Health Care: Let's Liberate the Masses

I work for the General Electric Company. It is, at least at NBC Universal, a very nice place to work and I am very lucky to work there.

You meet lots of interesting and accomplished people, there are lights and cameras and action.

And GE is a good company, with well-established systems to hire, transfer, promote and sometimes fire the hundreds of thousands of people that make up the business.

One perk of being a GE employee is that you get special access to a GE product store where you can buy things like stoves and other GE Appliances at discounted employee rates. A nice perk, especially if you need a well-crafted stove.

But if you decide you want to buy your appliance someplace else, no problem, the GE Appliance Store is there if you want it at any time, but there is certainly no obligation to buy there. And they certainly don't pay me in expensive GE stoves, because I would much rather have actual money that I could then go and use it to buy any stove I want, maybe even a smaller, cheaper one since I live in New York City. Or if I didn't need a new stove, I could just use the money for something I did need.

The same is true for all of the non-health insurance I have. They have nothing to do with where I work, so I can change my homeowners insurance and car insurance at any time, and the insurers are forced to compete based on my preferences.

And yet that is exactly the opposite of how the Employer-based Health Care model works: they decide your choices, and if you don't like their limited selection, you end up having to forgo their entire subsidy and pay for the plan you want completely out of pocket. It would be like getting partially paid in stoves that you don't need and can't sell.

However, when you compare my predicament to the 47 million people without health insurance, I couldn't seem more whiny. The fact is that GE does provide me with excellent health insurance, so this really has nothing to do with benefiting me personally. But the cost of health insurance in this country is out of control, and it is not only keeping millions from accessing proper medical care, but it is also hobbling our large companies in the global marketplace and strangling at birth many of the small businesses we need so desperately to get job growth going.

Meanwhile, innovative health care programs like the Mayo Clinic are out of reach of most of the 174 million Americans currently on Employer-based health care, protecting the majority of insurers from competing against the Mayo Clinic's amazing advances. This in turn prevents the smarter, less-expensive large scale health care companies from growing large enough to cover the currently uninsured.

As it stands now, being forced into an Employer-based health care system encourages the exorbitant spending that is bankrupting our country.

Imagine, if you will, that you are going out to nice steakhouse tonight with every person that you work with. Now imagine that everyone in advance knows the total bill will just be split up equally at the end, no matter how much each of you orders. How many people do you think will order just a salad when they know that they will be paying for part of your double filet? Now imagine that half the bill will be paid by your company, except with the caveat that they get to pick the restaurant. Would this system ever work for a group lunch at your company? So why would we use it for something as important as health care?

So as we all watch this bill make its way with 564 Proposed Amendments on its first day, pay close attention to the employer voucher option being offered by Ron Wyden, which seeks to directly address this massive flaw. And once again, we must ask if our government really does work for the taxpayers and the well-intentioned doctors and hospitals who care for them? Or do they work for the entrenched insurers, employers that wish to stifle employee competition, employee benefit Management companies and unions that make billions or wield their power based on the current broken system and are lobbying hard to keep it that way? This will be yet another litmus test.

Follow Dylan Ratigan on Twitter: www.twitter.com/DylanMSNBC

Comments

[CalousteGulbenkian]

Dylan you know an insurance quote is not like a stove. If you choose to not buy a stove, the price of the stove does not change for other GE employees.

Insurance prices are based on the size of the pool of risk being negotiated. To maintain the prices of the insurance it negotiates for its employees, firms need enough people signing for those selected options.

This is the thinking behind the single payer (or even public option). That by pooling everyone together, the government creates a huge pool.

And this also points to a hole in your favorite suggestion that we allow more competition in insurance. Atomized insurance companies will have too little a pool to diversify away into.

In insurance, its all about size.

[Dale Larson]

"In insurance, its all about size."

You bet it is!...

It's time to end our "risky experiment" of "For-profit health insurance". It's a proven failure.

