The Young, the Old and the Uninsured
I’ve fielded a lot of response from the story about young adults lacking health coverage. Feedback is always encouraged and appreciated, but I was surprised that many who commented did not see the connection between their premiums and the young adults out there living without insurance. There is one, and it is spelled out below. These numbers ran with the story on Sunday:
BY THE NUMBERS
Insurance in Oklahoma
$4,704
The average annual premium for single coverage in 2008.
$680
Amount paid by insured individuals per year to cover the uninsured.
$1,127
The amount insured individuals will pay for the uninsured in 2010.
300,000
Approximate number of Oklahomans 18-32 who do not have insurance.
SOURCES: THE KAISER FAMILY FOUNDATION,
HEALTH RESEARCH & EDUCATIONAL TRUST,
STATE INSURANCE DEPARTMENT, FAMILIES USA
One gentleman failed to see this connection, so I thought I’d point it out again.
You bemoan the plight of those who do not try, or can’t provide for their own care. But how about those of who are up against the wall, playing by the rules and are contributing to our communities children?
All of us should be concerned that so many fall between the cracks. No it isn’t just young people. 600,000 people in Oklahoma are without health care. Is that acceptable?
A very brilliant woman (who now works in the National Institutes of Health) once told me,
“We have a sick-care system and not a health-care system. We have a whole industrial complex around this sick-care system. There will be a huge resistance to any change.
Thank you for joining our conversation on WatchDog. We encourage your discussion but ask that you stay within the bounds of our commenting and posting policy.
The Oklahoman has quoted Walter Williams (Opinion May 23) in which he disparaged universal health care by a comparison with Canada, which has waiting periods for a specialist contact, of around four months. Of course, without the system some people would be able to see the doc in two weeks, and others would have a waiting period of — forever.
Williams suggests that if the price of a good or service is zero, demand will rise until it exceeds supply. He suggests that the the only way to cope with this is queuing or rationing.
The fault in his reasoning is that he presents those as the only possible solutions. Another fault is his proposal that the market should set the price, which of course would favor those with the money, to the total disadvantage of those without it.
This is a reasonable formula for the sale of swimming pools or new cars. It is not reasonable when we are speaking of life and death, or the suffering of illness. In some countries, where there are few resources at all, it might still make sense. But in a country where such deprivation is unnecessary, it makes no sense at all.
A very obvious solution would be income-related pricing. For example, a doctor’s office call might cost an hour’s pay. An annual deductable might cost a day’s pay. A first day in the hospital might cost a day’s pay, and an annual premium might cost a week’s pay. Under those conditions, people would do their own rationing, and would make their own decisions about it.
Joe Burgerflipper, earning minimum wage, might pay his own doctor bills until he has paid $50 for the year. Then he makes his next appointment, and his office call costs $6.50
John Q. Lawyer, making $100 an hour, pays his first $500 in medical bills, and after that pays $50 for an office call, matching the terms of private insurance. If he chooses not to have the insurance, he pays whatever the doctor charges, but is not covered in case of catastrophic illness, either. He might opt for a lower-priced high-deductable insurance, that pays only for catastrophic or major chronic illness.
There could be a cap on deductables and office call charges, such that for a regular plan, it would never be more than $500 for the deductable or $50 for an office call for anybody, including Bill Gates or Ross Perot.
After a person has expended a month’s pay on office calls, the fee could drop to half until the end of the year, and half again after he has expended another month’s pay. This would be rationing according to need and ability to pay, which would not shut anybody out. Moreover, it would promote self-regulation, and reduce the problem of waiting of which Williams speaks.
Williams goes on with his usual blather about whether there is such a thing as a right to health care. Because health care deals with suffering and death, I would say yes. Absolutely yes.
Now, this principle may not apply in India or Somalia, because the resources simply are not there in great measure. But in countries where the wealth level is great, there is simply no excuse for denying health care to anybody.
In that case, telling a lower-income person to go away and die is presently a matter of choice, not of necessity, because wealthier people have better things to do with their money. Western Europe has already made a decision on that, and provides health insurance to everybody.
Certain things are simply the minimums acceptable in the wealthiest land on the planet. Certainly, there is no reason why anybody should lack for food, at least some food, when we produce surpluses, export them, and even store them to keep the prices high.
There is no necessary reason for any American to have no clothes, or no place to sleep. There is no reason for any American to be illiterate because he can not afford to attend elementary school.
And likewise, there is no reason for any American to have a body wracked with pain, atrophied and weakened to helplessness, or dead for a lack of paying for medical care. We can demand that care as a right, because the resources are available here, and it is only reasonable that we do have that right.