Insurance access must improve
By Mary Ann Garnar
OP-ED
Special to The Courier-Journal
Monday, December 3, 2007
Most thoughtful people in the United States recognize that the difficulties of obtaining health insurance — with the resulting lack of access to quality medical care — must be remedied.
Advances in the field of medicine, dazzling new diagnostic tools, the ever-increasing range of procedures and the proliferation of new and better drugs have driven the cost of medical care beyond the reach of far too many people of even average means, if they lack health insurance.
At the same time, health insurance premiums continue to rise to unconscionable levels, in large part to satisfy stockholders’ demands for higher and higher profits, to the point that purchase of health insurance is an impossibility for millions.
Those of us with insurance take for granted our routine medical examinations, blood work, X-rays, inoculations, etc. If we have the flu, we don’t hesitate to see the doctor, who prescribes the needed medicine and off we go to the pharmacy, hardly giving a thought to the actual cost of it all. We spend a few days recovering and then return to work.
If the gall bladder goes bad, we are not troubled beyond anxiety about the actual surgery. We yield to the surgeon’s knife, spend a day or two in the hospital being looked after by doctors, nurses and attendants, and don’t worry too much about the co-pay.
But there are millions of people whose asthma, aching joints, chest pains and even more serious ailments go untreated because they lack health insurance. Critical diagnostic procedures are missed because they cannot afford to pay the doctor. Drugs are not bought. The consequences can, and often do, escalate into something more difficult and more costly to treat.
Allowing this crisis to continue is morally and economically indefensible. Because of damage to the health, finances and dignity of people affected, and to the larger economy, we must find a solution — and find it soon.
People of conscience are earnestly trying to sort through the many plans being proposed to correct the inequities in order to determine which plan will provide a remedy that is both affordable and covers the cost of needed medical care. And they are beginning to understand that the solution must not be piecemeal; it must be one which guarantees insurance for everyone. No one can be left out.
Most people now agree that government must be a part of any solution.
A realistic and honest assessment of the proposals leads to the inevitable conclusion that the best solution for the greatest number is what is called universal, single-payer health insurance. That is, health insurance for all residents of the United States, largely funded with a tax based on income, and benefits paid out by the federal government. (A bill now in Congress, HR 676, the United States National Health Insurance Act, if passed, would establish just such a plan.)
Single-payer insurance is the most efficient use of available health care resources because there is no profit motive and administrative waste is eliminated. Medicare, the model for a universal, single payer system, spends only 3 cents of every dollar paid into the system on administrative expenses. Fully 97 cents on the dollar is spent on patients’ medical bills. Private insurance companies and health maintenance organizations (HMOs), on the other hand, spend 20-30 cents on the dollar for administrative costs and only 70-80 cents for patient care.
Single-payer insurance is not “socialized medicine.” Those who now have private insurance would receive the same medical care from the same doctors, dentists, psychiatrists, hospitals, etc., as they do now. Those currently without insurance would have their medical needs met. And the joy of it is that, for most people, their costs would be less than the costs of their private insurance, because the unnecessary costs of the private health insurance industry would be removed.
Opponents’ claims to the contrary, we can afford to do this.
No new government program will be free of problems. But people of goodwill will be prepared to give such a program a chance to work.
We cannot continue to allow people to go without medical care because they cannot afford to pay the doctor or buy insurance. And we must not treat inability to pay as a moral failure.
The moral failure would be to allow the crisis to continue.
Mary Ann Garnar lives in Louisville and is a retired attorney. She is a 2007 Forum Fellow.