HR676 (http://hr676.org) Single Payer system that is proven, pro-business and pro-people:

* Slashes at least 30% of costs off the top by removing private insurance overhead.
* Companies take health care expenses off their books. Stock value increases. Better able to compete internationally.
* Small companies could have access to higher skilled workers because previously they couldn't compete in the labor market by offering similar benefits.
* More entrepreneurial ventures will launch since they have more money and less unrelated risk.
* Dramatic drop in bankruptcies.
* Dramatic drop in lawsuits. Most of these lawsuits are simply to obtain money to cover health care if something interrupts their coverage.
* Reduced system complexity. Greater efficiency due to fewer regulations.
* Savings from employees not having to fight with their insurers during work hours.
* HSA and MSA dollars redirected back into the economy for goods and services.
* Additional money to spend from not having to carry "uninsured motorist coverage" on your auto policy.
* Contract employment is more viable for workers since they are guaranteed access to health care.
* People are covered when unemployed. No chance of being wiped out financially if you lose your job.
* Health care providers (doctors, hospitals, therapists...) see increase in business with much less administrative expense.

[gvnn688]

Dylan fails to state the heated debate began when Americans were told their health coverage on their jobs would change. According to what was reported; Americans did not want the choice the President was offering. The media reported Americans liked and wanted to keep their insurance. So the President went around the country saying; "if you like your coverage, you can keep your coverage." Remember, the President always spoke about competition and making health care affordable for those without insurance. The competiton was mainly directed at those with insurance; where were Dylan then?

The Media have the habit of trying to think for us. The media should only report and let the public decide. Instead what we receive their opinions of the facts. Do any of you find it strange that no-one in the media talk to the uninsured or unemployed? Or how about those whose houses were saved by the Stimulus or the workers at GM, AIG, or Wall Street, etc.? Remember, these companies also had average hard working lower and middle class Americans who would have also been unemployed had it not been for the bail outs. Lastly, the media talk about the jobless numbers as if it is the President's fault, they are not, but he has helped Americans with the Stimulus. The latest Pew Poll polled the media at or around 27%, how ironic, the media talks about everyone poll numbers but not their own.

[lester22]

Please folks...get your health insurance horror stories out there. Together we can make a difference. There is a non-profit site called Health Insurance H e l l that is aiming to get as many of these stories together in one place. The more stories, the stronger the message.

http://www.healthinsurancehell.com

[TheOnlooker]

I think we should have more of such articles where things are broken down to explain as well as frame it in such a way that the unfairness of the current system becomes more obvious.

[northstar11]

"""""But the cost of health insurance in this country is out of control, and it is not only keeping millions from accessing proper medical care, but it is also hobbling our large companies in the global marketplace and strangling at birth many of the small businesses we need so desperately to get job growth going."""""

if health care cost are hobbling our large companies----why arent they four square againt the insurance lobby that wants to perpetuate the insane status quo.

i have not heard even one CEO --of a hobbled company----stand up in favor of cost controls and reform of the flawed system.

too partisan to participate???

[JShep]

Remember, it was our government that helped create the employer based health insurance system that plagues us today. When the govt. put a freeze on wages, the only way companies could reward their employees was with increased benefits, hence the creation of employer based insurance. And now, we expect our government to fix the mess they created?? Good luck!

[Gnrshrtd]

Stop the silly revisionist history lesson:

The employer based health insurance concept in the US was an innovation of the uber-capitalist Henry Kaiser for his employees at his steel mills in the 1930's, and then in his shipyards during WWII, and continuing after the war to attract and retain qualified employees.

When other private employers realized why they were unable to compete for qualified workers, they too started to offer employer based health plans. Eventually public/government employers had to start offering this incentive to attract and retain employees.

Times change; the world changes; and the economy changes. We have to adapt.

[Workingclassblues]

I see a forest. It is 300x600 miles in dimention. It is huge. Millions of trees. Tens of thousands of different types and sizes. This is the current state of the healthcare debate. Thousands of people focusing on one type of tree without seeing the forest. The forest has fur, oak, maple, ash, alder, basswood, etc. to equal cost, containment, quality, portability, competitiveness, choice, etc. But in order for any of this to be relevant, you must have a bill that has American's needs in mind. You don't have to see every tree to know that this is a forest.

If congress is bought and paid for by big insurance lobbies, then only big insurance will benefit. Only one tree is going to get any attention. While you folks squabble over each tree, congress is giving the forest to the insurance corporations(for a fee, of course). The insurance companies make a killing off of you again, congress makes a killing off of you again, and you are left with a tree to beat your neighbor over the head with. This is American politics at it's worst. Where is the press? Where is the truth in all this? Insurance pays congress for access, congress pays them back by letting them write their oun ticket(which no one reads), and then congress gets a gratuity in the form of campaign contributions on the legal side, and cash payments and a world of monitary graft on the illegal side(the 'family values' side).

