copyright © 2008 Betsy L. Angert
Senators Clinton and Obama, bicker as you might, neither of you have proposed Universal Health Care plans. Those who support you [plural] state a semantic argument attests to your authenticity. Many espouse “universal” means “to affect, relate to, or include the whole.” Granted, all Americans will be changed by your plans. However, not everyone will be insured if either proposal is implemented.
Indeed, every United States citizen can connect to the need for coverage. Universally, we recognize we are in quite a predicament. Whatever options are offered, the entire electorate will be forced to consider a personal response. Universality, or an appeal to the aggregate, perhaps better defines what each of you have designed or delivered.
Have you Hillary Clinton or you Barack Obama introduced an actual Universal Health Care plan? No. Constituents concerns will be integrated into the agenda. However, the proposals you have presented to the public, do Not guarantee that life for those who currently are without health insurance will be any better than it is now. The only certainty Americans have is that some of what is will be altered, just slightly.
Insurers will still control costs. Pharmaceuticals can continue to profit, and the poor persons in Middle America will remain insecure, underinsured, and yes, even uninsured. As one who for most of my adult life has not had insurance, I can assure you, that if a person lives paycheck-to-paycheck, they cannot afford insurance at any price!
I could recount the times that I lay writhing in pain, slipping in and out of consciousness; yet, unwilling to call for help for I feared the cost. I might share the stories of how or when I went without treatment for the financial expense seemed far greater than the physical toll on my body. I might mention my fear of an accident, or an age related concern that I need to attend to. Preventative medicine, pooh-pooh. I am among many who hope that my mind will control the matter.
I am among millions who still feel the repercussions of decisions made in the 1990’s. You may remember then, the headlines screamed of the impending crisis. Employers Winning Wide Leeway to Cut Medical Insurance Benefits. People cringed. The then President stepped in. I am certain Senator Clinton you recall the day. Bill Clinton appointed his wife to head a panel, which promised to better circumstances.
Yet, fight as you say you did Hillary Clinton your combative energies did not cure what ails society. What was, is. Circumstances convened more than a decade ago continue unchecked. So long ago, Americans read of a reality they lived. Today, this phenomenon is normal.
A rapidly growing number of victims of cancer, AIDS and other serious illnesses are discovering that under recent court interpretations of a law that was originally intended to protect employees’ benefits, their insurance coverage can evaporate when they need it most.
The recent  Federal court rulings have given employers that now act as their own insurers wide leeway to cut back on existing coverage — or to skimp on coverage in the first place. These “self-insured” employers, a large majority of companies from giant corporations to an increasing number of smaller businesses, have been exempted from state insurance laws governing what ailments insurance companies must cover. . .
At the same time, a Supreme Court decision has made it much harder for patients under all kinds of health insurance plans to sue to get benefits they say have been unfairly denied . . .
In effect, the court rulings and the health plans that take advantage of them are another manifestation of a system of private health insurance in which the sick are increasingly separated from the well.
Americans have no assurance that this situation will improve. Actually, there is ample evidence to indicate it will not. The prospects for business are grim. The economy suffers, as do the people.
The economic situation has become distinctly less favorable since the time of our July  report. Strains in financial markets, which first became evident late last summer, have persisted; and pressures on bank capital and the continued poor functioning of markets for securitized credit have led to tighter credit conditions for many households and businesses.
Slowing job creation is yet another potential drag on household spending. . .
The risks to this outlook remain to the downside. The risks include the possibilities that the housing market or labor market may deteriorate more than is currently anticipated and that credit conditions may tighten substantially further.
Lest we forget, illness is the cause for one half of all personal bankruptcies. Most of those who are infirm realized they cannot cover the debt. These persons have health insurance. A Harvard University study, conducted in 2005 revealed the inadequacy of many private insurance plans. Doctors and lawyers examined the current crisis and offered, many policies offer worst-case catastrophic coverage, but little financial security for less severe illnesses.
“Unless you’re Bill Gates, you’re just one serious illness away from bankruptcy,” said Dr. David Himmelstein, the study’s lead author and an associate professor of medicine. “Most of the medically bankrupt were average Americans who happened to get sick.”
