Florida congressman Alan Grayson.

Florida congressman Alan Grayson. (Photo credit: Wikipedia)

We have Alan Grayson to thank for reading all the fine print in healthcare insurance plans and explaining their essence in two sentences.

“Don’t get sick. If you do, die quickly,” (or go bankrupt).

That is GOPcare in a nutshell. Obamacare is a step in the right direction. It is a COMPROMISE between what we have had, GOPcare, and what I believe is the ideal, Medicare for all. If the Affordable Care Act (Obamacare) is flawed, and it is, it is because it is a COMPROMISE, and compromises never satisfy everyone.

Supporters of GOPcare claim that we have the best healthcare system in the world, and I suppose we do if you can afford it. Most of us cannot. My wife was born and bred in Canada and her relatives still live there and are much more satisfied with the care they receive at little cost than we are with the care we receive at a much greater cost. Of course, they and we represent the low-end of the income scale. If we were a part of the 1% and could afford the best in healthcare, our reactions to Obamacare and Canadian medicine might be different.

Health care insurers


Insurance (Photo credit: Christopher S. Penn)

From The Predator State by James K. Galbraith:

“A successful private insurance company follows an ancient formula: it stratifies its clientele by risk class and charges premiums adapted to each class. The most successful companies are generally those that manage to exclude the riskiest clients.

“Public universal health insurance schemes like Medicare do not evaluate risk. Since they are universal, they do not need to. Therefore, they save the major cost of providing private health insurance. They pay their personnel at civil service salary scales and are under no obligation to return a dividend to shareholders or meet a target rate of return. Insurance in general is therefore intrinsically a service that the public sector can competently provide at a lower cost than the private sector, and from the standpoint of an entire population, selective private provision of health insurance is invariably inferior to universal public provision. Private health insurance companies would not exist except for their political capacity to forestall the creation of universal public systems, backed by their almost unlimited capacity to sow confusion among the general public over the basic economic facts.”

The trouble with insurance

Health Insurance Does Not Insure Health

Health Insurance Does Not Insure Health (Photo credit: SavaTheAggie)

The trouble with healthcare insurance is that you don’t know what needed care will cost. I don’t have dental insurance so my dentist can tell me in advance exactly what my needed care will cost. I believe that it is too expensive even with a discount for cash, but I know before I authorize treatment. With healthcare insurance, I don’t know.

Today I had my second visit to a dermatologist. Apparently Medicare plus a high plan secondary was sufficient to buy treatment without a co-pay, but I won’t know for months what my out-of-pocket costs are until the insurers send their statements/bills. This must change for consumers to make informed decisions. My wife and I am both postponing needed care because we fear costs not covered by insurance will overwhelm our limited budget.

GOP healthcare

English: US Citizens with Private Health Insur...

English: US Citizens with Private Health Insurance in %; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 Deutsch: US Einwohner mit privater Krankenversicherung in %; Daten nach U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

My wife and I shopped around a year ago for less expensive supplemental healthcare insurance as the GOP advise since they believe in competition. Today the insurer informed us that our monthly premiums are increasing 9.65% on September 1. The letter included the usual BS about how much they regret the necessity to increase premiums. My wife and I are both retired healthcare professionals who by necessity are following the GOP healthcare prescription of, “Don’t get sick. If you do, die quickly.” Much of the GOP plan is out of our hands.

Age 50

Cover of "In America"

Cover of In America

In America, life gets tough at age 50 for many people, especially if you lose your job. By age 50, many are entering their peak earning years and are planning to save for retirement. That is difficult to do if you are unemployed and can’t find a job that pays as well as the job you lost. Good paying jobs are disappearing in good times and are next to impossible to find during bad times like the present Great Recession. Employers seeking to cut costs have an incentive to replace highly paid older workers with younger workers who aren’t paid as much. Age discrimination is illegal, but poorly enforced. It is much more widely practiced that most people realize until it happens to you.

In addition, health problems start to appear around age 50. I spent the final 20 working years of my life working in hospitals and particularly hospital ERs. I noticed that patients started appearing at around age 50. To make that point, I started telling my co-workers that everyone comes from our Maker with a limited warranty on parts and labor that expires at age 50. Every day beyond age 50 is a blessing to be thankful for. Insurance companies noticed that fact too and charge higher premiums for health insurance for older workers. That represents a double whammy for the employer, paying higher wages and higher health insurance premiums for older workers. No wonder there are concerted efforts to push older workers out the door.

Now there is an effort in Washington to raise the age for Medicare and Social Security to 67 or higher. What do our politicians expect people to do to survive between age 50 and retirement at age 67, 68, 69 or 70? In a more perfect world, age discrimination would be penalized and an employer’s health care costs would be superseded by a single payer system. In a truly perfect world, people could retire at age 50 with full Social Security and Medicare benefits.