End the shame of our health-care crisis
Chicago Tribune
Letter to the Editor
09/26/2007
Presidential candidate Hillary Rodham Clinton presents us with yet another health-reform proposal based on the fatal strategy of keeping private insurance companies in the driver’s seat.
Her proposal won’t cover the 47 million uninsured, or even guarantee that people who have coverage today will have it when they fall ill and are unable to work.
Clinton’s proposal “preserves existing health insurance,” and includes the responsibility of individuals “to get and keep insurance” through the current private insurance market, or through a Health Choices Menu of private plans, or through a Medicare-type public program.
Thus her proposal is an individual mandate to purchase private insurance that is no longer affordable for average-income individuals, or to purchase a public plan that will be even more expensive because of adverse selection.
To make the plans affordable for individuals, she would use a combination of refundable tax credits and a cap on premiums at a percentage of income.
Assuming that the plans would provide adequate benefits and adequate protection against financial hardship, the increased spending through the tax system would be exponentially more than the estimates in her plan.
And most of the proposed savings to pay for these increases are largely nebulous, and some of those measures would actually increase costs.
Further, the administrative complexities of refundable tax credits and means-tested premium caps would still leave many without coverage.
Coverage will never be universal unless it is truly automatic for everyone.
If we are going to use the tax system to pay for health care anyway, then why should we waste funds on the profoundly inefficient system of segregated private health plans?
A universal risk pool that is equitably funded through the tax system is the most efficient and least expensive method of ensuring comprehensive coverage for everyone.
Also known as Medicare for All, a single-payer national health-insurance system would bring quality care to all Americans at a cost we can afford.
Indeed we are already paying for it: Americans pay the highest taxes for health care in the world.
Many will try to contrast the differences in the Clinton, Barack Obama, John Edwards and GOP proposals, but they are all basically the same. In spite of their rhetoric, they have each made the protection and enhancement of the private insurance plans a higher priority than patients.
It’s time for Medicare for All., which has 82 co-sponsors in the Congress. With the right presidential leadership, it could end the national shame of our health-care crisis.
Quentin D. Young, MD
National coordinator
Don McCanne, MD
Senior health policy fellow
Physicians for a National Health Program