The Fundamental Case for Universal Healthcare Reform: Part Two the Case for Healthcare Security

One overlooked aspect of our disastrous healthcare system is the inherent lack of healthcare security which is a major destabilizing element in millions of Americans lives.  Healthcare insecurity is not just the obvious concern of over 47,000,000 Americans, to the contrary Americans with healthcare insurance, especially the under insured often discover that the coverage they thought they had could evaporate at any time.This healthcare insecurity leads is a major stressor in millions of Americans lives and many healthcare insecurities can be alliviated with relatively simple legislation.

The biggest threat to a private insurance policy holder is finding out they are not covered when a major illness occurs.  The horror stories are almost innumerable where thousand and thousands of Americans who thought they had proper healthcare insurance find out their treatment, testing, prescriptions or medical devices were not covered under their plan.

There are 10 basic reasons to justify healthcare security

1. Your private healthcare coverage can be dropped at anytime in most states for almost any reason.

If you have individual coverage or are a small business employer or employee you can lose your coverage at any time for any reason in almost every state.  Because individuals or small groups are not very important to private healthcare insurance corporations on a case by case basis they pay the highest rates and have the least level of healthcare security.  Larger businesses have more clout but they too can be dropped by private healthcare insurers once a year when most healthcare contracts expire.  All the major bills under consideration in Congress will correct this fundamental healthcare security problem in our current healthcare insurance system via creation of healthcare insurance exchanges with a public plan included.

2. When you get a major illness they can and often do drop your private healthcare coverage.

Again those with individual coverage or own or work for small businesses this is absolutely true.   Most people who have coverage say they are satisfied with their coverage but most of them who say that do not need coverage for a major illness at the current time.  People that have major illnesses are seldom happy with their coverage which is a major result of healthcare insecurity.  Again in all major plans that have passed committee so far in Congress have address this concern and no one can be dropped because they become a victim of major illness in healthcare insurance exchanges.

3. When you lose your job you lose your private healthcare after COBRA is over.

This is perhaps the greatest healthcare insecurity that exists in the employer/employee based system we have today since the majority of healthcare coverage is tied to people’s employment.  One of the biggest reasons people do not change jobs is because they are afraid to lose the healthcare coverage that they have.  A major obstacle to starting or working for a small business is risking healthcare security.  Often small businesses cannot afford coverage for themselves or their employees because their healthcare insurance premiums are much higher than corporate group premiums.  In fact healthcare premiums are so high that only 3o% of small businesses offer healthcare coverage. Since small businesses generate more jobs than big business these realities lead to the every rising numbers of people who become uninsured.  It may sound like a skipping CD by now but the healthcare insurance exchanges will eliminate this healthcare security fiasco.

4. When you change jobs you probably need to change your healthcare insurance plan.

This healthcare insecurity is always true if you change jobs and move to another state but often happens even when you change jobs in your own state.  One of the huge benefits of the current healthcare bills in congress are that with the formation of healthcare exchanges, coverage will be portable.  Formation of a public plan would add that much more healthcare stability because you can literally have the same healthcare cover for life which is the penultimate healthcare security.  One of the main reason people who have Medicare and VA care would never want private insurance to be their primary insurance is due to the inherit security in public healthcare.  The creation of healthcare insurance exchanges will eliminate this concern because coverage will be portable, especially with a public plan.

5. Even if you have private healthcare coverage they refuse coverage or do not reimburse you.

The horror stories in our current private healthcare system have almost become an integral part of Americana these days.  They usually start like this, someone that has paid their private healthcare insurance premiums all their lives suddenly faces a major illness for the first time in their lives.  Then they find out they are not covered for one manufactured reason or another even though they have been true to their part of the bargain all those years.  Since statistics are difficult to find on how many claims are denied by private insurance one of the best sources to get anecdotal evidence about denial of healthcare coverage is the White House’s “Health Care Stories for America”.  Just browsing a few pages shows how callous and greedy private insurers are.  There is simply an inherent conflict of interests between paying off claims for major illneses and generating mazimum profits in a private healthcare system.  According to the major healthcare reform bills passed through committee in Congress so far treatment of any bona fide medical illness or injury will not be refused.  Furthermore there will be no ceilings on how much coverage individuals are eligible for in the various pieces legislation.  However since almost any illness entails a variety of treatment options some treatments will be favored over others and the cost of equivalent treatments will be a factor in deciding which treatment is covered by even a public healthcare insurance.

6. You cannot get private healthcare coverage if you have a preexisting condition.

This healthcare insecurity is completely true for individuals and small businesses who are seeking healthcare coverage.  When private heathcare insurance can this enables them to cherry pick clients to maximize their profits and is one of the inherent reason why private insurers cannot be relied upon to be the main pillar of our healthcare system.  This healthcare insecurity is one of the man driving factors for universal healthcare reform and is again eliminated in every major congressional healthcare bill being evaluated by way of establishing healthcare insurance exchanges which will act like massive group plans.  On a personal note, this is the primary reason why I cannot get healthcare insurance with my health history.

