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Thursday, April 28, 2005

Policy - Medicare B

Like I’ve said before, I try not to talk too much about policy around here. No one, even me, likes to sound like a huge geek (note to all Democrats running for office: drop the geek-ness). While I do enjoy talking in general, I like it even more when someone listens. Cats, I find, are good for this (at least they act like it).

But, dig into the cookie bag and reward yourself for being a good boy or girl and listen for a few minutes.

The United States is facing a crisis of health care. Things have changed a lot since my grandma paid the doctor fifty dollars and a live chicken for “birthing” her youngest son (my uncle). I haven’t actually tried to give my doctor a live chicken for seeing me, but I’m willing to bet he would prefer the insurance co-pay.

I’m fortunate and I know it. My wife works for an insurance company, so we are pretty well guaranteed some of the best coverage available – as long as she works there. There have been times when I was not covered. Anyone who refers to health insurance as a luxury has never stayed awake all night listening to the breath rattling in their child’s lungs and praying that it doesn’t stop. They’ve never limped to work with a knee that didn’t quite bend fully. They’ve never watched a doctor’s face change as he noted on your chart that there was no way you could possibly pay for his time, much less the x-rays and CT scans and blood work he’d really like to have.

Health insurance, in modern America, is a necessity.

Yet it is a necessity too many working people do without. I’m not talking about the homeless or indigent here. I’m talking about men and women (mostly women) who get up every day and go work at least eight hours a day and see a deduction in their paycheck to pay for Medicare. It’s inhumane to make someone pay for health care for the elderly while they do without the same benefits. It’s robbery.

A report released today by the Robert Wood Johnson Foundation shows that almost a third of all workers in the state of Texas do not have any medical coverage at all. New Mexico, Florida, Montana, Oklahoma, Nevada, and Arkansas all have more than 20 percent of their workforce uninsured. Nationwide, over forty percent of these people have been unable to see a doctor in the last 12 months because of the cost of doing so. More than half of them don’t have a personal doctor and twenty percent rate their health as fair to poor.

According to Regency Blue Cross of Idaho more than 70 million Americans (out of a total of 180 million) go without health insurance for at least one month out of every twelve. The average time spent without insurance by those people is between five and six months (because a new job requires 90 days before you get benefits usually). Better than 60 percent of these people are under the age of 34 and only 20 percent are unemployed. Less than a quarter of these people have less than a high school diploma (meaning they aren’t stupid) and more than a third work for small businesses of less than 25 people (which is too small for group benefits and exactly the type of business the President loves to promote). Almost three-quarters of those without insurance were born in America.

Not exactly the picture of lazy, illegal immigrants soaking up benefits the right likes to paint, is it?

The fact is that everyone already pays for these people not being insured. Think about it. If your child has a high fever are you going to do nothing? Most likely you’ll take them to the hospital – to the emergency room. Of course you can’t pay the bill. Does this care come free? Hardly. Instead, hospitals over-bill others in order to break even (or make a profit).

The top four reasons a person is without insurance are: 1) They can’t afford the coverage offered by their employers; 2) there is no coverage offered by employers; 3) they lost their coverage when they lost their job; and 4) loss of coverage due to divorce or children are too old to be covered on parent’s policy. None of these are the fault of people who are doing their best to make ends meet. To say that it is their fault is to spit in the face of every working man and woman in America.

I suppose Congress believes that the retired poor should have just as crappy a life as the working poor. Congressional Republicans now agree that they will only cut ten billion dollars from the Medicare program instead of the twenty billion dollars the House wanted to strip from the program. At the same time, they are voting for another $70 billion in tax cuts. It’s a good thing they passed that prescription plan for Medicare because it won’t have any money to buy prescriptions anyway. (Oddly enough, they never explain how cutting $10 billion in spending and $70 billion in revenues works towards balancing a budget.)

So what’s the answer? As I blogged not long ago, the answer is to expand Medicare. Allowing every American to buy into Medicare B (or optional C) would flood the program with money. Coupling it with a one dollar an hour hike in the minimum wage would provide almost all of the money needed to buy into coverage. If the cost is split with the employer, who can then get a tax break (remember, small businesses are good), then everyone actually ends up slightly better off than they were when the mess began. Instead of following Wile E. Coyote over the cliff, we actually stop with the Roadrunner and take a step back from the cliff.

I’m trying hard to get this idea in front of enough people to make some headway. It makes sense to me. No one gets hurt and everyone benefits. Why is it so hard to get such an idea in the public arena? Perhaps it’s because it doesn’t scare anyone and, thus, does not translate into votes.

We need Congressional leaders who are more worried about leading and less about how they look when they lead. We need some leaders with enough spine to defy both parties and say, “This is best for the country.” Two nights ago I listened to Rev. Jim Wallis tell a crowded lecture hall, “You are the leaders you are waiting for.”

My friends, today I lay those words at your feet. What you do with it lies on your conscience.

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