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Dick Gephardt in 2004 and John Edwards now still want employers to be the major venues through which Americans get health insurance. The proposals that are offered by many candidates concentrate on supplementing this main venue.
A disclaimer. I am not an employer, never been one, nor is my spouse. Never even been a self employed one. However 8 years ago, during yet another change of jobs and facing a very expensive COBRA payment I decided to pay for my own. Yes, it is expensive and is getting more so every year. But at least I figured that I would get one while still healthy and relatively young (everything is relative) with the hope that if I do develop a major health problem that I will be in and will not be terminated.. though one can never know..
We have to remember that employers who pay for health insurance call the shots. They are the one who change carriers whenever they see fit; they are the one that carry - if they choose - a copy of the health history that every employee has to fill when joining the program. They are the ones who get a report of which employee sees which provider. No, not the details of the visit but if a female member of the family visited an OBGYN who is known to be the only one in the area to still perform abortions... if a family member sees an oncologist..
This may be me: I like to keep my privacy. I don't think that it is anyone's business if I develop a devastating disease. Perhaps I will tell my boss, but I would like to determine when and where. Perhaps it is an age differences with so many today expose all on Oprah, or on MySpace and other public places...
I also think that when employers pay for health care they use this as an excuse to cut on wages. I'd rather be paid for what my work is worth and let me seek the best health insurance for me at this time of my life.
Some 10 years ago Congress came with the portability law where if you are covered and change jobs you cannot be denied a new coverage. However, I think that pre-existing conditions still kick in so we still have the unhealthy situations where people stay in jobs that they hate, or that they have long lost any fit just because they need the medical coverage. And I think that I've seen comments about this even here on DU.
We have to remember that employer provided "benefits" came after WWII when there was a wage freeze.
And I have to wonder how much of health care costs have enjoyed a free ride upward all those years since most of us do not pay directly. Yes, our premiums are going up but do we know the real cost? Can we negotiate, seek the best deal for ourselves? And how many of us actually see a doctor's or a hospital's bill? Most of us pay the office visit, or the deductible and let the insurance take care of the rest.
We trust the market economy for all of our other purchases to lower prices based on changes in consumer demand. Why not for health care? No, when we are having a heart attack we are not going to search for the best ER or a cardiologist; we will do this when shopping for our health insurance. And if we were real consumers we may stay away from those insurance companies who give obscene compensations to their CEOS, or who are even traded on the stock market. And we will demand that our representatives look at the spiraling increase cost of health care - if we think that something is not right there. We may even move to a system where our payments go to the ones who actually provide health care, not the ones shuffling papers and making sure that they keep costs down (meaning denying coverage).
To go back to my first comment. All the proposals are aimed at helping the ones who are not covered by the "preferred" program - employers. And this is why many realize that universal health program will be soundly rejected, we even see this here, on DU. Most Americans who are covered by their employers and are the most active in politics like what they have. Or if they are currently unemployed, liked what they used to have.
But if we are responsible for our own coverage, perhaps we will eventually settle on some type of a hybrid program where we pay taxes for a universal care but that leave us to go "private" if we so desire. I have often compared such an approach to our school systems. All of us support public schools with our taxes - whether we use them or not. However individuals are free to send their kids to private schools, and to pay for them.
Oh, one last point. About 30 years ago Congress decided to encourage Americans to provide for their own retirement and established the IRA (traditional) where payments were deducted from their gross income.
I think that something similar needs to be done with payment for health insurance. Instead of letting health care cost that exceeds 7.5% of income to be an itemized deductions, payments for health insurance, at least, should be an income adjusting item. No doubt, Congress has the means to calculate the loss of revenue from these adjustments and compare them to the cost of treating uninsured people in the ERs.
I would appreciate DUers input. I supported Edwards in 2004 but now am not sure, precisely for the main pillar of his platform - forcing employers to pay for health coverage.
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