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National Health Plan:

Right for a Sustainable Middle Class?

Most of us have received good health care without a National Health Plan, but do we have a moral obligation to cover everyone? Is our current, mostly private, system too expensive and inefficient to sustain?

Like millions of Americans, our family has an employer-based health insurance plan, Blue Cross/Blue Shield. My employer deducts money from my paycheck and makes a company contribution to cover the monthly premiums. When I have a problem with a medical bill not getting paid by BCBS, I contact our Human Resources administrator, who has access to some phone numbers for direct lines to administrators at Blue Cross that are not available to me.

Our HR administrator is always very nice and tries to be responsive and helpful, but, as seems to happen all too often, inquiries end up getting passed from one office to another: from Human Resources to the insurance company, to the doctor's office, to the lab, back to the doctor's office, back to the insurance, back to the HR department, and back to me, telling me to provide some additional piece of information before the whole process repeats itself over and over again. Ever try to sort out a health insurance issue during the day while you are also trying to do your job? How many worker hours in lost productivity are spent dealing with these kinds of problems? Is it time for a single-payer National Health Plan?

A couple of years ago, my former employer announced a new voluntary flexible spending account program offered by a company called Generic-Tech," which is not its real name, that would allow us to deposit money, pre-tax, into an account that we could then draw on to pay for certain medical expenses not covered by Blue Cross. We needed to review the Generic-Tech literature and one of its representatives would visit our office for an informational meeting. As a side note, I work for a consulting company and when we are not performing work for a client, we're on overhead. When we have too much overhead, the company doesn't make a profit and we don't get raises or bonuses. I tend to be impatient with these kinds of meetings.

We had our meeting with the representative of "Generic-Tech." The man speaking to us was well dressed and groomed, articulate, probably college educated. Probably a business or marketing major, though I really don't know. He explained to us the "beauty" of the plan, which put pre-tax dollars into a medical expense account. It had the "terrific" benefit of lowering the taxes withheld from our paychecks (not to mention boosting the federal and state budget deficits, which someone will deal with later). More of our own money in our pockets!

Somewhere buried deep in the slick Generic-Tech brochure was a brief disclaimer indicating that the pre-tax contribution to the medical expense account could eventually result in lower Social Security benefits. The Generic-Tech representative did not mention this, however.

Another feature of the plan, which only came into the conversation when one of my co-workers raised the question, had to do with cash left over in the account. With the medical expense account, a certain amount of money would be withdrawn from our pay each month. To access this money and pay medical expenses, we would need to submit a form along with receipts-certain kinds of receipts-credit or debit card receipts were no good. Generic-Tech would then compare our claims against the list of covered expenses, process the claim, and reimburse us for the expense. And here is the real kicker: any money left over in our accounts at the end of the year would belong to Generic-Tech! Under a National Health Plan this profit expense could be avoided. Wouldn't you rather see revenue go to pay the people who actually provide health care goods and services? I would.

If you are like our family, things get pretty hectic toward the end of December, what with kids and gifts and trips to see friends and relatives. I bet a lot of folks forget all about their medical expense accounts.

We are talking about how we purchase health care. Mr. Generic-Tech is not a medical doctor. He's not a nurse, not a medical technician, not a physical therapist, not a pharmacist, not a hospital administrator, not a hospital janitor, not a dietician, not a medical researcher - we could go on and on. His job has nothing to do with making people well. He's a businessman playing a kind of shell and pea game. He's probably quite good at it. Is he an example of what is wrong with our American system of health care?

Bill Ford, one of the most powerful CEO's in the world, asked his Vice President to study the concept of a National Health Plan and report back to business leaders. Auto companies in the United States spend more on health insurance than steel. Imagine the headaches health insurance must be for employers nowadays. Recently, the company that makes Lifesavers candy moved out of Holland, Michigan and relocated their factory in Canada. A major reason for the move, according to a company spokesperson, was (you guessed it) lower health insurance costs. Less cost and less hassle.

QUESTION:

Are we paying more for health insurance that provides less coverage with higher copays and deductibles? What is the endpoint of this process?

Dr. Marcia Angell, former editor of the New England Journal of Medicine, has written extensively about problems with the pharmaceutical industry. I highly recommend Dr. Angell's article.

Other Recommended Links:

Physicians for a National Health Program

Disability Management and Information

Henry J. Kaiser Family Foundation

Keywords : National Health Plan, universal health care, uninsured Americans, medical bankruptcy, health savings account, universal medicare, single payer health coverage.