Thursday, November 10, 2005

It's Not About the Uninsured

Kevin Drum picks up something from the Weekly Standard (of all places) and uses it to craft what I think is the best possible strategy for pushing Universal Healthcare.

Here is what they said in the conservative Weekly Standard:
Instead of approaching health care reform as the left does, as a problem for the uninsured — a matter of charity for those less fortunate — conservatives should cast the health care crisis as what it really is: a problem for the insured, for people whose insurance plans will lapse if they lose or shift jobs, whose plans don't cover expensive crises, and who must pay extra, in the form of higher premiums, to cover the medical bills of the permanently uninsured.

From there they spiral into some market-driven fantasy solution bullshit, but as an initial sales pitch, it's gold.

Drum expands:
...If liberals want to sell the idea of national healthcare, we should quit marketing it as a welfare plan for the uninsured. Instead, we should be focused on the healthcare complaints of those who already have insurance but are dissatisfied anyway: Lack of choice in physicians. HMOs that make it hard to see a specialist. High copayments. Fear of losing coverage if you lose your job. Long waits for non-urgent care. New (and usually worse) healthcare coverage every time your HR department is told to find a cheaper plan. Fear that preexisting conditions won't be covered if you take a new job. The risk of financial ruin if someone in your family has a truly catastrophic illness.


So forget the uninsured for now. Liberals should concentrate instead on making sure that ordinary middle class workers understand just how bad and how expensive their current healthcare is, and how much better it could be under a decent national plan.

Exactly. This applies to me and my family right now. I have a poor-paying job working for a state college. But I have excellent BCBS health insurance. I have been actively seeking a better job for a while now, but I have genuine concerns that going out into the private sector is going to subject me to all kinds of bullshit healthplan compromises if not outright downgrades.

I've always been healthy, and my family history is pretty good, but my wife is 29 and has rheumatoid arthritis and a history of cancer in her family. My daughter is three and has a cataract that requires surgery and might be on the road to juveline rheumatoid. These will be pre-existing conditions. These are the kinds of conditions that absolutely kill you if you try to get your own insurance (or even life insurance). If I get a new job, am I going to have to battle some new fucking scumbag insurance company to cover my daughters follow-up care? Do I need to pay COBRA from my old job til I'm out the woods? What if in three years she needs surgery again? If I move thirty miles from Ann Arbor to Royal Oak for a job, am I in some different network requiring me to dump all of our doctors and the U-M hospital system?

This is the kind of stuff that torments families daily in this country and "Healthcare Savings Accounts" do nothing to address this. In an era where it is clear people will change jobs (if not careers) several times over the course of their worklife it makes no sense at all to stay with an employer-based healthcare system. And this isn't even addressing the advantages for businesses and employers to be free of the nightmare of constantly shifting plans to maintain coverage and costs.

Driving home the point to middle-class families that, "Fine, you might have healthcare now, but that could change or stop at any time—and—it could be even better and you could have it wherever you work or live" will likely get a better response than the more abstract "There are 40 million people you don't know who don't have health insurance."


Elizabeth said...

I totally agree, especially since the tactic of the right is to scream bloody murder- that the left wants to take the insurance of the middle class and give it to the poor.

ORF said...

I feel for you! I'm getting ready to quit my job in a few months and pretty much the only reason I'm freaking out about it is health insurance. The system in this country is a complete crock and totally needs to be re-worked. It is barbaric that we are the biggest economy in the world and some absurd percentage of our citizenry (it's like 30% isn't it?) doesn't have medical insurance.

Mr Furious said...

A serious (scary) question for you...when you quit your job and go overseas (India, right?) what happens if you need medical care? I realize this is outside the normal healthcare parameters here in America, but generally, aren't most average people coveresd somehow through their current healthplan (which you likely won't have anymore)? Or will you be covered by the system in place where you are travelling? I'm pretty sure if I went to France and got sick—no problem. I just go to the doctor or hospital and I am covered like anyone else there. If not, my healthplan will somehow kick in.

What will you do?

Anonymous said...

You can probably find the answer to that question on the immigration website of the destination country. If you were a citizen of a country that had a national healthplan, many countries have some sort of reciprocal agreement in place. Most Americans are covered under their existing healthplan, but without an existing healthplan, it's quite possible that an American would be SOL.

The best thing to do in such a situation would be to take out insurance before you leave the US. Many companies offer reasonably-priced short term travel insurance that's basically emergency medical.