Zeev's Turnips Talk Politics (ZTTP)

[Ace Hanlon]

ROMNEY HEALTHCARE PLAN IS A CON

STEFFIE WOOLHANDLER AND DAVID HIMMELSTEIN, PHYSICIANS FOR A NATIONAL
HEALTH PROGRAM - The politicians assumed that only about 500,000 people
in Massachusetts are uninsured. The Census Bureau says that 748,000 are
uninsured. Why the difference? The 500,000 figure comes from a phone
survey conducted in English and Spanish. Anyone without a phone or who
speaks another language is counted as insured. The 748,000 figure comes
from a door-to-door survey carried out in many languages (including
Portuguese and Haitian Creole, common languages in Massachusetts). In
sum, the reform plan wishes away 248,000 uninsured people who don't have
phones or don't speak English or Spanish. It provides no funding or
means to get them coverage.

Second, the linchpin of the plan is the false assumption that uninsured
people will be able to find affordable health plans. A typical group
policy in Massachusetts costs about $4500 annually for an individual and
more than $11,000 for family coverage. A wealthy uninsured person could
afford that ? but few of the uninsured are wealthy. A 25 year old
fitness instructor can find a cheaper plan. But few of the uninsured are
young and healthy. According to Census Bureau figures, only 12.4% of the
748,000 uninsured in Massachusetts are both young enough to qualify for
low-premium plans (under age 35) and affluent enough (incomes greater
than 499% of poverty) to readily afford them. Yet even this 12.4% figure
may be too high if insurers are allowed to charge higher premiums for
persons with health problems; only half of uninsured persons in those
age and income categories report that they are in "excellent health".

The legislation promises that the uninsured will be offered
comprehensive, affordable private health plans. But that's like
promising chocolate chip cookies with no fat, sugar or calories. The
only way to get cheaper plans is to strip down the coverage ? boost
co-payments, deductibles, uncovered services etc.

Hence, the requirement that most of the uninsured purchase coverage will
either require them to pay money they don't have, or buy nearly
worthless stripped down policies that represent coverage in name only.


Third, the legislation will do nothing to contain the skyrocketing costs
of care in Massachusetts ? already the highest in the world. Indeed, it
gives new infusions of cash to hospitals and private insurers.
Predictably, rising costs will force more and more employers to drop
coverage, while state coffers will be drained by the continuing cost
increases in Medicaid. Moreover, when the next recession hits, tax
revenues will fall just as a flood of newly unemployed people join the
Medicaid program or apply for the insurance subsidies promised in the
reform legislation. The program is simply not sustainable over the long
? or even medium ? term.

What Are the Alternatives?

A single payer universal coverage plan could cut costs by streamlining
health care paperwork, making health care affordable. Massachusetts Blue
Cross spends only 86% of premiums paying for care. It spends the rest -
more than $700 million last year - on billing, marketing and other
administrative costs. Harvard Pilgrim and Tufts Health Plan ? our other
big insurers - are little better; each took in about $300 million more
than it paid out. That's ten times as much overhead per enrollee as
Canada's national health insurance program. And our hospitals and
doctors spent billions more fighting with insurers over payments.

Overall, Massachusetts residents will spend $13.3 billion on health care
bureaucracy this year ? nearly one third of our total health bill. If we
cut bureaucracy to Canada's levels we could save $9.4 billion annually,
enough to cover all of the 748,000 uninsured in Massachusetts and to
improve coverage for the rest of us.

Study after study ? by the Congressional Budget Office, the General
Accounting Office and even the Massachusetts Medical Society - have
confirmed that single payer is the only route to affordable universal
coverage.

And single payer is popular. The Massachusetts Nurses Association
supports it along with dozens of other labor, seniors and consumer
groups; so do 62% of Massachusetts physicians according to a recent
survey. National polls find that almost two-thirds of Americans favor a
tax-funded plan like Medicare that would cover all Americans.

But single payer national health insurance threatens the multi-million
dollar paychecks of insurance executives, and the outrageous profits of
drug companies and medical entrepreneurs.

http://www.pnhp.org