Like Your Private Health Care? Here's Why You Can Actually Thank the Government for That

[one...two...tree 2,762]

For those who think the government shouldn't be involved in health care, they already are. And you should be grateful.

By Paul Krugman, The New York Times

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to "keep your government hands off my Medicare." The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program -- but the voter, Mr. Inglis said, "wasn't having any of it." It's a funny story -- but it illustrates the extent to which health reform must climb a wall of misinformation. It's not just that many Americans don't understand what President Obama is proposing; many people don't understand the way American health care works right now. They don't understand, in particular, that getting the government involved in health care wouldn't be a radical step: the government is already deeply involved, even in private insurance. And that government involvement is the only reason our system works at all. The key thing you need to know about health care is that it depends crucially on insurance. You don't know when or whether you'll need treatment -- but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor's visits, are where the real money is, so insurance is essential.

Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient's acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.

And in their efforts to avoid "medical losses," the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on "underwriting" -- screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare -- which is, by the way, one of those "single payer" systems conservatives love to demonize -- covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don't buy it directly: they get it through their employers. There's a big tax advantage to doing it that way, since employer contributions to health care aren't considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can't discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it's thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

So here's the bottom line: if you currently have decent health insurance, thank the government. It's true that if you're young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays.

Which brings us to the current debate over reform.

Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don't work for health care -- never have, never will. To the extent we have a working health care system at all right now it's only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That's not radical; it's as American as, well, Medicare.

http://www.alternet.org/healthwellness/141...nment_for_that/

[Kathryn41 3,205]

Thank you. Good article.

[GaryC 7]

And now we will be able to thank them for destroying rather than fixing it.

[one...two...tree 2,762]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

[GaryC 7]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

[one...two...tree 2,762]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

[GaryC 7]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

Well, who passes the regulations? The very people you say we have to thank for private health care. If those regulations or lack of them have screwed up private health care then who is to blame? I am waiting.

[one...two...tree 2,762]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

Well, who passes the regulations? The very people you say we have to thank for private health care. If those regulations or lack of them have screwed up private health care then who is to blame? I am waiting.

Those on the Right will blame it on the pepper...saying that pepper can never be good for steak. As to how much pepper to use, sometimes you got to cook a few steaks before you know just what is the right amount.

Have you looked back 30 years ago as to what changed from then to now with insurance companies in terms of their policies of coverage? There's a paper trail and I'll guarantee you that it has been some form of deregulation or another that has brought us to this point that we are with insurance company policies for coverage.

[dalegg 143]

So part of this new plan is a low cost government ran health insurance plan. Does anyone know if this plan is an option for large employers who already offer health coverage as a benefit to their employees? Are they going to be able to switch?

[GaryC 7]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

Well, who passes the regulations? The very people you say we have to thank for private health care. If those regulations or lack of them have screwed up private health care then who is to blame? I am waiting.

Those on the Right will blame it on the pepper...saying that pepper can never be good for steak. As to how much pepper to use, sometimes you got to cook a few steaks before you know just what is the right amount.

Have you looked back 30 years ago as to what changed from then to now with insurance companies in terms of their policies of coverage? There's a paper trail and I'll guarantee you that it has been some form of deregulation or another that has brought us to this point that we are with insurance company policies for coverage.

Well OK, who did the de-regulation? Unless you are saying it all happened from 1996 until 2004 and before that everything was peachy-keen then you would have to blame a dem congress for the problems. Remember, the president can't change regulations, only congress can do that. So are you saying the very people that gave us private health care are the same ones that screwed it up?

BTW, I would say bad regulation not deregulation screwed it up for everyone. Now we are asking the very people that made the mess in the first place to fix it? I would say they are incapable of it.

[one...two...tree 2,762]

So part of this new plan is a low cost government ran health insurance plan. Does anyone know if this plan is an option for large employers who already offer health coverage as a benefit to their employees? Are they going to be able to switch?

