To:-- Leading Senators and Specified Congressmen
21 December 2008
Dear Sir/Madam,
The president elect has asked for citizen input with respect to health care. This is my response.
1. The U.S. health care system is an obscenity and a disgrace. It requires a medical and a law degree to understand coverage, and Miranda warnings before consulting a physician. It does nothing to promote healthy living or health care but exists only to exploit sick and well alike for venal purposes
2. I am in favor of comprehensive, single payer health care for all, as a matter of social right, based on a system of progressive contributions by all.
3. Any health care reform that retains private, for profit insurance companies as the mechanism for delivering health care, must have the following features
a. Be portable - No “move and loose”. The freedom to change jobs or domicile is a basic right (and sometimes a necessity) that should not be penalized by loss of insurance and potential disqualification by a new insurer.b. Be inclusive - No condition or risk exclusions. The purpose of insurance is to cover people when they get sick. Excluding people because they might get sick subverts this purpose and results in a system that simply poaches on the healthy for profit while it dumps the sick, often literally, in gutters.c. Be comprehensive. All health care polices should provide coverage for necessary medical, dental, nursing, rehabilitative, medical device and drug needs.d. Be Affordable - No Pricing Discrimination. It is vile nonsense to require insurance companies to provide coverage while allowing them to price the coverage beyond ordinary reach. While premiums could be based on a sliding scale, they must be affordable by all.
4. To implement these four absolute requirements, it will be inescapably necessary to establish a National Health Arbitration Board to regulate coverage and premiums and settle disputes. Insureds should not be forced by adhesion contracts into accepting private “arbitration” that is controlled in all but name by the Insurers.
5. The above listed four requirements inevitably highlight how impossible the present for-profit system actually is and why national single payer is the only truly efficacious solution. The moral bottom line is that either we provide health care to our citizens or we allow men, women and children to be used and exploited by profit-predators.
6. I am attaching a basic calculation that compares two standard PPO plans. The calculation proves that the lower and high deductible plans are about the same and that under either plan a single insured will pay approximately $12,000 in out of pocket premium and medical costs before insurance supposedly reimburses at 100%. Out of a $20,000.00 in total costs, the insurance company will have paid only $7,000.00. For most people, this is a prescription for bankruptcy
7. I would point out, in all candor, that it will serve any of you ill to beg off providing for the rest of us at least the kind of coverage security you all have as federal officers. Neither would it serve well to conjure up bugaboos with tremulous cries of “socialism!”. One hundred and twenty years ago, Chancellor Bismarck laid the foundations for one of the first social-welfare states. To the outraged cries from his own conservative party, Bismark replied “Call it socialism or whatever you like -- it’s all the same to me.”
What is not all the same to me, is that you fail to provide health care reform as described. What Bismarck understood is that, by whatever name, no modern state can survive based on the grotesque social inequities that prevail in the United States today. Giving new meaning to “American Exceptionalism” we still haven’t caught up with the rest of the first world and parts even of the second. I hope you can manage to be at least as progressive and enlightened as Bismarck.
Yours truly,
.
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