EricHoefler.com

First, I want to re-emphasize something: this debate is about health insurance reform, not health care reform … despite the sloppy language surrounding the issue. Therefore, any talk about “government take-over of health care” is off-base from the beginning. The only controversial thing being considered currently is the creation of a government-run public health insurance option. Personally, I would go further and argue that we need completely government-run health insurance, but that’s not even being considered at this point.

Still, charges of “socialism” are both hyperbolic and hypocritical in the midst of other social services that no one seems to mind: Medicare, Tricare, education, fire, police, water-treatment, libraries, postal service, etc. When we’re talking about essential needs (as health care certainly is), placing profit motives in the middle is potentially much more problematic and dehumanizing than a government-run system (or at least, a government-run option). Yet, that’s the system we currently have: CEOs and investors are making decisions about our health, and they’re unquestionably motivated by profit. How can anyone see this system as something worth fighting to protect while accusing the proposed changes of being fascist and comparing them with Nazi policies?

Consider this simple, clear argument in support of government-run health insurance:

Then remember that this isn’t even what’s being proposed. The current proposals will be much less effective comprehensive, even with a public option.

I’ve been reading and thinking about this issue quite a bit and have attempted to collect my reasons for wanting serious health-insurance reform. Where possible, I’ve also supplied sources. If you read this, I hope you’ll consider these points and then provide your own thoughts and resources. I welcome: additional reasons; additional sources; critiques of the reasons and sources provided; reasons and sources that argue against substantive reform. However, I ask that all claims be backed up with sources if at all possible … it just helps to keep the debate honest.

We’re paying too much:

Total spending on health care, per person, 2007:

• United States: $7290
• United Kingdom: $2992
• Average of OECD developed nations: $2964
• Japan: $2581

[source]

For all this extra money, we’re not doing so great:

At last ranking (in 2000), the U.S. is ranked #27 in the current World Health Organization’s rankings (below France, Italy, Spain, Japan, the UK, Ireland, Switzerland, Germany, Saudi Arabia, Israel, Canada, Australia, Chile, and Costa Rica)

[source]

The current system isn’t helping enough Americans:

• Over 44,000 Americans lose their health insurance every week
• 46 million Americans (18% of the population under 65) don’t have health insurance
• 10% of children don’t have health insurance

[source]

It doesn’t help us precisely when we need it most:

• The proportion of all bankruptcies attributable to medical problems has increased 50% since 2001
• Medical debt contributed to 62% of personal bankruptcies in 2007; For 92%, high medical bills directly contributed to the bankruptcy
• 78% of bankruptcy filers burdened by healthcare expenses did have health insurance
• Many end up bankrupt due to medical problems because they are under-insured (and usually don’t realize it until it’s too late), lose their insurance because they became too sick to work (which means they’re also losing their income), or are denied because of "pre-existing conditions"
• Nationally, 1/4 of all firms cancel coverage immediately when an employee suffers a disabling illness; another 1/4 do so within a year.

[source]

The debate is being unfairly influenced:

• The industry uses much of its profit to "pay off" members of congress for "protection" (at the rate of nearly $4 million in 2008) [source]
• The most influential Congressional reps in this debate together represent only 13 million people, meaning those speaking for just 4 percent of America are attempting to control the debate for the other 96 percent. [source]

Many arguments against the current proposals are based in misunderstandings:

• Misunderstanding: it will pay for illegal immigrants. To the contrary, the House bill specifically forbids federal dollars from going to the health insurance policies of undocumented workers residing in the United States.
• Misunderstanding: it will create “death panels.” To the contrary, the initial proposal (now gone, sadly) merely ensured that those who wanted end-of-life counseling would be able to receive it for free.
• Misunderstanding: it will pay for abortions. To the contrary, the only types of abortions that would be covered under any public plan would be for cases of rape, incest, or or life-endangerment, as was mandated in the 1976 Hyde Amendment and is already the case with private insurance companies. Abortions for any other reason would be paid solely through the premiums of the insured. In addition, insurers would not be required to offer, or prohibited from offering, abortion services. [additional source]
• Misunderstanding: a public option will force people out of their current plan. To the contrary, the House bill allows for existing plans to be grandfathered in. However, should the public option prove to be a better choice than those privately available, why wouldn’t you want that plan? On the other hand, if government-run programs are as inefficient as critics claim, then private insurers should be able to compete easily and provide better choices at a better price. At any rate, why are we so concerned about protecting insurance companies?
• Misunderstanding: it will result in healthcare rationing and/or put a bureaucrat between patient and doctor. In reality, this already exists and is managed by insurance companies who, as businesses, have profit as their primary motivation.

For sources to these claims, as well as corrections to additional misunderstanding, please see this source.

What is your understanding of this debate? What are your reasons for opposing or supporting health insurance reform? What arguments or resources can you offer to help clarify the relevant issues?

Also, I’ll continue to share related articles I find interesting on my Tumblr account, tagged healthcare (most of which end up in my public bookmarks, also tagged healthcare).