I love America; to an extent. Sometimes we, not only as Americans but as people, tend to let certain ideologies and categorical beliefs direct our judgment. As of lately, there seems to be one such area where everyone seems to have a strong dissenting opinion, and I am not talking about who is to blame in the Jon and Kate Plus Hate fiasco or “why are those people in the Snuggie commercials wearing their robes backwards,” hence my conditional love of our country. No, that center-ring star of the national circus would be public health care. I have heard and participated in many debates, both of sound mind and body and those of more sound, less mind (drunk), where both sides assessed the merit of a public health care system.
And what did all of those conversations have in common? They were all pointless.
No one ever wins when it comes to these debates and we always just walk away thinking about how big of an idiot that other person is. So I decided to try and figure out a way to convey my opinion of a public health care system in the most productive way possible. My first thought was that I could write portions of MY IDEAS IN ALL CAPITAL LETTERS, AS TO CONVEY A SENSE OF THREAT AND URGENCEY. As enticing as it would be to write while completely ignoring any literary conventions and general intelligence, that would be just too folksy for me. My next possible avenue was that of extreme conservatism. I could roll up on my adversaries’ place of business and just forcibly tea-bag my opinion down their throat. That method, although enjoyable and making for good television, would just get messy. My third option was that of the liberal route. I could be painfully meticulous and boringly informative in the explanation of my opinions, and at the first sign of political opposition I could fold up like a Prius in a head on collision – also no.
With potential teaching methods exhausted, I thought to myself, “What would Tom Emanski do?” It was simple. Since I do not personally know the Crime Dog, I had to return to teaching fundamentals myself.
When offering simple advice like “be careful before you cross the street,” you do so assuming that the person doing the crossing knows that getting hit by a car is painful. Otherwise by not knowing, said person sees no possible harm from the cars and your advice comes off as just hollow and preachy. So, like learning the simple knowledge of getting hit by a car hurts, I will go back to insurance basics for my reasoning why public heath insurance is actually a benefit to you.
To begin our return to the basics of insurance, we shall begin our quest for knowledge like anyone generally does these days: by looking up “insurance” on Wikipedia. Now I know using Wikipedia is not the most scientific and sound research engine, but it’s the most common. Wikipedia states that insurance “in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed and known small loss to prevent a large, possibly devastating loss (“Insurance”).” So in a nut shell, insurance is all about managing risks.
The earliest known uses of insurance can be traced all the way back to early Chinese farmers and Babylonian traders. These people would send their goods to market in group of ships or vessels. The idea was that if something happened to one of your ships, you still had the others left to sell. Your risk was spread out among the many, as opposed to the potential crippling loss of transporting with one. Various forms of insurance and risk management groups evolved and grew throughout many civilizations as time passed. In modern times, you become part of the insurance group by paying your insurer their required premium. This small premium is then combined with the other members of your insurance group’s premiums into a larger insurance pool. The size of this pool is what affects the premium you pay and the overall effectiveness of the insurance.
The larger the insurance pool, the lower your individual premium. This is in the case of when the insurer is trying to offer you the fairest price possible, as opposed to maximizing profit. You also assume that not all members of the group will need to collect on their policies at once, which would cause any insurance to fail. Since I do not expect you to take my word for it, I will give you some examples of how this would come into play. I found an article by Gerri Willis on CNN Money that gave a good example of how the size of an insurance group can affect your premium (Willis, Gerri). The article compares a small company with that of lets say 10 employees to that of around one thousand – and I will add that we will assume similar sample demographics. In a company with ten employees currently enrolled in your group health care, a few people incurring large health bills will greatly reduce your insurance pool and will most definitely increase your premiums. With the larger one thousand employee pool and lets say 40 people running up large health care costs, there will be no change in the cost of your premium as the costs are distributed throughout the larger group. This is the simple reason for supporting a public health care program.
