[an error occurred while processing this directive]

LATEST SUBMISSIONS

Why Private Insurers Fear Single-Payer Health Care

Saturday, May 12 at 12:01 AM

This Speakout has not been edited

By Michele Swenson, Health Care for All Colorado

A Colorado insurance broker’s recent newsletter warns against “government healthcare” like “the failed systems of Canada and Europe, where quantity and quality of healthcare is declining rapidly.”

Odd assertions, considering every other industrialized nation has better health outcomes while averaging half the health costs per capita as the U.S. Such fear-baiting by the private insurance industry can be understood in light of the broker’s subsequent statement, accusing single-payer advocates of coveting the “one-seventh of the U.S. economy that is healthcare.”

The fact is, over 30% of health care dollars don’t go to health care, but rather to wasteful administrative costs of providers, hospitals and multiple private insurances; as well as to marketing, lobbying, profits, and unseemly CEO salaries. Accusations of government bureaucratic waste don’t hold a candle to the failed, wasteful corporate health care bureaucracy.

Truthfully, government Medicare (before the Medicare Part D prescription drug reform was written to assure billions of dollars of taxpayer-subsidized profits to the insurance and pharmaceutical industries) has run 3% overhead costs, contrasted with average 15-20% overhead costs of private insurances. Private insurers frankly fear losing the profit-centered health insurance model of escalating premium dollars in return for less coverage, whereby profits are guaranteed by insuring the healthy and wealthy and eliminating everyone else.

Big-money insurance and pharmaceutical lobbies have a stranglehold on the legislative process, writing health policy to insure their bottom lines, while spending big bucks on media to scare people with misinformation ( recall “Harry & Louise” ads). In the current environment, meaningful health reform desired by the majority becomes an uphill battle. Even the term “politically feasible health reform” implies acquiescence to the inordinate political power wielded by the big lobbies whose policies create inflationary health costs and reduced access.

Better to ask, how can we develop the political will to achieve meaningful reform? Health Care for All Colorado drafted one of 19 comprehensive reform proposals submitted to the 208 Commission for Health Care Reform. Because we don’t have the funding enjoyed by those profiting from the current system, our efforts have to be grassroots – people around the state rising up to lead the leaders and counteract powerful lobbies. Following is a brief overview of the HCAC proposal. Read it and judge for yourself; then talk to your legislators.

The Colorado Health Services program represents systemic health care reform designed to ensure integration of financing, delivery and administration in order to provide quality health coverage for all in place of our current fragmented, chaotic, profit-centered multiple-insurance model. CHS is a comprehensive, public-payer (insurance), private provider (health facilities, providers) system that permits free choice of providers and hospitals. By eliminating wasteful administrative spending, the program is designed to provide quality, equitable health care access at greatly reduced cost by creating a single, statewide risk pool for all residents.

Comprehensive benefits encompass a broader range of coverage than currently available through any single private insurance plan.

CHS administrative savings alone are projected at 15-20 percent of health spending. Additional savings result from elimination of insurance profit-taking, and negotiation of costs for pharmaceutical and durable medical goods. Providing universal access to primary, preventive care avoids resort to higher-cost delayed, crisis emergency room care. The elimination of multiple duplicative insurance paperwork reduces hospital and providers’ costs. Treatment instead of imprisonment of many suffering substance abuse or mental illness would significantly reduce prison/jail expenditures. Universal access to continuous health care greatly reduces costs of malpractice premiums and awards.

Key to any successful systemic health care reform is a statewide fully integrated Information Technology network, permitting simultaneous tracking of expenditures, utilization and outcomes, with assessment of best practices and resource utilization to improve quality of care and expedite chronic disease management; and to reward hospitals and providers for excellence. Statewide coordination of public health and infrastructure prevents duplication of services and administrative waste. Accountability and transparency of data facilitates informed health care decisions by all.

Federal, state and local monies now earmarked for health care would be transferred to the CHS Trust, insulated from the general state budget. Waivers would be sought for federal programs (e.g., Medicaid and Medicare). The medical expense portion of liability, Workers’ Compensation and automobile insurance would be folded into the program, eliminating administrative and adjudication costs for auto and job-related injuries. Exercising administrative oversight, a governing board representing five state regions would remain accountable to the people. CHS would be operated as a publicly-owned not-for-profit insurance company. Employers and employees would contribute through payroll deduction or a progressive tax.

Health costs for the vast majority will be substantially reduced below current premium and out-of-pocket health expenditures (currently averaging $11,000 per family annually).

Divorcing health coverage from employment also frees businesses to better compete in the global marketplace. All institutions, including public education and the state, would realize savings when relieved of responsibility for inflationary health coverage costs. Coloradans will no longer experience threat of bankruptcy due to high medical bills (the cause of an estimated 50 percent of U.S. personal bankruptcies), or denial of coverage due to ‘pre-existing’ health conditions.

Equal access to health care across the state would be facilitated, as providers and hospitals receive the same reimbursement for the same level of care, negotiated annually. Education funding for health care providers and incentives for service in high-needs areas are key features, as is wellness education for the populace and job-retraining for displaced workers.

Read the full Health Care for All Colorado proposal and background information at www.healthcareforallcolorado.org .

READER COMMENTS