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A group on Aug. 12 at Ohio State University, where U.S. Sen. Sherrod Brown (D-OH) was to speak on Health Insurance reform. (AP photo)

A retiree likes his Medicare and wants younger people to have the same plan

COMMENTARY | August 30, 2009

Frank Schneider, a retired lawyer who used to represent insurance companies, advocates a “Medicare for all” plan. He says health care insurance plans aren’t the solution, they’re the problem, and that people don’t know how good or bad their insurance is until they have to use it—and then, for many, it’s too late.

By Frank L. Schneider

I write to support a universal health care plan for all, similar to Medicare coverage for Seniors. As a Senior, I am well aware of the benefits of the program. From my own experience I feel that some of the doctors’ rates should be raised, but the system as a whole works well to keep me in good health at a price I can afford.
In contrast, the present health care insurance program is broken and does not work for many people. More than 46 million Americans have no health insurance and must delay or forego medical treatment (until crisis occurs). Those who have insurance in most cases do not realize how good or bad it is, because most people do not have to use insurance for critical or long-term expensive medical attention. When they do have to use it, they find out, but then it’s too late. More than 50 percent of bankruptcies take place because of medical expenses, and almost three-quarters of those involve people who in fact had health insurance when they got sick.
The present health insurance plans working their way through Congress have many good features. For example, preexisting conditions would not be excluded, and insurance companies would not be permitted to raise premiums excessively because of claims experience. But unanswered are how the insurance companies, which, after all, are in the business to make a profit, will charge and pay for these added benefits. Also, small businesses, whose employees are most at risk of having no insurance because of cost, will be exempt from the requirements to provide employee insurance. The result will be a complicated for-profit system little better than the present one.
I have concluded that a health care insurance plan is not the solution to our problems. Rather, it is the problem. Health insurance companies and health care providers have created a bewildering and sometimes impenetrable maze of coverages, exclusions and limitations which appear proper on their face, but which deprive those most in need from access to the health care they need. If we removed health insurance and health care companies from the system, estimates are that we would save approximately 30 percent of our health care costs, even if no other changes are made! (emphasis intended). We would no longer have medical underwriters to exclude previous conditions or retrospectively examine applications to see if some misstatement will allow the insurance company to evade its obligations. We would no longer have claim “specialists” whose job it would be to scrutinize records and delay treatment to pressure sick people and improve the insurance company’s bottom line. And most important, we would no longer have the obscenely excessive multimillion dollar pay packages now given to health care and insurance company executives.
Insurance companies, health care providers and conservatives in Congress and elsewhere argue that the system would put government between the doctor and patient. But insurance companies and health care companies are there now, and they are doing the job badly in many cases. Who has not heard of patients being unable to receive needed treatment because the insurance company would not pay for it? The argument is specious and self motivated. In Medicare, treatment is given and the bill is presented for adjustment and payment, and at a far cheaper price. The administrative expense of Medicare is widely reported as being less than 2½ percent (as compared to the 30 percent noted above). That should be the model for payment of all health care expenses.
Conservatives also argue that the cost of public health care would require additional taxes on Americans. I agree that the program should be financed by public taxation. I think that taxes, however modest, will give Americans an ownership interest (“entitlement”) they might not have if the costs are merely paid by someone else (like “the wealthy”). I propose an additional 2 percent Medicare tax on employees (with a corresponding tax on employers as we now do with Social Security and Medicare). It is true there would be more taxation. But employers and employees (and the self-employed) would no longer be limited to paying for private insurance or doing without. The present cost of health insurance varies, and in many cases more than $1,500 a month for a family. Eliminating that expense would easily allow payment of a tax, which for most people would be less than $80 a month.
I have no doubt that insurance and health care companies have and will continue to oppose public financing of health care; as Morton Mintz pointed out on this Web site, they are fighting for their corporate lives (and their bonuses). The underwriters would have to adapt, as would the claim “specialists.” The old familiar way of doing business would be gone forever. That is not to say that all these people would be necessarily unemployed. A public health care system requires claim evaluators and processors. The system would still have to have administers and executives. But the golden age of the system which works for those who run it would be over. Excessive costs, commissions and bonuses would no longer exist. The 97 percent of the health care dollar would go for its intended purpose – treating Americans. 
I hope all Seniors and all Americans will get behind the movement for real health care reform in America.                               

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