Pride, Prejudice, Insurance (Krugman)

General Motors is reducing retirees' medical benefits. Delphi has declared bankruptcy, and will probably reduce workers' benefits as well as their wages. An internal Wal-Mart memo describes plans to cut health costs by hiring temporary workers, who aren't entitled to health insurance, and screening out employees likely to have high medical bills.

These aren't isolated anecdotes. Employment-based health insurance is the only serious source of coverage for Americans too young to receive Medicare and insufficiently destitute to receive Medicaid, but it's an institution in decline. Between 2000 and 2004 the number of Americans under 65 rose by 10 million. Yet the number of nonelderly Americans covered by employment-based insurance fell by 4.9 million.

The funny thing is that the solution - national health insurance, available to everyone - is obvious. But to see the obvious we'll have to overcome pride - the unwarranted belief that America has nothing to learn from other countries - and prejudice - the equally unwarranted belief, driven by ideology, that private insurance is more efficient than public insurance.

(...)

Why does American medicine cost so much yet achieve so little? Unlike other advanced countries, we treat access to health care as a privilege rather than a right. And this attitude turns out to be inefficient as well as cruel.

http://www.truthout.org/docs_2005/110705O.shtml

... factor for many companies to retain an expensive privatized system. Many people feel (and some here have expressed this view) that they don't have as much job mobility as they would like because of poorer and poorer health care at potential new employers.

If an employer maintains an adequate health care plan, they tend to retain employees at lower wage costs. A single-payer system is, likely, pro-worker in more ways than one. If health care is no longer a consideration for the worker, that increases the worker's mobility in the job market and tends to raise wages by forcing employers to once again compete for talent, something many corporations have been loathe to do for some time.

Many corporations are self-payers and use the insurance companies only for billing purposes and policy management, so they're not paying straight rates or even group rates for health care. Their rates are actually lower than what small businesses might pay. The biggest winners in a shift to a single-payer plan--apart from workers--would be small businesses, because they would suddenly have access to a part of the skilled and professional labor pool that they couldn't otherwise afford because of the costs of insurance.


edit for syntax

of health insurance to my employers. They made a conscious and public decision to keep paying for good-quality health insurance, at the expense of giving us raises.

If we could have a system like the Europeans, my salary would be a few thousand dollars higher. And I bet we could pay for it with the cost of what we currently spend on interest for the national debt.

In my fantasy world, where we ran a balanced federal budget, and had nationalized health care.

The amount of money spent every year in the US on health care was 15.3% of the GDP in 2003, projected, by your government's own figures, to rise to 18.7% of GDP, or 3.6 trillion dollars by 2014.

Of that, approximately 1/3 is spent paperwork and billings.

Factoids:

There are more uninsured in the US than the population of Canada. Throw in Great Britain, and you have an approximation.

At least 18,000 unnecessary deaths every year result from lack of adequate health care.

Medical care premiums are at 520 billion USD and rising, even though fewer and fewer people have health care.

Approximately 1/2 of bankruptcies are caused by health emergencies for the insured!

The price of prescription drugs is growing at roughly double the rate of inflation, and the US is the only country in the world without a cap on drug prices.

The infant mortality rate in the US is on a par with that of Mauritius. (Mauritius? Yep.)

If the current amount spent on health care every year were spent on a single payer system, you would truly have the best system in the world, and could cover every citizen in the country adequately.