Commentary––

Health Care For Dummies

By William A. Collins

Health expenses,

Are no trick;

Just try hard,

To not get sick.

Are you one of the 356,000 Nutmeggers without health coverage (43 million nationally)? No sweat. All you need to do is move. Any place in Europe would be fine, or Canada or Japan or South Africa or Cuba or Libya, or any of several other spots with universal care. Maine is now closing in on it, too.

Not so, however, the rest of the United States. In fact, we’re going the other way. Due to rising costs and sinking unions, more and more employers –– our most common source of coverage –– are whittling away whatever protection they still offer. Indeed, plenty have already whittled it away completely. And since in this country business pretty much runs things, employers can do whatever they please.

Unfortunately government often follows suit. Connecticut, for one, has cut back the HUSKY program, suddenly dropping the parents of eligible children. Similarly, Washington is turning Medicaid over to the tender mercies of the states. Those states, in turn, are likely to squeeze cash out of the program to reduce their own deficits, at the expense of poor recipients. And the president and Congress have just finished undermining Medicare, seriously compromising future protections for senior citizens.

That new law, in fact, illuminates the true heavy hitters in our health care system. Obviously it’s not you and me. Aside from a very scrawny prescription drug plan for some seniors, the big beneficiaries are the HMOs and drug companies. Over time the HMOs will get to cherry pick all the healthy seniors for themselves, sticking Medicare with the sick ones. The pharmaceutical companies, in turn, have departed Washington cuddling their new prohibition against government agencies using muscle to bargain for cheaper prescription prices. They must have paid plenty for that one.

So overall, who can blame employers for not wanting to foot the bill for all this hanky-panky? They’re in business to make money, not to provide social services or to subsidize greedy corporations. If one of their competitors decides to drop health coverage altogether, they’re really behind the eight ball.

Thus it is hardly a mystery why all those other countries have switched to universal care. For one thing, it covers everybody, eliminating the need for expensive special programs for the very poor. And in our case it would bring those missing 43 million people in under the tent. That’s not a bad start.

Such universal care is also cheaper. The United States spends about 31 cents of its health dollar on administrative costs. Canada runs only half that, and Medicare is lower yet.

Further, under such a system everybody would have to pay. No deadbeats allowed. Each employer and each citizen would pony up according to their payroll, just like Social Security. To balance that, no one would have to pay insurance company premiums any longer. With everyone covered, it would also be a lot easier to conduct preventive medicine programs.

Nor would there any longer be HMOs, perhaps the single biggest blessing of reform. No more CEOs ripping off their policyholders and stockholders. Drug companies would take a hit, too. Our national insurance agency would be able to bargain for fair prescription prices, with the benefit going to us. That’s what Canada does, which is why we love to shop up there. The companies could then focus more on research, less on marketing.

The sad irony is that everyone in government and the press knows all this. But Republicans are financially beholden to the drug and insurance industries, while the Democrats fear charges of “socialized medicine.” Thus nothing changes. Candidate Dennis Kucinich shows what happens when you blurt out the truth. The media, panicky over losing their pharmaceutical and HMO advertising, have marginalized him as an extremist. Which calls to mind that central adage of American politics, “No good deed goes unpunished.”

(Columnist William A. Collins is a former state representative and a former mayor of Norwalk.)