Tonight, at a neighborhood party, I listened to three men, each of whom own small businesses: one employs 5, one employs 17, one employs 52.
They all said the percentage of their overhead which went toward employee health insurance was from 15-30%, but that wasn't the worst of it: They did not know, from year to year how much it would rise. It was impossible to plan for this cost. One simply resorted to telling his employees he would cover only 50% of the insurance premium--they were on their own for the other half.
The guy with 52 employees surprised me. He is slightly to the right of Ghenghis Kahn on most social issues, but he said health care is simply "something we should do." He said his company spent more on health insurance than it did on aluminum last year and he makes things on a Defense Department contract out of aluminum.
I pointed out that the health insurance companies were only doing what these businessmen were doing in their own businesses--trying to maximize profits--in this case for shareholders. The guy with the Defense Department contract said his profits were fixed by the government and they could do the same for the health insurance companies.
"Oh, so you're for price controls now?"
"Well, yeah, I live with them. Why can't they?"
"Because they are publicly held companies and the CEO of each wants to maximize shareholder value so he can get his $30 million bonus."
I suggested the problems they had detailed all arose from one basic problem: Health insurance and health care are two different things and health care should not be profit driven, not a profit center. This shocked them at first, but the idea seemed to grow on them, until one of them said, "But how many people do you think work in health insurance? If you eliminated all their jobs, there'd be a Depression."
I have tried to get estimates of this number from Professor Google, but it's a hard number to pin down: You should include all the health insurance company employees of course, but many of the insurance companies sell multiple types of insurance, so it's not clear everyone at these companies would be out of work if we shut this commercial health insurance system down. But there are also all those clerks at doctors' office who do nothing but deal with insurance companies. Ditto for hospitals and outpatient clinics.
What is the number of all these superfluous people whose jobs would become unnecessary if we shifted to a National Health System or a single payer or a Medicare for All? 500,000? 250,000? Who knows. A lot of jobs would be lost.
When hospitals and doctors' offices switched to electronic medical records, all those people who worked in medical records offices, transcribers for doctor's notes and correspondence--all those jobs went "poof!"
But, the plain facts are:
1. American industry is burdened unnecessarily and unfairly with the cost of health care for its employees, a burden our foreign competitors in the global economy do not bear.
2. The entire health insurance industry is unnecessary, and we are carrying this dead weight as an albatross around the neck of companies, large and small businesses and health care providers.
We are doing things the way we do them because we have done things this way since 1941, when employers, scrambling to attract workers while half the work force was away fighting the war, started enticing employees with health insurance.
That was 76 years ago. Seventy six years during which America has fallen behind because we as a nation have been too chicken to try something else. We have been scared into sticking with the horse and buggy system we have by loud mouthed marketeers of gloom and doom and the rest of the world has sped past us.
The 800 pound gorilla in the room, nobody wants to talk about is: We do not need health insurance companies. They are a frill. They add nothing of value to health care. They do not innovate. They do not save lives. They do not care about lives. They care about money, profit and their own jobs. They do not care about you.
The trouble with single payer is not that it wouldn't work, or it would drive health costs up--it would cut costs by 90%--the problem is, a lot of people would lose their unnecessary jobs if we eliminated or substantially reduced commercial health insurance. We have been carrying these people on our back for 76 years and nobody wants to admit it.
They all said the percentage of their overhead which went toward employee health insurance was from 15-30%, but that wasn't the worst of it: They did not know, from year to year how much it would rise. It was impossible to plan for this cost. One simply resorted to telling his employees he would cover only 50% of the insurance premium--they were on their own for the other half.
The guy with 52 employees surprised me. He is slightly to the right of Ghenghis Kahn on most social issues, but he said health care is simply "something we should do." He said his company spent more on health insurance than it did on aluminum last year and he makes things on a Defense Department contract out of aluminum.
I pointed out that the health insurance companies were only doing what these businessmen were doing in their own businesses--trying to maximize profits--in this case for shareholders. The guy with the Defense Department contract said his profits were fixed by the government and they could do the same for the health insurance companies.
"Oh, so you're for price controls now?"
"Well, yeah, I live with them. Why can't they?"
"Because they are publicly held companies and the CEO of each wants to maximize shareholder value so he can get his $30 million bonus."
I suggested the problems they had detailed all arose from one basic problem: Health insurance and health care are two different things and health care should not be profit driven, not a profit center. This shocked them at first, but the idea seemed to grow on them, until one of them said, "But how many people do you think work in health insurance? If you eliminated all their jobs, there'd be a Depression."
I have tried to get estimates of this number from Professor Google, but it's a hard number to pin down: You should include all the health insurance company employees of course, but many of the insurance companies sell multiple types of insurance, so it's not clear everyone at these companies would be out of work if we shut this commercial health insurance system down. But there are also all those clerks at doctors' office who do nothing but deal with insurance companies. Ditto for hospitals and outpatient clinics.
What is the number of all these superfluous people whose jobs would become unnecessary if we shifted to a National Health System or a single payer or a Medicare for All? 500,000? 250,000? Who knows. A lot of jobs would be lost.
When hospitals and doctors' offices switched to electronic medical records, all those people who worked in medical records offices, transcribers for doctor's notes and correspondence--all those jobs went "poof!"
But, the plain facts are:
1. American industry is burdened unnecessarily and unfairly with the cost of health care for its employees, a burden our foreign competitors in the global economy do not bear.
2. The entire health insurance industry is unnecessary, and we are carrying this dead weight as an albatross around the neck of companies, large and small businesses and health care providers.
We are doing things the way we do them because we have done things this way since 1941, when employers, scrambling to attract workers while half the work force was away fighting the war, started enticing employees with health insurance.
That was 76 years ago. Seventy six years during which America has fallen behind because we as a nation have been too chicken to try something else. We have been scared into sticking with the horse and buggy system we have by loud mouthed marketeers of gloom and doom and the rest of the world has sped past us.
The 800 pound gorilla in the room, nobody wants to talk about is: We do not need health insurance companies. They are a frill. They add nothing of value to health care. They do not innovate. They do not save lives. They do not care about lives. They care about money, profit and their own jobs. They do not care about you.
The trouble with single payer is not that it wouldn't work, or it would drive health costs up--it would cut costs by 90%--the problem is, a lot of people would lose their unnecessary jobs if we eliminated or substantially reduced commercial health insurance. We have been carrying these people on our back for 76 years and nobody wants to admit it.
Of course, we could go to single payer (the government) but then all your friends would say "Keep the Government's hands off my Medicare" (or Medicade or ACA). Clearly, universal health care is what we need - just like most other large, civilized countries have today.
ReplyDeleteAnon,
ReplyDeleteIf we went to single payer then most companies would stop offering health insurance and the balance of those opting for that single payer (likely Medicare) would be likely 80% Medicare and the remaining 20% private insurance through workplace policies--as it is in England. The United Auto Workers might have a Cadillac plan and those lucky workers would go first class on their flight through the medical system while the rest of us goes economy class. Which would be a fine outcome, far as I'm concerned. There would still be a few private health insurance companies, still some workers in that industry, but still a seismic disruption in the labor market.
It's like that old story about making drugs legal in Baltimore, which would have likely ended the sales of heroin, cocaine etc in the inner city, if you could get it at local dispensaries. A serious objection was made: You can't do that--the economy of inner City Baltimore would collapse! So many people were employed in the illegal drug market.