26 August 2009

Privileged, but not secure

Where health insurance is concerned, I am among the more fortunate people in the United States. My employer pays the full premiums for my insurance. When I needed surgery last year, the insurance picked up the entire forty-thousand-dollar cost (since then I've been billed a total of maybe one thousand dollars for various odds and ends like doctors' fees and physical therapy, but spread out over almost a year it was easy to absorb that, and it wasn't much for the out-of-pocket cost of major surgery). So personally I have very good coverage. Yet I've still come to the conclusion that the system needs reform, even for the sake of people in my position.

1) I could lose it. If I lost my job, I would need to either give up my insurance or continue it at ruinous cost out of my own pocket until I found another job. Under a system of genuine socialized medicine (such as Medicare or the systems found in every other developed nation on Earth), coverage may be more limited, but it can't be taken away from you.

2) It ties me to a particular job. Even when the economy is good, the prospect of changing or temporarily losing insurance would discourage me from changing jobs, even if it was a good move from other viewpoints. In a system where health insurance is not linked to employment, employees have more flexibility -- and thus more power relative to the employer.

3) It can't last. As premium costs continue to climb, at some point my employer will probably start to cover only part of them rather than all of them. They actually tried to do that during this year's contract negotiations, probably figuring that the recession would deter people from resisting. The union squelched it. But if costs keep rising and rising, eventually the issue will likely be revisited.

Under our present system, no one except those on Medicare and those who are rich enough to pay by themselves for any medical care they might need has real security.


Blogger Ranch Chimp said...

That really is a great thing to have your premium's paid like that! I wonder though if you had "dependent's", if they would pay for them too?,maybe not dependent coverage. But nonetheless, that was one hell of a deal...considering the grand out of pocket only. Because that was really a big surgical job in my opinion...just looking at what needed to get done. And this year...your already biking to work! I have heard testimony after testimony of folk's just around us in our community here in Dallas, of where they been dropped,jacked, denied,and a number of other unpleasant thing's that folk's got from their insurance provider's. A good frank posting though Sir.

Sound's like a decent employer also.

26 August, 2009 05:47  
Anonymous rita said...

I used to have good health insurance through my husbands job when I was married. Now I have none although i do work full time, too. It's kinda scary. I have not had to go to the Doctor yet. (crosses fingers)My only option is to try very hard to stay healthy.

26 August, 2009 08:27  
Anonymous Anonymous said...

Yep, Chimp's right, a decent employer you have, Infidel.

Rita, that option, of trying to stay healthy, is a good one and I hope you continue being successful at it as long as you can.

We desperately need a change in the way health care is delivered in this country. That casino-like set-up with the private insurance cartel ruling the market and screwing people all around is immoral and inefficient.

As Marcia Angell says, we have the only health system in the world based on avoiding sick people.

Makes no sense. (Unless you are an insurance company's CEO.)

Good post, Infidel.

26 August, 2009 10:17  
Blogger Infidel753 said...

RC & Elizabeth, yes, it's a good employer. In the long run though, they may be unwilling or unable to keep providing benefits like this, if the basic system is not reformed.

Rita, this is another problem with the way insurance works now. A lot of people have insurance because they're listed as dependents of a person who has a good job. If they lose the status of dependent for whatever reason, they too can lose coverage.

26 August, 2009 11:50  
Anonymous NickM said...

The best soultion, IMHO, and I have recently had a lot of dealings with the NHS is something like the French or Danish model. Independent service providers but universal insurance.

Most of Europe does this.

We (UK) don't and the USA doesn't in a different way. Both are different varieties of screw-ups.

I would though argue one thing. Infidel, your healthcare is not a "perk". That is a de facto salary deduction.

One other thing. If I had had such major surgery then, even with the NHS, I would be more than that out of pocket on it.

Glad to hear you are feeling better. Most excellent news.

27 August, 2009 05:14  
Blogger Infidel753 said...

I would though argue one thing. Infidel, your healthcare is not a "perk". That is a de facto salary deduction.

That's one way of looking at it. The cost of the insurance is part of the employer's cost of employing me, which I get in the form of something other than cash.

Another way of looking at it is that if I were actually getting that money (a rather hefty amount) myself, but paying it back out in the form of an extra tax to support a national health system, neither I nor my employer would be any worse off in dollar terms, but the insurance I'd be getting could not be taken away from me if my employment situation changed.

Independent service providers but universal insurance.

I've made a similar point (#2 here). A voucher-type system where the government paid the costs out of taxes, but a range of service providers remained, would preserve the element of competition between providers which keeps quality up.

27 August, 2009 06:23  

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