Steffie Woolhandler, Associate Professor of Medicine at Harvard Medical School, in an interview with the Chicago Tribune, described what many of us know but do not wish to discuss.
“Our study is fairly shocking. We found that, too often, private health insurance is an umbrella that melts in the rain.”
Certainly, Senators Clinton and Obama you have not touched on this tender taboo in your “debate” rhetoric. Businesses bleed. Benefits hemorrhage; and Americans lose Health Care coverage, financial stability, or their lives. The “Universal” not health care for all plans you each offer exacerbate or ignore what is. Employment is provisional. Company provided Health Insurance is more and more a luxury. When institutions do offer the option, an individual is expected to pay a large part of the expense. As Americans assess the plans put forth, if they bother to, your [plural] proposed policies do not offer much relief. Sadly, for countless of the under or uninsured voters, such as I, we have been down so long, now a discussion looks like up. In truth, talk is cheap.
Mandates that require a citizen with an uncertain salary to provide for their personal insurance needs will leave many in a legal predicament. For the millions who struggle to survive lower rates bring them no hope.
As prices for fuel, food, and shelter rise, those who could not afford to go to the movie theatre, buy clothing, dine away from home, or vacation certainly will not find the funds to purchase medical insurance, Gainfully, employed citizens who cannot afford to purchase beyond the basics will not be able to pay for coverage. The tens of millions who fear a minor fall, for they know, even one Emergency Room visit can break the bank will not be moved to purchase what remains out of reach. Please Senators, before you begin your ascent to the Oval Office reflect on what is real for most Americans.
[O]f the 47 million uninsured people in the United States, 7.3 million come from families with incomes of $75,000 or more, and an additional 6.9 million earn between $50,000 and $75,000, according to 2006 census estimates.
Some of those with moderate or high incomes may have been shut out of the insurance market because of age or pre-existing health conditions. Researchers believe a majority are self-employed or among the growing number of Americans whose employers do not offer affordable insurance. Their only insurance options may be high-priced individual policies.
Those comfortably covered love to discuss the individuals who waste their dollars or do not pay for what they believe they do not, or will not need. In a recent New York Times report readers were introduced to a twenty-three year old lovely who believed she paid her way through taxes. She smiled and spoke of the free medical clinics available to her. Ms. Coons mused,
“I’m young and in pretty good shape,” Ms. Coons said one recent afternoon, on her way to the treadmill at the Fitness Factory in Midtown Atlanta. “I looked at Blue Cross Blue Shield. But the only thing I could see myself really needing it for are prescriptions and dental . . .
She continued, “The insurance premium was more than what I would pay for my prescriptions, so I just decided not to deal with it.”
Times journalists asked Americans to consider the circumstances of those who use the system and do not pay premiums. Fraud was implied, or a “free ride” was defined and accounted for.
Many free riders are assumed to be young and at little risk of major illness, but they do consume health care. A recent analysis by the New America Foundation, a Washington policy group, found that 16 percent of the patients who received uncompensated medical care in 2004 had family incomes of at least four times the federal poverty level (which would currently be $41,600 for an individual and $84,800 for a family of four).
They accounted for $5.8 billion of the estimated $41.4 billion in uncompensated care that year.
However, what was not discussed was the ounce of prevention and the pounds paid for a hopeful cure. Ms. Coons might have been me years ago. She may not have stated or contemplated an illness, or unexpected injury. I too appeared fit. An interviewer might have seen me on the way to the pool. He may inquire of my Health Insurance plan, or lack there of. I, possibly would not have explained that I severely injured my back long ago, and then, due to the damage lost my job. At the time, my employer feared medical charges I might incur, and now I must swim daily to remain physically stable.
In embarrassment, in my youth, I could have, would have, given a glib response. For decades, I did not wish to speak with strangers of the bulimia I battled. The preexisting condition that I paid for dearly, helped to affirm medical coverage was not available to me.
