HEALTH CARE/Joan Retsinas

Naysayers United

The Opposition Rises

In health care discussions, a chorus of naysayers, roused by right-wing talkmeisters, is drowning out the voices of common sense.

Before you, Joe Q Public (or Dickey Flatt or the Common Man), joins the skeptical band, it’s time to ponder the nexus between self-interest and the nation’s interest.

Ask yourself: Are you insured now? If so, then “reform” of any sort may not help you. Or so you think.

Would you bet your life, literally, that you will be insured in another year? Another two years? Do you see no chance that you will be swept under in a recessionary flood, that your company will downsize you? That your company will declare bankruptcy? Or drop insurance? Only if you are a member of Congress (or a cable-show talkmeister) can you be certain of perpetual coverage. If you are covered under a spouse’s policy, would you bet your life on your spouse’s longevity? Or — a trickier bet — on your marriage’s longevity? The number of people without insurance has been inching up. You may well find yourself in that marginal increment.

Ask yourself: Is your insurance comprehensive? Will it cover whatever a physician says you or your family need? What about cardiac rehabilitation? Plastic surgery to correct a child’s facial deformity? A bone marrow transplant? The free market in mortgages gave us a panoply of toxic products. You may have a toxic insurance policy — one with such high co-payments, such a high deductible and so many exclusions and pre-conditions and limitations that you will end up bankrupt. A lot of insured Americans declare bankruptcy each year, floundering in medical bills. You could end up in that sad bunch.

If you answered “yes” to the above questions, and are covered by Medicare, Medicaid, the Veterans Administration or a program administered by your state, step back from the chorus. You already have government-backed insurance. It is hypocritical for you to scream of its dangers while you enjoy its benefits.

Assume you are among the lucky minority: insured with a private-sector policy, comfortable that you will have coverage well into the future, wealthy enough to pay for the fine-print exclusions embedded in your policy. Before you join the cacophony yelling “no” to government intrusion, here are some more questions.

Do you want a large swathe of Americans to be ill, with no regular access to health care? This is not a test of compassion, one of those are-you-your-brother’s-keeper platitudes. That swathe may well include the person who makes your morning coffee, launders your clothes, parks your car, takes care of your children and mows your grass. You may be feet away from hepatitis, pneumonia, influenza, and tuberculosis. Public health authorities want every American to have a “medical home” — a first-call place where people go for basic care, including immunizations. If people get sicker, the home-base will refer them to specialized care. People without insurance, however, are medically homeless. Our system of publicly funded hospitals and clinics is too sparse, too poorly funded to serve all of them.

Now turn to the public interest. The bugaboo of “cost” looms over the town-hall debates. The naysayers point to a rising sea of red ink that will drown the country. But in the status quo, the budgetary ink is decidedly crimson. Our hodge-podge system gobbles up 17% of our gross domestic product — far higher than other countries. The administrative costs of Medicare — the largest United States government insurance program — hovers at 3%; private insurers’ administrative costs reach double digits. Ultimately reform promises savings to the nation.

As for savings to you, personally, look at the amount you pay in premiums. Unless you work for the government, your premiums have been soaring as your employer has passed more of the increasing costs on to you. Not surprisingly, a growing number of workers each year opt out of their employers’ policies: they can’t pay their share. For public programs, like Medicare, the government discounts premiums to people with low incomes.

At this point the chorus of naysayers should have shrunk to a ragged, vitriolic, bunch of talkmeister groupies, abetted by lobbyists for the private-sector insurance industry. The chorus of supporters is long overdue. Speak up.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, September 15, 2009

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