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Paying for others’ health care

Sunday, October 21 at 12:00 AM

This Speakout has not been edited.

By Francis M. Miller

You wake up in the morning, sleep-deprived with low energy levels. A cup of coffee, the morning commute and a donut and you’re now returning text messages. Mid-morning you take a break and decide to work on your personal finances. As you are looking at your needs and desires something begins to dawn on you. First, that snorkel trip to Cozumel and that new pair of shoes on sale offers a lot more satisfaction at a sensual level than making sure you have health insurance. But, insurance is offered by your employer and a shopping trip to the mall isn’t.

In looking at your last pay-stub, one thing is obvious. You can see the deductions off the top for Medicare and your portion of health insurance. But the employer match, which would otherwise be take-home pay is disguised. And, the amount of income tax you pay that goes to Medicaid is not disclosed. But, you think, if only the working class is paying, then you have to figure at least 25% of your income is being siphoned off to keep the health care system afloat.
But, there is a glitch. You are basically healthy. You exercise, eat right and have not yet hit the “zone” where life’s chronic abuses have become illness. So, here you are struggling to pay the rent and make payments on your car and student loans and a lion’s share of your income is going to pay for something for someone else or for illusory benefits you won’t use for years to come, if ever. You might die of natural causes in your sleep and all those expenditures for health care will go to a bunch of free-riders.

When one generation pays for another’s health care, an implied social contract is in force but its legitimacy is periodically re-examined. You see these old goats who smoked, ate pork rinds and guzzled beer instead of water and it brings into question your charitability. By and large, it’s really not poor children you are aiding, but those who refuse to wear a motorcycle helmet or quit smoking. You pay for their health care and you pick up the slack at work when they use sick leave.

You can at least rationalize that you are one of the lucky ones who has health insurance. You work the new coffee bar at King Soopers and the union demands you have benefits, something that most employees at Wal-Mart don’t get. But, if health insurance in the open market is $1,000 a month for a family and you have forgone take-home pay, shouldn’t there be something in return? Like, maybe frequent-buyer credits that allow you to least to get pair of shoes at Nordstrom’s once a year?

Being coerced into paying for another generation’s entitlements is one thing, but being forced to pay for health care upfront through premiums years in advance and possibly never using it is another thing. What if I change jobs or health plans? Who gets all that money I never tapped in to? Suzy next to me got a facelift out of it. Joe’s doctor conjured a diagnosis of cataracts and he got Lasik surgery and now he doesn’t have to wear glasses anymore. What did I get for allowing my personal income to become a sinkhole drain in the name of the socialization of risk? I was dispossessed of a huge chunk of my income over my working years, and what I get is to go find a new doctor since my lifelong primary-care physician doesn’t take Medicare.

Francis M. Miller is a resident of Parker.

READER COMMENTS

If you can afford shoes at Nordstrom’s you can afford health insurance.

And according to most socialists, you can also afford to pay for everyone elses health care.

Posted by CA on October 22, 2007 08:24 AM

So - Hank & Francis all bent out of shape because their reasonably good health has lowered the cost of insurance for all folks in the same "pool" as the company they work for. Boo-de-damn-hoo. I don't see either of them whining about the fact that every member of Congress has platinum health care - paid for by the taxpayers - which they get to take with them when the retire or someone is elected to take their place. If Congress had to face the same health care coverage as the average working stiff , we'd have a national health care plan (the cost of health care for Elizabeth Edwards could bankrupt even her husband John) - and if they didn't qualify for permanent retirement benefits equal to whatever Congress' current pay is, Social Security would have been fixed too.

By the way - for both of you who seem to be looking at a best case scenario of never having to use that health insurance - here's a worst case scenario: your child (under 21 & covered by that health insurance) who to that point has lived a healthy life (eats relatively healthy for a kid, exercises, doesn't smoke, etc), is diagnosed with cancer - and you have declined health coverage. Convince me you aren't going to need help - and use whatever governmental assistance you can get.

Posted by Mary on October 22, 2007 03:29 AM

"You can at least rationalize that you are one of the lucky ones who has health insurance."

Luck had nothing to do with it. I worked and planned responsibly for it, knowing that I was the one--and the only one--who God appointed as accountable for me. And my Constitution second's that very position. I never viewed myself as a welfare junkie needing or wanting a village of strangers to take care of me and mine. That's why, today, I have the desired "pot" that I earned and that others from which want to steal.