[Chernynkaya]

I'm happy to be your first fan.

[Aikaterina]

American businesses spend nearly 3 times what foreign competitors do for employee benefits. This puts them at a competitive disadvantage. To maintain profits, businesses outsource jobs, lay-off or freeze hiring, or simply move production facilities off-shore.
As jobs and businesses leave, tax revenues decrease while demands for public services soar, further straining federal, state and municipal budgets, increasing deficits, debt, and mandating further cuts in other government services: public schools, road maintenance, etc.
Health care costs have soared 138% over the past decades, while profits have soared for the health care providers and insurers. Health insurance used to pay 95% of revenues in claims, but now pays less than 78%, which increases their profits, but limits accessibility to medical treatment for those WITH insurance (denial of claims, increased co-pays, deductibles, and premiums), while denying accessibility to those without coverage (denial of coverage or job losses).
Medical catastrophes are the leading cause of personal bankruptcies, seconded by the predatory sub-prime home loans. This destroys people's lives, eradicates life-savings, and pushes more people into Medicare and Medicaid programs when they can't afford treatment or premiums (if they could get coverage at any cost).
Big pharma sells drugs in the US at over 200% of what they charge for the same products in other countries.
This insanity must stop, but our lawmakers are too intent on preserving the profits of their patrons, from whom they take $millions, while enjoying the government-run, taxpayer-subsidized health care they vilify.

[Chernynkaya]

Great post. And while all that you mention has happened, during the same period wages have stagnated- in great part due to the costs of employer-based insurance. The middle class shrinks more each year. So why are so may people content with the situation? Can the public ( even if only maybe 35%) really be this ignorant? It appears so.

[Firbolg]

Most foreign competitors don’t pay anything for employee health benefits, except for operations that may be located in the US.
In other industrialized countries public single-payer (and often single-provider) systems are funded from general taxation and not even linked to employment.
Most also allow private sickness insurance as an option. Often these are group plans for say all members of a professional body (like Accountants) or employees of a company. The professional body or employer helps by collecting and remitting premiums, thus securing discounts, but the policies belong to the individuals.

[Capibara]

I never understood why health insurance became so inextricably linked to ones employer. Imagine if we had a free market for health care. You go to the doctor you want, they give you a price list, you decide what treatment you really need. I think people would be outraged by what doctors charge, perhaps even realize how unnecessary some "medicine" is.

[nellyb stl]

Same with drugs; same with dentists, etc. Let's have 'free market' health care.
WHAT IS THAT !! ??

[nellyb stl]

"Free Market" health care. [What is that?] Public Option?; Co-ops;? Where can I go to buy this FREE MARKET health care ???

[MattoutinAZ]

Ask the government. They say us peons are not smart enough to have so many complicated choices.

[anyman]

i heard on npr this morning that 14 billion has been spent by the insurance lobby so far . where the heck could that much money go ? and why should it be able to turn the argument into a choice between no public option and a public option that makes the government the collection agent for the private companies? as long as your doctor has the opportunity to send a bill to "them with the deep pockets" and "them " have the opportunity to turn around and raise your rates to pay and make money at the game there is no one to put the brake on the "spiraling medical costs" last time i looked an aspirin was about a penny if a doctor hands you one its 100 dollars . expanding medicare and setting a fee schedule "take it or leave it" is the only way to reign in these monkeys

[Chernynkaya]

I sure can't account for all of the $14 Billion, but lots goes to Congress (who should be convicted of taking bribes). And sorry to say, lots of that money goes into false ads and mailers and fliers all targeting Republicans and Independents and gets them to show up for Tea Bag rallies and Town Halls. Someone has to write out the false talking points, design the mailer or ad, and publish or print them-- all that costs bucks.

[PhilipTaylor]

WYDEN-BENNETT = WHAT ALL AMERICANS NEED:

Internet Health Coverage Exchange so 100% of Americans (including 180 Million with Employer Coverage) can simply Compare&Rank 1,300 Insurers+Medicare Public Option on Total Annual Cost, coverage, deductibles, co-pays, etc. Then make a choice! STRONGEST Medicare Public Option is HR 676 Medicare Choice OPTION!

If Medicare Public Option is ranked for 1,300 Insurers by ANNUAL COST then Medicare will frequently be the Best Plan (Near Top in the Sorted List) so competition will be the key to having market competition!

