget runs out, which is sure to happen. This means that hospitals, which rely on the free care pool for compensation for patients who don’t pay their hospital bills, will just have to make do or fold. This does not bode well for community hospitals, which don’t have the lobbying power of the large hospital conglomerates.
Meanwhile, we spend over $1 billion per week for health care in Massachusetts. That is $62.1 billion per year, 33 percent more than our national average, and more than other state or country in the world.
Where is all that money going? Certainly the health insurance industry’s expenditures for lobbying, paid for with our insurance dollars, increase administrative costs (which are 10 times higher than with the government-administered Medicare). And there are of course, the multi-million dollar salaries for CEOs, also paid for with our premiums. Health care lobbying not only drains our health care dollars, but also ensures that business as usual reigns in the health care world: powerful vested interests are trying to maintain an unsustainable status quo.
Fundamental change in the health care insurance system must occur. Single-payer health care would eliminate profits and the need for lobbying for those profits. (“Single-payer” means that health insurance is administered by the state government instead of multiple for-profit insurance companies). In addition to eliminating the profits of insurance companies, which are increasing the wealth of a few at the expense of the health of many, single-payer health care insurance would also eliminate the other administrative costs that make this system so much more expensive than Medicare.
With single-payer health care, for-profit insurance companies would not exist. Businesses would not have to support health insurance companies with their own hard-earned income, nor worry about health insurance expenditures for their employees. As a result, they could be more competitive in a world where every other industrialized country has single-payer, universal, government-administered health care, and doesn’t rely on employer benefits.
Every patient in a single-payer system — rich or poor, old or young, employed or unemployed, sick or well — would have comprehensive health care coverage, and would not have to worry about rising premiums, deductibles, and co-payments. Doctors would love the simplified paperwork, and have more time to spend with their patients, instead of dealing with insurance-related administrative tasks.
The new mandated health insurance bill is an attempt to provide universal coverage, but it does not address affordability, nor is it sustainable, either for the individual or for our state. And vested interests, which will profit from this bill, have helped to craft it through their lobbying efforts. If you are one of the many patients for whom no one is lobbying, you should call your legislator and let him know how the current mandated health care bill will affect you, and whether it represents progress in addressing your rising health care costs.
Of the candidates for the upcoming Democratic primary election for state Senator Nuciforo’s position, Chris Hodgkins is the long-time supporter of single-payer health care, and has promised he will work to make it a reality. He understands that single-payer health care is not just a single issue that benefits individual lives and livelihoods, but that it also would decrease the cost of doing business in our state and benefit our economy. Vote in the Democratic primary on Sept. 19 with this in mind!