In the previous example, smaller numbers were used to make it easier to grasp. With a public health care option, your insurance pool will see a drastic increase in size. Let us say you are, like me (yes, I am insured), a member of Highmark Blue Cross Blue Shield of Pennsylvania. Their website lists membership in their health care programs is 4.6 million (“Corporate Profile”). Now with a national health care system your membership would jump to around 308 million. I do not have any numbers to relate what this could do for your potential decrease in your individual pay requirement, but I am going go out on a limb and say that it is probably going to go down when your risk pool is about 67 times larger. You are probably thinking that not all of those 308 million will be paying members, and you are right. Subsidies withstanding, even if only a fifth of those pay into the plan, that would still leave your group at a contributing 61.6 million members. So in our return to insurance fundamentals, which by our previously established definition is basically risk management, a national health care system should be supported for its ability to greatly distribute risk and reduce your individual premium.
There you have it, my simple apolitical reasoning behind supporting public health, “it’s just science” of risk.
So far, I have been examining health care on a large scale, now I will narrow the scope. Writing an article about a national health care system really couldn’t be done without at least touching on current health care providers. Many people claim to be happy with their current health care provider, but most of these people who champion their current health insurance are in fact healthy. This raises the question of what happens when you become sick. An article from CNN points out that in a survey of those who filed for bankruptcy in 2007, 62.1% of those had to do so as a consequence of medical bills and medically related issues (Tamkins, Theresa). The more interesting fact is that of those who went bankrupt due to medical bills, 78% of them had health insurance. So, is your current health care provider really a warmer of the human heart? Most likely not.
This October, a mailer campaign by the Blue Cross Blue Shield of North Carolina garnered a lot of attention for its proposed “customer concern.” The letter asks that people campaign their local lawmakers to oppose the public health care option (Avery, Sarah). I can understand their concern. How can they be expected to pay their top executives like Dr. Kenneth R. Melani of Highmark Blue Cross Blue Shield of western PA, who earned $3.2 million in 2007 (McCoy, Craig R. and Von Bergen, James M. page 1), when a public health care option would increase competition and lower individual costs. Melani’s salary rose from less than $1.7 million in 2004 to the $3.2 million in 2007 (Snowbeck, Christopher), a pay increase of 88%. That must of meant that the insurance group was doing fantastic and we were rewarded with a huge drop in premiums too – ah, no. But I am sure Highmark is already running their company at maximum efficiency and the government is just trying to bully them around. I feel for you BCBS. I really do, but I also think I will be better off under a national health care system. I am not the only person who would feel better under a national health care plan, just ask a guy who is ridiculously smarter than any of us. In reference to the United Kingdom’s National Health Service, Stephen Hawking said “I wouldn’t be here today if it were not for the NHS.” Also saying, “I have received a large amount of high quality treatment without which I would not have survived” (Ellicott, Clare). But then again, health care is probably way too complicated for Stephen Hawking to understand.
Another favorite argument of people against the passing of a national health care system is the old “I don’t want my money paying for other peoples health care.” I can understand that. I would also rather have my money going to my own personal gain. But the problem with that statement is that you are already indirectly paying for a large portion of the general public’s health care bills. The Centers for Medicare and Medicaid Services’ 2008 summary of Medicare and Medicaid states that in 2006 government programs like Medicare, Medicaid, and the State Children’s Health Insurance Program accounted for $718 billion in spending, or more than one-third the country’s total health expenditures for that year (Office of the Actuary page 4). There was also an additional $252 billion in spending for other public health care sectors that year. This means that about 45% of that year’s national health care expenditures where from public funding. So, not only are you already paying for you own health insurance, but are also indirectly helping pay for about 1 out of every 2 others. You might as well just pay for the one larger national insurance program and reap the rewards of a reduced premium. Does this mean our current congressional attempts at public health care reform will be a fiscal saving grace for all American citizens? They probably won’t, but not from their lack of potential.
A public health care program has the possibility to benefit all Americans, but its potential could be limited by bipartisan lobotomies. Our current stumbling block to any meaningful reform or progress seems to stem from our desire to faction and oppose based purely on political party. Don’t get me wrong, I like to “jabber-jaw and go tit-for-tat” as much as the next guy, but that doesn’t mean you always have to take an idea with prospect and make it a bad one for the sake of bipartisanship.