[Thanks&Congrats to Ed&Dy1an Ratt!gan for Strong Support of Excellent Solutions!]

[PhilipTaylor]

0BAMA="Cho­ice+Compet­ition+Port­ability" =Quality+A­ffordableC­overage+Ac­countabili­ty

Current 5 Bills now = Over 85% are legally prohibited from choosing any options?

Wyden = “Free Choice Proposal” = Empower Consumers to make GOOD CHOICES

0BAMA often said = "You should get the same deal that members of Congress get"

Wyden = Universal coverage model like members of Congress+Fed employees

Private&Public Choices=Co­mpetition= Lower Cost+Negotiate Fair Provider Pricing

Put Consumer in driver seat = Turn Tables on Insurers

Wyden+Bennett of Utah, Republican co-sponsor is NOT backing off from his support

Senator Bennett = Says we need choices and competition for private sector

Wyden-Bennett Bill = Stabanow + Cantwell + Merkley on board

Insures lower prices+increase coverage to compete =Best way to increase Innovation

Accountability= If insurer rips you off in Sept 2009 then Jan 2010, you CHANGE

INTERNET EXCHANGE =1,300 Insurers (ZIP state allowed)+Strongest Public Option

[NickConrad]

This is a really good article, and my views of Mr. Ratigan are slowly moving into a pretty darn favorable range (although Wyden's voucher program is ridiculous in my opinion comparatively to the exchange); however, I am going to need a lot more after telling Ed Schultz to his face that we shouldn't have a public option because it will cost too much.

[Chernynkaya]

Did Ratigan or Wyden tell Ed that?

[ederlore]

If you want to get an eye-opening view regarding the for-profit insurance corporations take a look at the House Oversight Committee on Health care chaired by Dennis Kucinich. Especially Wendell Potter's testimony regarding the insurance lobby and how they work to kill reform.

http://www.c-span.org/Watch/Media/2009/09/16/HP/A/23251/House+Oversight+Cmte+Hearing+on+Private+Health+Insurance.aspx

http://www.c-span.org/Watch/Media/2009/09/17/HP/A/23315/House+Oversight+Hearing+on+Private+Health+Insurance+Companies.aspx

[ijgibson]

One of the things I find most entertaining in all these comments is that in a so called 'classless society' (Americans usually consider the UK to be class ridden) so many of your correspondents refer to the middle class ( or more accurately refer to themselves as a deprived and attacked middle class !) It never ceases to amaze me that in both the UK and the USA so many people consider themselves, or aspire to be 'middle class'.
How many of these so called middle class can get by without working for a living ? My guess is very few. So in reality there are only 2 classes - those who can survive without working for their living ie the 'capitalist class' and those who have no alternative to working for their living ie the 'working class'. I'd love to understand why so many of those who work hard for their livelihood feel ashamed to be working class. I retired as a Senior Lecturer in a Polytechnic that had just become a new University. I had to work for my living and am quite happy to be 'working class'.

[oldpol2]

The term middle class is usually refering to someone who is not part of the working poor.While most people are working, some work for so little compensation that two similar jobs would not provide enough to support themselves or a family.Hence "the working poor". The other workers are the working non poor. They work and are compensated enough to support themselves and their family. The term middle class rolls off the tongue much easier than the working non poor.

Since the working poor have no money to pay taxes and the wealthy have loopholes you can drive a truck through that leaves the "working non poor" holding the tax bag. AND you are correct we do consider ourselves deprived and attacked by the tax man and now you.

[ijgibson]

Have never seen the term 'working non poor' before. The people I referred to NEVER write about themselves as anything other than the 'middle class'.
The seriously poor are poor - working or not. All who work for a living - and can't survive without work are - in my view 'working class' and should be proud of it !!
Since the working class ( or working non poor) are by far the most numerous in any country - why don't we insist that our governments (NB OUR) close the ridiculous loopholes that allow the wealthy to 'get away with it'. As I've said many times - all but the very poorest should - in my view - pay the same PROPORTION of their total income in tax. That would lower the burden on you and the other 'working non poor' and make for a much fairer society. (In reality I believe that the seriously wealthy should pay a bit more than the proportion the majority pay - they can afford to without it altering their lifestyle !!!)

[joebaggadonuts]

Another great article, Dylan. Please keep it up.