A retiree's case for change
My wife and I are well past 75 years of age, but we've been blessed with excellent health care coverage through a combination of retiree health insurance and Medicare. We have assigned both of those "payer sources" to Kaiser Permanente as our principal health care provider. I know that the annual premiums we pay to Boeing, my former employer, and to Medicare fund only fractions of the real costs of those programs, but I don't know the precise percentages.
At present, we are well satisfied with the health care coverage we have. Ultimately, however, it is probably unsustainable. For one thing, the Medicare trust fund is projected to be depleted in about eight years. It has long been known that Medicare and Medicaid are not properly funded. In my view, that doesn't reflect a problem with those programs, per se, but with the unwillingness of successive presidential administrations, and Congress, to tackle the hard work of actually providing them with adequate long-term funding. Then, on the other side of the coin, how long can Boeing accept continually rising insurance premiums without either drastically curtailing retirees' coverage or canceling it altogether?
With Congressman Kevin McCarthy, R-Bakersfield, scheduled to host a town hall meeting on health care insurance reform this Wednesday at Cal State Bakersfield, I thought it worthwhile to lay out a couple of personal reasons that I believe change is needed desperately, and soon.
But there are plenty of not-so-personal reasons, too. About a sixth of our populace is completely without health care insurance, while another sixth or more is under-insured because the premiums are too costly. The uninsured category is expanding daily due to fallout from the country's economic crisis: the lack of health care benefit portability when workers lose their jobs and simultaneously lose health care coverage for their families.
Nationwide, approximately half of the funding of health care benefits is via health care insurance provided by private companies such as Aetna, Cigna, Blue Cross & Blue Shield, etc. Fundamentally, those private corporations exist to generate profits for their owners, i.e., their stockholders. They are in the health care business, but making certain that their policyholders receive timely and excellent health care certainly is not their primary concern. Rather, their focus is mainly on paying adequate dividends and increasing market value of their stocks on Wall Street.
There may be nothing inherently wrong with that as a business model. However, too often its pursuit leads to predatory practices harmful to policyholders: cherry-picking clients, insuring only the youngest and healthiest; denying coverage because of pre-existing conditions; canceling policies for made-up reasons when clients contract catastrophic conditions, such as cancer; refusing to allow continued hospital stays for patients who "don't recover fast enough", etc. But, hey, that's the free market at work, right?
The fact is, with private health care insurance, policyholders already "have insurance-company bureaucrats standing between them and their doctors," the very condition with which you try to frighten us into eschewing a strong public option.
Incidentally, have you noticed that with Medicare, Medicaid and VA medical services (whereby governments provide the other half of funding), the U.S. already has three functioning examples of the "socialized medicine" that your cohorts on the right try to frighten us from allowing to happen?
Then there are the excessive costs to consider. Medicare has a track record of operating with overhead expenses of about 3 percent. Private health care insurers are known to have overheads approaching 20 percent -- plus company dividends and marketing expenses totaling up to an additional 20 percent. How In the world could a strong public option not save money?
Now, with that as background, here are the principles that I believe should be applied:
* Health care reform without a strong public option is no reform at all, it is just tinkering.
* No U.S. citizen should be left out: everyone should have excellent health care coverage.
* Medical bankruptcies should be entirely eliminated, becoming a thing of the past.
* There must be regulation of the private health care insurance industry to eliminate predatory practices and to prohibit their treating the public option as a dumping ground for "the uninsurables."
(Perhaps this could be achieved by adapting the structure of the Federal Employees Health Benefits Program to the entire nation. You have great options; why don't we all?)
* Actual health care services must continue to be provided by private doctors, clinics, hospitals, etc.
* Health care benefits provided by employers should cease to exist. The funds thus saved by employers should be retained by them to strengthen their competitiveness.
* Reform legislation must ensure that fiscally responsible-long-term funding is in place. This is undoubtedly the hardest -- but also the most essential -- part. Innovative options should be given serious consideration. (For example, Howard Dean's proposal to pay for health care subsidies via a combination of a carbon tax and a modest gasoline tax.) As a member of the minority party, McCarthy can't expect to get everything his way. But I see no reason that he can't work with the majority party to ensure that what is legislated is good for individual citizens, the people of Kern County. For once, why not strive for non-partisan legislation? Simply working to maintain the status quo, to preserve big insurance companies' profitability, will neither be constructive nor acceptable.
Paul Combs of Tehachapi is a retired Rockwell International employee but, by virtue of inter-corporate machinations, is officially a Boeing retiree.