I know not of Ms. Coons. I can only speak for myself. Bulimia or other “disorders” do not burden my life today. I do not imbibe any alcoholic beverages. I never did. Drugs do not deliver me from depression or dismay. Prescription and street fare were not my medications of choice. I have no addictions to strain my budget. I am but one of millions who scrimps, wishes to save, finds it futile, and fears the veracity.
[T]here is also a shift to the privately insured. Hospitals and doctors raise their fees to compensate for the losses they incur by treating uninsured and underinsured patients, and insurers pass those increases along to consumers. A 2005 study found that the shift added 8.5 percent to the average premium.
Presidential aspirants, please ponder what the pundits have not. Numbers on paper may look lovely. Economists can scribble statistics on scratch paper. Power Point presentations can graph the details in glorious color. Experts can pen impressive essays, and America trusts that you, the candidates can eloquently deliver the text. Yet, as you may know . . .
Neither campaign has provided enough detail about its plan to enable more than guesswork about how it might influence consumers . . . They have not detailed what kind of subsidies would be needed or who would be entitled to them. Mrs. Clinton has not fully explained how she would make everyone comply with her plan or exactly how she would cap the amount a family would have to spend on premiums.
Each candidate would raise the money needed to subsidize premiums by rolling back President Bush’s tax cuts for high earners, taxing businesses that do not insure their workers and reducing costs through electronic record keeping, preventive medicine and chronic disease management.
But there is little certainty about how much those initiatives might save, or when. . . . There are also questions about whether the new savings and tax increases would be enough to subsidize insurance for all who need help.
Both candidates are backed by teams of prominent economists from top universities and policy groups. But with little real-world precedent to guide them, their assessments are necessarily an amalgam of statistical modeling and back-of-the-envelope calculation.
“In a campaign, people put out proposals that aren’t highly specified, that don’t have enough detail to model them effectively,” said E. Richard Brown, director of the Center for Health Policy Research at the University of California, Los Angeles, and an Obama adviser. “These numbers are based on a lot of assumptions.”
In speeches, debates and dueling advertisements, Mrs. Clinton and Mr. Obama have brandished projections that even their originators acknowledge are tenuous.
Senators Clinton and Obama, when your own authoritative advisors admit the claims are unsubstantiated, formulas are fragile, and the numbers are shaky, there is reason for concern. Stalwart as you each may be, this character trait may not be a strength in times such as these. Lives are at stake. Illness and injuries occur in every moment. Accidents are not preventable. People bleed as the two of you argue over the specifics of inadequate agendas.
If you truly wish to insure every American, be honest with yourselves and us [the citizens of the United States]. The only genuine Universal Health Care Plan is a Single Payer, Not For Profit program.
Your passionate pleas, your tears, and talk do not comfort a citizenry or a system sick and in dire need of help. Please, feel our pain and protect us. We, the people need a President that cares. Provide the preventive, practical, and profound programs. Do not continue to play with language. We the people languish, as either of you smile and say, “My plan provides Universal Health Insurance.” I could just cry, but I worry. What if I were to weep endlessly? Dehydration might send me to the hospital. I cannot afford to see a physician, let alone the premiums you [plural] wish to charge me.
Universal Woes; Wounds, Worry, and the Source of Scars . . .
- pdf The Democratic Debate in Cleveland. The New York Times. February 27, 2008
- 2 Plans and Many Questions on the Uninsured, By Kevin Sack. The New York Times. February 23, 2008
- pdf 2 Plans and Many Questions on the Uninsured, By Kevin Sack. The New York Times. February 23, 2008
- Employers Winning Wide Leeway to Cut Medical Insurance Benefits, By Milt Freudenheinm. The New York Times. March 29, 1992
- Testimony. Chairman Ben S. Bernanke, Semiannual Monetary Policy Report to the Congress. Before the Committee on Financial Services, U.S. House of Representatives. February 27, 2008
- Harvard study finds medical bills push many into bankruptcy. Harvard Law School. February 3, 3005
- Medical bills make up half of bankruptcies. Associated Press. MSNBC News. February 2, 2005