7. Healthcare insecurity is linked directly to individual, private and public financial insecurity.

One major healthcare crisis can lead to financial disaster for the vast majority of Americans leading to the greatest financial insecurity in our country.  62% of bankruptcies are attributable to medical bills and 75% of all bankruptcies have medical bills included in them.  Furthermore, 78% of filers had health insurance.  This does not even account for people like myself who did not have to go bankrupt but who lost our entire retirement and savings to pay for medical bills due to major illnesses and had insurance.  Moreover there is absolutely no doubt that the nation including many businesses will go bankrupt if healthcare costs are not contained.  Financial security for all is one of the main justifications of why we need a public plan to compete with private insurance to drive costs down.  So far the public option is in tact we must keep pushing for it to be in the final bill.

8. The number of uninsured Americans has jumped from 47,000,000 to over 52,000,000 since the recession started in Dec 2007.

There is simply ZERO healthcare security for tens of millions of uninsured Americans whose only access to our healthcare is through our limited means or through the ER.  Nothing makes people feel more insecure about their lives than not having proper healthcare coverage.  I can unequivocally say this from personal experience.  On a scale of 1 to 10, fear of terrorism or WMD does not even register when you have no healthcare coverage while being unisured is a 100.  All the major healthcare bills in Congress address this primary source of healthcare insecurity but probably not quickly enough or comprehensively enough.  Mandates in the healthcare bills are crucial to end this healthcare insecurity because after all universal healthcare is an oxymoron without mandates.

9. Healthcare insurance costs have double in eight years and are rising three times the rate of wages.

Again this is a financial insecurity as it relates to our healthcare system but it runs much deeper than that if you examine the way skyrocketing healthcare costs have eroded American prosperity for at least a decade and will continue to add to economic insecurity.  Middle and working class wages have flat lined for over eight years even when the economy grew at times, however due to the Bush tax cuts the rich have been getting richer over the same period until the financial collapse.  One of the main reasons wage growth is flat and this point cannot be underestimated is because the salary increases Americans have earned are going to pay for healthcare benefits.  Let me repeat middle and working class salary increases are going to private healthcare instead of working Americans.  I often debate with conservatives that if tax rates increased at the rate that healthcare costs have increased over 20 years now conservatives would start Civil War II.   Rising healthcare costs are taxing businesses as well because while they can pass some of their costs onto employees via higher premiums their costs go up drastically as well.  This makes American businesses much less competitive in the global marketplace.  Financial security is the main reason the public option needs to be available to compete with private healthcare insurance to drive costs down.  So far all the bills passed in congress include a public option.

10.  The most horrible effect and direct consequence of our lack of healthcare security in this country are the lives lost because of our terrible healthcare system.

Some studies indicate that about 20,000 lives are lost in this country each year because of inadequate healthcare.  The reason the uninsured and even the under insured and insured do not go to their doctors soon enough to diagnose major diseases even when they feel symptoms of their illnesses for years in many cases is because they fear how much treatment will cost.  Even though an ER cannot refuse to treat you if you are ill the millions of Americans that rely on the ER for their healthcare coverage cannot afford there ER bills so they hesitate to get treatment until it is too late.  The universal healthcare bills in congress are comprehensive and will cover 97% of Americans eventually but people need to remain vigilant even after legislation is passed to make sure it lives up to it’s promises.

One study claims our lack of healthcare insecurity is even more disturbing:

“France best, US worst in preventable death ranking

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.

Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine tracked deaths that they deemed could have been prevented by access to timely and effective health care, and ranked nations on how they did.

They called such deaths an important way to gauge the performance of a country’s health care system.

Nolte said the large number of Americans who lack any type of health insurance — about 47 million people in a country of about 300 million, according to U.S. government estimates — probably was a key factor in the poor showing of the United States compared to other industrialized nations in the study.

“I wouldn’t say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don’t, I think that’s the main problem, isn’t it?” Nolte said in a telephone interview.””

Ironically one of the difficulties in advocating for universal healthcare reform is that there are so many compelling reasons to substantially change our disastrous healthcare system and the messages get too complicated for the public to digest.   Healthcare security should be a main theme to promote healthcare reform because it affects the insured and uninsured and is a simple message to convey.

The best way to alleviate these healthcare insecurities is to create portable healthcare insurance exchanges which include a robust public option to most effectively drive down ballooning healthcare costs.  If the dreaded co-ops passes congress and are added to these exchanges instead of a true public plan many of these healthcare security problems will be eliminated however co-ops will not address the fundamental problem of financial security since they will not lower costs enough.  Make no mistake if co-ops are adopted the resulting legislation will be much closer to comprehensive private healthcare insurance reform rather than universal healthcare reform.