From what I've read, employers who don't provide insurance for their employees would pay a penalty tax.

Edited August 1, 2009 by Col. 'Bat' Guano

[one...two...tree 2,762]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

Well, who passes the regulations? The very people you say we have to thank for private health care. If those regulations or lack of them have screwed up private health care then who is to blame? I am waiting.

Those on the Right will blame it on the pepper...saying that pepper can never be good for steak. As to how much pepper to use, sometimes you got to cook a few steaks before you know just what is the right amount.

Have you looked back 30 years ago as to what changed from then to now with insurance companies in terms of their policies of coverage? There's a paper trail and I'll guarantee you that it has been some form of deregulation or another that has brought us to this point that we are with insurance company policies for coverage.

Well OK, who did the de-regulation? Unless you are saying it all happened from 1996 until 2004 and before that everything was peachy-keen then you would have to blame a dem congress for the problems. Remember, the president can't change regulations, only congress can do that. So are you saying the very people that gave us private health care are the same ones that screwed it up?

BTW, I would say bad regulation not deregulation screwed it up for everyone. Now we are asking the very people that made the mess in the first place to fix it? I would say they are incapable of it.

If you believe the Fed is incapable of effectively regulating the health insurance industry then you are essentially against reform, yes?

[GaryC 7]

So part of this new plan is a low cost government ran health insurance plan. Does anyone know if this plan is an option for large employers who already offer health coverage as a benefit to their employees? Are they going to be able to switch?

From what I've read, employers who don't provide insurance for their employees would pay a penalty tax.

That should help, because of the tax those companies will lay people off and the government will take in less payroll tax. All it would do is increase the burden on those that are working. Nice plan.

[GaryC 7]

And now we will be able to thank them for destroying rather than fixing it.

Yes, because...(wait for it)....government can do nothing right. Ta-da!

Well, if we have them to thank for private health care and it is messed up right now then yes, the government screwed it up yet again. Hey, just going with your premise.

Regulations are like pepper on your steak. You can complain there's not enough pepper or there's too much, but don't blame the pepper itself because you happen to not like the steak.

Well, who passes the regulations? The very people you say we have to thank for private health care. If those regulations or lack of them have screwed up private health care then who is to blame? I am waiting.

Those on the Right will blame it on the pepper...saying that pepper can never be good for steak. As to how much pepper to use, sometimes you got to cook a few steaks before you know just what is the right amount.

Have you looked back 30 years ago as to what changed from then to now with insurance companies in terms of their policies of coverage? There's a paper trail and I'll guarantee you that it has been some form of deregulation or another that has brought us to this point that we are with insurance company policies for coverage.

Well OK, who did the de-regulation? Unless you are saying it all happened from 1996 until 2004 and before that everything was peachy-keen then you would have to blame a dem congress for the problems. Remember, the president can't change regulations, only congress can do that. So are you saying the very people that gave us private health care are the same ones that screwed it up?

BTW, I would say bad regulation not deregulation screwed it up for everyone. Now we are asking the very people that made the mess in the first place to fix it? I would say they are incapable of it.

If you believe the Fed is incapable of effectively regulating the health insurance industry then you are essentially against reform, yes?

I am against most if not all federal regulations and mandates. Let the free market work without restrictions. The insurance companies that screw their customers will see those customers go to companies that don't. The bad ones will fall by the wayside. The American health industry is the most regulated business on the planet. It hasn't seemed to have help but in reality it has caused the problems we now see.

Edited August 1, 2009 by GaryC

[dalegg 143]

So part of this new plan is a low cost government ran health insurance plan. Does anyone know if this plan is an option for large employers who already offer health coverage as a benefit to their employees? Are they going to be able to switch?

From what I've read, employers who don't provide insurance for their employees would pay a penalty tax.

No, that's not what I'm asking. My company now has several options. Are they going to be able to add Obamacare to their list of choices or, if it is financially beneficial will they be able to cut out the other options entirely and force all of us to choose Obamacare?