Health care insurers

Insurance

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.

Town hall

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

Recently I attended a town hall here in Saint George to meet my newly elected US Representative Chris Stewart. Chris is a retired USAF pilot and a best-selling author and a member of the GOP. He represents the 2nd district in Utah which is geographically the largest of our four districts, stretching 320 miles from Saint George to Chris’s home in Farmington, north of Salt Lake City. Chris lives farther away from Saint George than do our two Senators, Orrin Hatch in Salt Lake City and Mike Lee in Alpine, a Salt Lake City suburb. I believe that Congressional districts should be compact and competitive so that my vote can make a difference. Only the 4th district is both compact and somewhat competitive, and it is now represented by Jim Matheson who was my representative in Congress before the 2010 census and subsequent redistricting.

I attended the town hall to see how many attended and the strength of the defund Obamacare movement. There were between 600 and 700 attendees, mostly elderly because of the 5:30 pm timing and all were white. They gave raucous support to defunding Obamacare. Chris stated his strategy was to defund or delay. Chris spoke for a short time before opening the floor to questions. He asked for short, focused questions, but most were long and rambling. Chris said that the sequester was a terrible law, but that he voted for it. As an excuse, he stated that the sequester was President Obama’s idea. That is false. In addition, if it were Obama’s idea, the GOP would not have voted for it, since they oppose the President at all costs.

I really do not understand the logic of opposing Obamacare (the Affordable Care Act) by the vast majority of the attendees at the town hall. I assume the majority are on Medicare and will scarcely be affected by Obamacare at all. Perhaps more people are on Medicare Advantage than I thought. When I turned 65 and was eligible for Medicare, I investigated the choices and selected Medicare over Medicare Advantage because I was convinced that Medicare Advantage was a GOP plot to wean seniors from Medicare and then terminate Medicare and voucherize Medicare Advantage. Medicare Advantage costs the government more than Medicare and will be restructured under Obamacare to help fund extending insurance to 30 million of the uninsured.

US national debt

English:

English: (Photo credit: Wikipedia)

If we pay payroll taxes for 30 or 40 or 50 years as I did, then an individual is entitled to expect that the government lives up it its promises and provides adequate Social Security and Medicare benefits. If lenders lend money to the US government to fund the US national debt as wealthy citizens here in the US and around the world together with some governments have done, then they are entitled to expect repayment with interest in the future. Thus it is possible to look at all government expenditures as an entitlement of some sort. One principal difference among the various forms of entitlement is whether the funding is voluntary or forced through taxation. Another principal difference and one that is often overlooked is who are the beneficiaries of government entitlements? In the case of Social Security and Medicare, the beneficiaries are the 99%. The 1% pay payroll taxes too, but they are wealthy enough to pay for their own retirement and health care, most of us are not. The beneficiaries of the national debt being repaid are the 1%, wealthy individuals here in the US and around the world and some governments.

As I see it, some in government are willing to reduce some entitlements if the beneficiaries are the poor and middle class, while entitlements for the 1% must not be touched. Looked at that way, the GOP willingness to reduce Social Security and Medicare while preserving those entitlements of the wealthy 1% make perfect sense.

If

Ron Paul, member of the United States House of...

Ron Paul, member of the United States House of Representatives from Texas. (Photo credit: Wikipedia)

If I lost my home due to fire, earthquake, flood, hurricane or tornado, and the insurance company refused to reimburse me or went bankrupt due to a large number of claims, I would be homeless.

If Congress reduced my Social Security payments below the rate of inflation and cut Medicare payments and I did not save enough for retirement, I would live my golden years in poverty.

If I suffered a major accident or acquired a life-threatening illness and my insurer refused to cover the necessary treatment, I would live on with pain or die early.

If I subscribed to the above, I would support Ron Paul and the GOP. However, I do not subscribe to those views and therefore I support Barack Obama.