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NAVIGATION PNHP RESOURCES
Posted on April 1, 2008

Health insurers are the issue

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By Susanne L. King, M.D.
Berkshire Eagle, MA
Monday, March 31

Is it time for your annual health insurance renewal? Have you noticed that your premium has gone up, while the coverage you receive is less than the coverage you had last year? Have you noticed that you are paying more, but getting less; that before you can even use your insurance, you have to pay a sizable deductible; and that if you visit your doctor or buy medication, your co-payment has increased?

Welcome to the land of “cost-sharing,” an insurance euphemism for sticking you with the rising costs of health care, without touching insurance company profits.

Massachusetts state Senators Theresa Murray and Richard Moore have introduced legislation to attempt to address rising health care costs in our state. One provision of the bill would create a panel to review insurance company premium rate increases, and hold them to an annual 7 percent increase. If the legislation passes, you know the inevitable result: your deductibles and co-payments will rise even more, at the same time as CEOs like William Van Faasen of Blue Cross Blue Shield of Massachusetts will continue to take home $16.4 million in retirement benefits in a single year. Health insurance companies will continue to get returns for their investors that will maintain their place near the top of the Fortune 500.

We continue to hand over shocking amounts of our health care dollars to insurance companies to do nothing more than to administer our health care funds. Insurance companies provide no health care: they merely handle the money, deny coverage and care, and make huge profits while doing so. The current Massachusetts health care reform, and Murray’s proposed legislation to control health care costs, only perpetuate our dysfunctional system because they do not eliminate health insurance companies.

With true health care reform, as in a single-payer health care system, health insurance companies would be eliminated, and either the state or federal government would administer our health care funds. “Single-payer” simply means that one payer would be the administrator, eliminating the hundreds of insurance company payers we now have. Nationally, this would save over $350 billion per year in administrative costs alone, enough money to cover the 47 million uninsured in our country and provide more comprehensive benefits for all of us.

Expanding coverage as we have done in Massachusetts, without controlling administrative costs, is not a sustainable policy. Unfortunately both of the Democratic presidential candidates are proposing a Massachusetts-style health care policy for our country: Neither Clinton nor Obama propose true reform of our health care system.

There are those who say that single-payer health care reform is not politically feasible, and I would guess the presidential candidates believe this. What they are not considering are the polls that show strong majority support for single-payer health care, when people are fully informed about this option.

What do people want in health care reform? They want choice of doctors and hospitals, not of a bewildering array of health care plans. They want to be able to keep their doctors, and to know that the treatment he or she recommends will be paid for, without deductibles and co-payments. They want lower prescription drug costs. They want to know that the quality of their health care is the best. They want their health insurance to remain the same, whether they change jobs, work part-time, retire before being eligible for Medicare, or develop a major disease. And they want affordable health care.

Hard-working middle-income taxpayers are feeling the squeeze. They are not seeing 7 percent increases in their wages, even as their share of the cost of their insurance premiums is rising. Small businesses are floundering as they try to provide insurance for their employees. Towns and cities are crippled by health care costs for their employees and retirees.

The current Massachusetts health care legislation does not address any of these issues. We need to divorce health care insurance from employment and eliminate private for-profit insurance companies. Only a single-payer health care program will provide affordable, comprehensive, portable, and accessible coverage for everyone. The current Massachusetts health care reform is not a viable model for the nation.

Dr. Susanne King is a Lenox-based practitioner.