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Deborah Burger

Deborah Burger

Posted: February 4, 2008 09:19 PM

A Message to Sen. Clinton -- Forcing People to Buy Insurance is Not Universal Healthcare


Someone needs to tell Senator Hillary Clinton and her minions to stop practicing consumer fraud on healthcare. Forcing people to buy insurance is not "universal healthcare."

Especially when you let insurers continue to charge as much as they want, and do nothing to stop their callous, all too routine practice of denying medical treatment or blocking access to specialists or diagnostic tests because they don't want to spend the money.

Sen. Barack Obama is right on this point. And his mailer, which the Clinton camp has denounced, is right when it opposes "forcing everyone to buy insurance even if they can't afford it. Is that the best we can do for families struggling with healthcare costs?"

In analyzing what is wrong with an individual mandate, start with its flawed premise that treats health as a commodity which must be purchased.

"Having" insurance is not the same as being able to use it. You're only being mandated to purchase the premiums; they're not mandating the insurance companies to make sure you get the care you need.

Nor does "having" insurance protect you from financial ruin. Consumer Reports, for example, last year identified four in 10 Americans as "underinsured." Among those, more than half postponed needed medical care due to cost and a third had to dig deep into their savings to pay for medical expenses. Additionally, over a third postponed home or car maintenance repairs due to medical bills.

Add to those numbers the onset of a recession and it's not hard to imagine an individual mandate exacerbating financial insecurity and encouraging many families to self ration care because they can't afford the rising co-pays and deductibles while still having to pay the premiums. And threatening to garnish your wages or put a lien on your home if you don't go along.

The individual mandate cheerleaders claim that if you don't put everyone in the insurance pool, only the sick will buy healthcare and insurance companies will raise costs. Have any of them noticed that insurance premiums have gone up 87 percent nationally the past decade without a national individual mandate? Expecting the insurance industry to practice price restraint after marching 47 million more customers into their offices is like handing a lion more steak and expecting it to become a vegan.

That is part of why individual mandates are so popular with the insurance industry and those close to it. Insurers reap millions of new customers with minimal requirement to change their behavior. It further entrenches a dysfunctional system, expanding the reach of an industry that treats every dollar spent on care as a "medical loss ratio."

It distorts the role of government, which should be to protect people, not act as an insurance agent.

It transfers the health risk and financial burden from the healthcare industry to individuals and families; just a crushing burden on individuals to make it on their own.

Just ask Gina Dooley of Albuquerque, one of hundreds who responded to a California Nurses Association/National Nurses Organizing Committee ad describing the disparity of care available to Vice President Cheney and members of Congress and the rest of us (www.cheneycare.org).

"I found out when I was 36 weeks pregnant that my unborn daughter had a lung tumor. With this advance knowledge of the care and attention we would need, we did a lot of research and had a lot of contact with our insurance company. I was working for a pharmaceutical company and had the best medical coverage available.

"After several second opinions we were told by our insurance company that only one hospital in town would be covered. We went to that hospital and had a month of treatment, surgery and bills. Months later we learned that the NICU (neo-natal intensive care unit) team was not part of our insurance network although they were the only doctors available in the hospital we had no choice but to go to.

"Because the doctors were out of network we paid 90 percent of all our bills after meeting our $1,200 hospital deductable. Five days after my daughter was born she had major surgery resulting in a $100,000 bill. We paid $90,000 of that despite paying $1,200 a month for insurance to cover everything."

There's only one way to achieve genuine universal healthcare, the approach taken by every other industrialized country with a national healthcare or single payer system. In the U.S. we have that opportunity with HR 676, a single-payer reform that would establish an expanded and improved form of Medicare for all.

Surely, Americans deserve better guaranteed healthcare, not just more insurance.

Follow Deborah Burger on Twitter: www.twitter.com/NationalNurses

 
 
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03:47 PM on 02/07/2008
The government money is the money of all of us (the taxes who we paid). We must to pay the medical care bills of all government?
01:09 PM on 02/05/2008
Hillary is putting money in the pockets of health insurance company. She tried 4 times to pass her health care bill and each time senate denied it! We need to pass a healthcare bill that will be excepted by the senate.Obama has that plan!!!
09:28 AM on 02/05/2008
This is an odd column. It criticizes one aspect of Clinton's health insurance policy as if it was the whole policy. That would not be so bad except that a central part of the criticism is that the one aspect of her health insurance policy does not work as a whole policy.

And while a single payer might be the best system to switch to, Obama's proposal is not a single payer system either, so that is hardly the relevant contrast in this context. The argument seems to be that Obama's proposal is better than Clinton's because a proposal that Obama is not actually making would be better than one part of Clinton's proposal taken in isolation.

Balanced analyses of the two proposals are very useful. And an arguement that neither is right but a third should be advocated is reasonable (although not directly relevant to today's primary). But this post is an odd mish-mosh.
05:35 AM on 02/05/2008
'Single payer' is not for US. SP is Socialized

Medicine. Socialism is bad. Ipso facto & stuff.

How many times do they have to tell you that?

(Said in jest, of course. Not ALL 'Socialist' ideas are bad, certainly. But *probably* we are not ready for SP yet, unfortunately. Let's inch toward it instead.)

Here's what to do for now: In place of a 'mandate' (which so far involves an unspecified penalty for not obtaining insurance), create an INCENTIVE for getting insured. A tax credit, or a deduction (even for those who don't itemize), or whatever.

Find a way to get healthy people to join the plan, without resorting to punishment. That is essential, and sufficient.
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Roshi98
Honey badger don't care!
11:57 PM on 02/04/2008
Ms. Burger would do well to look at the actual details of Senator Clinton's health plan rather than blindly advocate for Barack Obama on the basis of, well, I'm not sure. Concerning the "Harry and Louise, redux" ad recently put out by the Obama camp, I would suggest all who are interested in facts rather than hyperbole look at FactCheck.org's piece on the matter:

http://www.factcheck.org/elections-2008/harry_louise_again.html
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10:41 PM on 02/04/2008
i agree with your support of a single payer system such as is offered in the house of representatives every year. i do disagree with your implied attack upon clinton but not obama, though. apparently practices such as ruling a provider as not in the scope of coverage would be eliminated by law in either clinton's or obama's plans. both would eliminate the notion of preexisting condition in the purchasing of health insurance. both would require all insurers to insure anyone who requested it (and presumably paid the bills). but clinton would assist people too poor to pay premiums. i'm surprised you did not mention that.
10:21 PM on 02/04/2008
So simple, thanks for pointing out the obvious. It seems like most of us have failed to grasp it.
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LeeScho
poised on a longing
09:57 PM on 02/04/2008
Okay. Are you as right about nearly everything else as you are about this? Yes? Can you get on the presidential ballot in November? You have my vote. No? Okay. I'll vote for Obama as your surrogate.