Health Insurance Answers Depend on What Question We Ask

This election season we have heard a lot about “health care reform” and “health insurance reform”. Senator Clinton and Senator Obama have been sparring over the issue most of the month. On the other side of the aisle, Senator McCain has also had to address the issue of health care. Everyone agrees we have a “problem” when it comes to health care and health insurance, but there are wildly varying opinions about what should be done.

We all know that almost 47 million Americans do not have health insurance, and that this number has risen every year since 2001. That’s roughly one out of every 6 people. That is a problem for our workforce because we have workers who may put off or simply not seek medical care, to say nothing of the increased havoc that an epidemic or pandemic might cause in the absence people seeking timely, affordable health care. This is also a problem economically because somebody has to pay the hospital bills when the uninsured become so sick they can no longer avoid the doctor, and because medical expenses are a leading cause of bankruptcy.

So an obvious question to ask is “Why don’t these 47 million people have health insurance?” And there’s a quick, easy, wrong answer: since we also all know that in the United States, most people who have health insurance get it through their employer, there must be a lot of employers who are not providing health insurance to their employees. There’s a germ of truth here: “As costs climb, the number of firms offering health insurance falls. The study found that while 98% of firms with more than 200 workers still provide some sort of employee health benefits, only 60% of smaller companies do.” So the obvious answer — endorsed by Clinton and Obama and Romney and Schwarzenegger to name just a few — is to mandate that your boss get you into a group health insurance plan.

What? Do I hear laughter? That must be from the 4.9% of you who are unemployed, and this is the first good laugh over health insurance you’ve had since getting that sick joke known as a COBRA notice. Or maybe you are one of the 20 million self-employed. Or maybe you are a child. After all, children don’t have employers.

So again the obvious but wrong answer is to mandate all these people obtain coverage for themselves. Oh, and for their children. But this ignores all the other possible answers to “Why don’t these 47 million Americans have health insurance?” If we start looking for other answers, we might hear about skyrocketing premiums for declining benefits; we might learn about people with pre-existing conditions and people who avoid medical tests for fear of uncovering one; we might meet people who had health insurance — until they actually got sick and needed it; we might be saddened to learn about people who died because a paperwork mistake meant they didn’t have the insurance they needed.

Sure, we could have some sort of pool where people who don’t have employer-provided health insurance could buy coverage. But almost none of the plans being circulated would do a thing to make insurance companies cover people who actually need health care at reasonable prices. Our candidates instead ask us to line up and make sure these for-profit insurance companies get their premiums every month.

Most Americans believe we need radical change in the way we pay for medical care; most candidates are offering us bandages for a broken system.