And your weren't "dispossessed of a huge chunck of your income"--confiscated, taken and stolen are better words--nobody asked you. If it happened in a dark alley at gun-point, then you would have been right to call 911.

Robin Hood had it right all along--he took from the government (who confiscated/stole it) and gave it back to the poor. Where's Robin Hood when you need him? Meanwhile the same government is busy--"robbin' the hood," our hood.

Posted by Hank on October 21, 2007 10:40 AM

Francis,

Your complaints, scattered as they are, boil down to why should I pay to cover the risks of others and then not get any benefit for myself from the money I put in?

Many people ask this question and the two solutions to this problem are acknowledged then ignored.

First, as long as health care is kept as a bundled part of employment, there will be people who lose when they change jobs. Making health care expenses deductible from income taxes for individuals instead of restricting this benefit to corporations and businesses will ease part of the problem.

The second part, where those young and healthy are essentially paying for those older and less healthy, is a bit more complex.

We need to permit insurance companies to sell catastrophic coverage insurance. Like car insurance, it will insure against major expenses from diseases or accidents while requiring the individual to pay out of pocket for doctor visits and medications. Another part of this solution is creating universal availability of access to Health Savings Accounts. Right now this type of "insurance" is severely limited. Many reasons are given but they all end up with the finger pointing at government rules and regulations which were put in place to make these accounts difficult to obtain. I'll discuss the reason for this later.
HSAs work like a regular savings account. A set amount is deducted from each paycheck and deposited in the account. The money is drawn out with a debit card/check that is only usable for medical expenses. If you remain healthy, the money stays in that account for you to use for your medical expenses. Accounts can be set up for individuals or entire families. These accounts are most usually paired with a catastrophic policy to cover a major illness/accident. The money in the account is pre-tax funds so the amount of income you are taxed on is lowered. It also has a high upper limit in the account (usually somewhere about twice the catastrophic policy's "floor"). Funds in the account above that upper amount may be removed from the account for ANY purpose. Most just leave the money there as it protects them from worry. People who have these accounts can obtain discounts from health care providers because the provider is spared the paperwork required by an insurance company or the government they must provide prior to payment. If we add tax credits to the system to enable the working poor to obtain insurance on their own, or open their own HSA, we remove one layer of government interference from health care. If we extend this benefit, as an option, not a requirement, to Medicare and Medicaid subscribers, eventually the massive paperwork burden on the medical profession will ease and enable them to eliminate half or more of their accounting departments.
Insurance companies would have to adapt their sales efforts to offer HSA management paired with the catastrophic policies to compete for business. Insurance companies and their lobbying are a major reason the HSA policies are so restricted. People with bad health, or who are older will probably need insurance policies instead of these accounts but it will be an individual decision. In January my husband and I will exchange our insurance policies for one policy and a HSA. Both of us are diabetics. My husband is a disabled vet. I have a very bad heart, 8 heart attacks, 3 of them major, and counting, with multiple hospitalizations in the past year. We put the numbers on paper, expecting that we would need to keep the insurance policies. Hard numbers proved that the ability to negotiate the cost of doctor visits and benefit from reduced costs for medications available on the net and discounted for cash payments at many pharmacies as well, made enough of a difference that we could benefit from the accounts.

Your ask another question that needs an answer.

Why spend my money on other people? Answer: we are a society and we help one another. Sometimes that help is direct and personal. Other times that help is in areas like public parks, museums and libraries. In insurance we create a pool of money to pay for the cost of a product or service, like many wish to do to purchase medications for lower prices, to protect us in case of disease or injury. We are analyzed and grouped with people who share the same risk "profiles" we have. We all pay into the system and the insurance company invests the money and makes a profit on that money. When people get sick the insurance company most usually pays for that person's care from the profits instead of the money "pool."
That help needs no limits other than good management rules and close monitoring of and swift prosecution of fraud. We also receive more choices to make this truly beneficial for individuals. The only way to get that is with the free market. The pursuit of profit will make changes happen much faster and winnow out the bad changes quickly.

Government control and programs only add layers of paperwork and cost in health care. Time to sound the opening bell in the health care market. Competition for profit will work. It did before the government tried to "improve"it.

Worst part is that Esurance will probably run a bunch of health insurance ads starring their two dimensional, talking Barbie doll.

Posted by momma y on October 21, 2007 04:09 AM