For an example of what I mean, I will be describing a situation where a group of employees is deciding on what to make for there cook off fundraiser. The overwhelming majority of the employees decide that it would be a good idea to make apple pies, and the minority wants to serve raw onions. Of course no one will buy white bitter onions, making apple pies the clear decision. But upon defeat, the onioners decide to make work unbearable and just harass everyone with an opposing opinion. You probably think these onioners would just get fired, but for the sake of this example these are not real people, they are congressman. Now as a result of all this conflict, the senior member of the Bake-off caucus decides that it would be in the best interest of the organization to create a bipartisan resolution. He proposes that they will sell apple with onion pie, which the onioners gratefully approve. The apple pie-ers see this as a deformed mutation of what was their once good idea, which is now coupled with a bad one. The apple pie-ers seek clarification from the Bake-off leader who responds, “My decision was made in the vein of preserving peace and bipartisan reform, and now everyone gets to feel like their idea was part of the solution.” The apple pie-ers retort, “You have taken our delicious idea and doomed it to disappointment by making it taste awful.” The leader responds, “Actually, I think it tastes like democracy.” In a final defiance the apple pie-ers reply, “Really, because we think it tastes like failure.” Now in my fictional example, much like in real life, a good idea was weighed down by an equally bad one in the hopes of maintaining political civility. As you can see, when someone proposes an idea that can lead to beneficial reform, like public health care, it is unwise to oppose it on grounds of party affiliation.
There is the apocalyptic belief that after passing a public health care bill, we will all be reading the special edition of Marxism Hot 100: The Commies That Really Turn You Red, as we wait for seven hours to receive the kind of substandard health care that even a third-worlder wouldn’t subject their pet goat too. There is also the parallel universe where this new health care reform will be so successful that even the conservatives will sing its praise, and consequently Glenn Beck’s head will implode like a dying neutron star under the pressure of its own density. Now are these just prophetic extremes or do we need to call the O’Connell brothers so they can slide in and quantum mechanically engineer us some solutions? In those two cases, I would say that its highly unlikely, and only if we’re lucky. But that is where the beauty of the American governing system, and a reason for me to love America, comes into play. When something we create is not working for a majority of the people we can evolve or amend it, we do not have to adhere to a single cultural code or religious belief system when making our laws, thank god. To wrap it up, by just looking at the basic defining principle behind why you would insure against anything, a national health care system makes perfect sense. You are now greatly reducing your risk by increasing the distribution. I think as long as we return to the fundamentals of insurance, much like learning about the dangers of being hit by a car, we can all cross the road to a healthier tomorrow.
Avery, Sarah. “BCBS plea to customers on reform hits a nerve.” Newsobserver.com. October 28, 2009. November 12, 2009.
“Corporate Profile.” Highmark. November 12, 2009. https://www.highmark.com/ hmk2/about/corpprofile/index.shtml
Ellicott, Clare. “’I owe my life to the NHS’: Stephen Hawking tells US to stop attacking health service.” Mail Online. August 13, 2009. November 12, 2009
“Insurance.” Wikipedia. November 12, 2009. .
McCoy, Craig R. and Von Bergen, James M. “Top salaries key to approval of Blues merger.” The Philadelphia Enquirer. December 2, 2007. November 12, 2009.
Office of the Actuary. Centers for Medicare & Medicaid Services. Department of Health and Human Services. “Brief Summaries of Medicare and Medicaid.” November 1, 2008. November 12, 209.
Snowbeck, Christopher. “Bonuses boost compensation of 10 Highmark executives.” Post-gazette.com. March 17, 2006. November 12, 2009.
Tamkins, Theresa. “Medical bills prompt more than 60 percent of U.S. bankruptcies.” CNNHeatlh.com. June 5, 2009. November 12, 2009.
Willis, Gerri. “How does group health insurance work?” CNNMoney. October 26, 2009. November 12, 2009.