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Sunday, December 13, 2009

Health Insurance Debate, Part 2

From a story in today's Oregonian by Ezra Klein of The Washington Post:
"In 2009, the average employer-sponsored health-care plan cost a bit less that $13,500. ... Employers generally pay more than 70% of their employee's health-care costs."
There are roughly 300 million people in this country. If one third of them (100 million) have jobs that provide health insurance, that comes to 1.3 Trillion Dollars a year. How would like to be able to stick your fingers into that cash flow? You probably wouldn't even have to actually touch it. Just getting near enough to catch some of the spray would cover you with more money than you would know what to do with. No wonder there is a big fight going on over this whole health care business.

$13,500 a year is over a $1,000 a month. Minimum wage jobs (outside of Oregon) don't even pay that much. ($6 an hour times 40 hours a week times 4 weeks a month comes to $960.) So if you were to get a minimum wage job with health-care it should be worth just as much as a job that paid twice as much, but did not include health-care. I know if I was young and single and healthy which job I would choose.

For some time I've been kicking around the idea that health insurance should send an annual statement to their subscribers telling them just how much they paid the insurance company, how much their employer paid, and just how much the insurance company paid out on their behalf. I personally would like to see it, but I am kind of nerd that way. I could keep track of it myself: I get a statement from Blue Cross for every single transaction, but that would be a lot of work. The few times I have made an attempt at figuring it out, it came out about even. A lot went to the insurance company, but an approximately equal amount went out on our behalf. But that's just us.

Some people tried to get bills passed that would allow/force employers/insurance companies to issue benefit statements to all their employees, but according to the article:
"Both were stymied by an odd-bedfellows alliance of employers and unions."
One problem we have is with uninsured healthy people, (gangsters, I'm looking at you) people who don't think they need health insurance. Well, nobody needs it when they are healthy, but things happen, and something might happen to you, and then where would you be? In the charity ward, sucking up tax dollars, because we as a society don't believe in letting people just die on the street. We have to pick them and put them in a hospital bed, and if they don't get perfectly good care, the hospital is leaving itself open to a lawsuit from someone who might not even have paid their bill.

Even if nothing bad happens to you like getting shot or run over by a car, life still happens, people get married and have kids. Deliveries go bad, kids get sick, fall down, break bones. If we charged families by the amount of risk they present to the insurance company, their insurance premiums could be much higher than those for a single person. Their value to their employer would not necessarily be any higher than that of single person. If the employer was paying the premiums based on an individual's risk, they would be inclined to only hire single people. You got married? Sorry, have to let you go, your insurance costs too much.

Maybe that's the way it should be, but I don't think so. Let single people pay more than their share. They are going to get older, they are probably going to get married and have kids, they might have an accident, and eventually they will get old. I imagine the bigger half of the world goes through life without ever visiting a doctor. I suppose it might be possible even do that in this country. But we do have a safety net, whether you like it or not. It's part and parcel of who we are. So if you are going to be part of this society, you need to have health insurance, even if you never go to the doctor.

If you think the safety net should be folded up and put away, well, you've got your work cut out for you. Cthulhu might be your God. There might even be some places in the world where worshipping Cthulhu is the official state religion. You might want to try one.

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