Thursday, December 31, 2009

Should all Americans have universal health care?

January 2010 - My new health insurance kicks in today. It looks much the same as last year's, which looked similar to the year before that. Other than price increases, of which I don't have the patience to calculate, my health care has had negligible change in the past 10 years.

This year I'll go to the same doctor, dentist, and pharmacy. Unless I slip and fall on the ice while shoveling, I'll probably use similar medical services as last year - a couple of checkups and some high blood pressure pills.

The question I've been asking lately is, should Americans have universal health care? This sounds selfish, but I'm comfortable with my coverage. Why should I support something that could alter my, and my family's, contentment with what we have? There is a good possibility universal coverage (or even the pending healthcare bill that won't include the public option) will cost me more.

While I haven't done the numbers, nor talked to someone who has, it's my assumption that one argument supporting universal coverage is based on economics. Huh? Next time you go to the doctor, look at your statement. On mine, it shows what the procedure costs, and then what my insurance paid for it. What your insurance pays is significantly less than retail. This is because the insurance providers work out "deals" with the doctors. Kind of like how my Apple Valley contemporaries and I get a discount at the local golf course. We're part of a group (in this case, we live in the same city) and one of the group's amenities is a discount on golf. Such a privilege.

My guess is that if you don't have insurance and need a medical procedure, you end up being charged retail. And my second guess is, if you don't have insurance, there is a good chance you can't afford retail. If you could, you would have purchased insurance. Who pays your bill when you can't? Either the tax payers, or more likely, those of us who have insurance.

The economics argument then has to be based on the assumption (and I consider this an assumption) that if we were all forced into "groups," the groups will collectively negotiate discounts and get us less expensive service. I'm not sure if this passes economic mustered, but I can't think of another reason why the proponents of universal care argue that covering everyone will lower costs.

But let's say that economics don't matter. Let's argue, for a moment, that healthcare is a obligation of the state. If you know me, you might be surprised that I feel everyone has the right to medical care when in need. I say surprised because I typically lean towards putting responsibility, including the responsibility to get yourself health insurance, on the person rather than the state.

As a youngster I went through three, very costly, medical procedures (not life threatening). Not just doctor appointments, but surgeries with lengthy hospital stays. Fortunately my parents were insured and were able to afford this. But what if they weren't? It is here where I'm of the belief that kids, and adults who can't afford it, should be treated. But how do we pay for this?

I don't know how to pay for healthcare. I don't know if working for a big company should allow you the right to buy affordable insurance. If I ever start my own company (or become a moderately successful writer), I don't know if I should be able to avoid coverage. The complexities and variables are too arcane for me to understand.

So where do I stand? As for the economic argument that universal coverage will lower overall costs, I'm not buying it. As for insurance being mandatory, I'm not sure if the state should mandate you purchase full medical insurance like I have. It feels too invasive. However, I would listen to an argument for having the state mandate "major" medical insurance. By "major" I mean coverage for things like heart attacks, cancer, life threatening accidents, etc,.

But if the state mandates this, I mandate that we can buy coverage outside of state lines. In Minnesota, you can only buy insurance from a Minnesota insurance company. This is nonsense. Someone should be able to buy medical insurance from a company in Wyoming, who is offering it cheaper.