Health (un)insurance

I saw today X4mr has joined the ranks of the uninsured, those 45 million Americans who are rolling the dice and hoping nothing goes seriously wrong with their health. He seems optimistic that situation will be remedied in the near future, and I hope it is. Unfortunately, most Americans who share his fate don't have the same prospects for regaining health insurance.

It's worth noting x4mr is most emphatically not some lower-class, poor, uneducated working schmo. Read his blog, look at his profile ... this is a bright, educated individual who was, until recently, gainfully employed, and I expect will be again shortly. Still, even he can't, for whatever reason, afford health insurance in the interim.

Michael Moore, famous or infamous depending on where you stand on the political spectrum, has a new documentary out examining the US health industry, and comparing it to the way health insurance works in other countries. It's not likely to surprise anyone that the US market-based, privatized approach comes off second-best. The US is the only major western industrial power without national health insurance, and "Sicko" will definitely leave viewers asking themselves exactly why that is.

The management consulting firm McKinsey put together a very detailed report (free registration may be required) laying out the various costs and inefficiencies in the US system which cause it to be, by a vast margin, the most expensive in the world while not providing better general health care by any measurable standard. Yes, it's true if you are a billionaire and money is no object, the best health care available anywhere in the world can be found here. If, however, you are among the majority who actually have to worry about money, that simply isn't the case, as, for example, infant mortality rates and average life expectancy and even average population height can attest.

McKinsey noted the US system results, among other extra expenses, in $98 billion additional administration costs when compared to an average system. Some of those costs are necessary, certainly, but some of them are extraneous in a national health-care system. Costs for marketing, for screening prospective participants, for finding reasons to deny claims, all become unnecessary if our priority switches from profit-based to public-welfare-based. As a comparison, McKinsey estimates it would "only" cost $77 billion to cover all uninsured Americans in a national system.

None of this is new, of course -- many of these same issues were relevant when we last had a national discussion about national health, more than a decade ago now with the failed Clinton bill. What may finally push this over the top so something is actually done could be a coalition of business lobbies standing up to the insurance and pharmaceutical industry lobbyists. Sad, but true ... it seems nothing gets done these days because it's actually the right thing to do, but rather because one army of lobbyists manages to kick the butt of another army of lobbyists.

Soaring health insurance costs are becoming an increasing burden on companies and corporations. Starbucks famously announced two years ago it was spending more on health insurance than on actual goods needed for it's stores. Things have only become worse in the interim, and other companies are feeling the pain. A more recent study found health insurance is the fastest growing cost for employers, and will overtake profits by next year. This can't be sustained.

This country has a historical faith in markets, and markets work well if your primary purpose is to maximize profits. However, sometimes profit-making should not be the primary raison d'etre for an institution's existence, and national health care is on that list. Our health insurance system is sick. It's time to turn the table, deny it coverage and let it die, while the rest of us work toward something better.