The City's new health care plan (profiled in the latest SW Journal)
highlights the trend toward the privatization of health care.  The main
beneficiary of this plan is the insurance company and the main loser is the
consumer, by providing big incentives to employees to choose a high
out-of--pocket plan in exchange for low premiums. Sure, the deal looks very
attractive at face
value (potential savings of $2,000 - 3,000 per year for the consumer) and, a
young, healthy  individual who is lucky enough to not have an accident in a
given insurance year, is likely to save money.

The SW Journal article raises the question of whether it's too good to be
true, because all parties seemingly save money - the City, the consumer and
the insurer.  While this might be the case for
SOME consumers in the short run, it surely cannot be sustainable and seems
the wrong road to take.  It follows the larger national trend of privatizing
health care coverage.

Advocates of this approach point to better consumer shopping and
decision-making about health care services.  While I would love to have more
information on health services so that I could make more informed choices,
this plan does not do this.

The most serious flaw with the out-of-pocket plan (in exchange for low
premiums) is that it is a deterrent to preventive care.  Individuals, and
especially families with children, with a cost deterrent to receiving
regular checkups and seeing the doctor promptly for a health concern, are
less likely to receive early, proper attention and will suffer more down the
road, costing the system and consumer more, not less money.  Isn't the lack
of coverage for the uninsured so expensive for the public hospital system
(i.e., emergency room care) precisely because of the lack of good preventive
and care in the early stages of a health care need?

Preventive care is shown to save the health care system money, and
preventive care has never been more important in our modern society now that
(preventable) obesity and diabetes are the two largest growing threats to
our health, and they are beginning at a younger and younger age.

The direction of the new city health care plan falls prey to the dictates of
the health insurance system, which claims it can't cover growing health care
costs and insists on raising premiums or forcing larger deductibles and
out-of-pocket expenses from consumers.

For a long time in the 90s, the talk was all about preventive care and, that
a good way to promote preventive care was to merge health care services and
insurance into a few large health-care systems that would bear the cost of
expensive "late-care" service if their consumer didn't get good preventive
care services.

We don't hear much about this anymore as our health care system never
materialized the way it was promised.  Sure, it merged and became a small
set of large corporations (non and for profit), but it hasn't saved anyone
any money.  The health care system is more expensive than ever, with
everyone looking for someone else to pick up the tab. In the end it's the
consumer who pays - either directly through higher premiums and
out-of-pocket costs or indirectly through taxes.

Neither consumers nor employers can continue to pay unlimited increases in
premiums, deductibles and out-of-pocket expenses.  The system, as we all
know, just isn't working.

Health care is a public good (meaning it should be made available to all
regardless of employment status, income, age or any other criteria) and
should be properly insured - that means pooling risk (costs) and benefits.
No one should go uninsured and no one should not have to decide to seek care
or not based on the need to pay for it.  If the private system can't provide
health care for all, then there is a proper role for government.

Now that the democratic primary is over, the important and timely discussion
of universal health care is as well.  I doubt we are going to see the
discussion materialize at the national level any time soon (with Bush or
Kerry at the helm), and so the fight for universal coverage must be more
local.

The January 12, 2004 edition of the Minneapolis - St. Paul Business Journal
reported the finding of Governor Pawlenty's Minnesota Citizens Forum on
Health Care Costs (led by former state Republican senator David Durenburger)
that more than half of people interviewed support universal health care.
Naturally, the report points out people's concerns about a universal -
single payer system, but the main point is that consumers want the assurance
of guaranteed and adequate coverage for all.

http://www.bizjournals.com/twincities/stories/2004/01/12/daily11.html?jst=s_rs_hl

Now seems to be the time for the City to join forces with other employers
(public and private)  throughout the state to develop a (non employer-based)
universal health care system.  To be sure, the City will need to continue to
negotiate creative schemes to fund health care for its employees until a
better plan is available, but it should also begin to study and negotiate a
more permanent and universal health care coverage plan.  The current plan
may save the City money in 2004, but will likely cost more in the not too
distant future.

A good article on the case for universal health care can be found at:

http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm

Jeanne Massey
Kingfield



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