Sunday, September 12, 2004
"If you are not bleeding all over the place, you are put on the back burner," Ms. Pacione said, "unless of course you have money or know somebody."
Despite what politicians and academics say, I'm convinced that we have a superior system to Canada's. Very few people are unable to find a doctor here in the States, and our waiting times to see one for an acute problem are much lower - usually one or two days. When people complain about the uninsured, what they're really complaining about is the fact that they have to pay for their healthcare, not that they can't get an appointment with a doctor. The Canadians pay for their healthcare in spades through higher taxes, but they still can't get an appointment.
UPDATE: From a reader:
Let's be clear, Americans are paying in spades--the highest per capita expenditure in the world --whether you are paying in the form of taxes, employee contributions, reduced employer/corporate profits or lower wages we are paying--in some parts of the country the cost of a family plan now substantially exceeds one's gross earnings at the minimum wage. Let's not even discuss the lack of a correlation between our high per capita expenditure and health outcome/status (and on many independent polls we are not more satisfied than other industrialized countries).
And for many of the uninsured it isn't just a complaint that now they have to pay for health care--it is a complaint that it is either unaffordable or unobtainable. Realistically, tell me how a single mom or couple with one child affords health insurance when there is no employer contribution or they are self employed and make $13.00 per hour (not an unrealistic wage for many jobs). Imaging trying to squeeze it out at $6-10.00 per hour or if you only work part time, are an emancipated student, recently unemployed, etc.. Do the math after taxes, housing, food, transportation, and utilities--And remember, not every one lives in Ohio--how about Boston or SF where housing may well be double this.
Gross wages 26,000
Less taxes 4-6000 (state. local, sales, fica, federal, etc)
Housing + Utilities 6000-7,200
Transportation (for work) 4,000
Medical insurance 6,000 to 9,000
Yes, we do pay in spades - for health insurance. That's because there aren't many catastrophic plans out there, and because it's extremely difficult to get insurance as an individual. Things would be better if the risk were distributed more evenly across the population rather than through employment pools. For one, it would increase the competition for different health plans. People would be much more willing to purchase catastrophic plans and pay out of pocket for the simple things (an office visit with a primary care doctor is generally around $50-$60, cheaper for cash-only practices that don't have to process insurance claims.) But when an employer is paying the bill for the insurance, which is the case for most people, there's no incentive to purchase catastrophic plans. Everyone wants comprehensive plans that cover as much as possible. Unions demand them. Employees of small businesses expect them, or they'll find work with larger employers. As a result, few insurance companies offer catastrohpic coverage, but they all offer comprehensive coverage - at very hefty prices, of course.
As I said in the original post, divorcing health insurance from employment would be a major step forward in correcting this, and in making health insurance more affordable. Of course, that means giving up some benefits for the majority of people, which never sits well.
posted by Sydney on 9/12/2004 08:29:00 AM 0 comments