More insurance will not solve health care crisis

By Deborah Burger
The Rapid City Weekly News
April 24, 2008

The next candidate who thinks more private insurance is the solution to our national health care crisis ought to talk to Peggy Detmers of Rapid City. 

“My health insurance premiums have increased now that I have turned 50 years old,” Detmers said. “My premium is now more than one-fourth of my take home pay. We cannot afford insurance for my hubby because mine is so expensive.

“Before I was finally diagnosed with having a severe gluten allergy, I had made several trips to the ER. Needless to say, Blue Cross would not pay for everything, so my take-home pay then dwindled to half.”

Detmers is one of the more than 800 people with similar stories responding to a National Nurses Organizing Committee/California Nurses Association ad describing the disparity of care available to Vice President Cheney and members of Congress and the rest of us (www.cheneycare.org).

Health care has been at the center of the Presidential race this year, but virtually all the candidates have emphasized proposals to expand the reach of the insurance industry that leaves so many Americans like Detmers in that financial distress, that refuses to authorize delivery of care even when recommended by the bedside physician.

On the Democratic side, the Democrats have debated what is called individual mandate — forcing people to buy insurance. But selling insurance is not “universal healthcare” even if you provide subsidies for the lowest incomes, especially when insurers continue to charge as much as they want and have no limits on the callous, all too routine practice of denying needed medical treatment because they don’t want to spend the money.

At least the top Democrats are talking about comprehensive reform. By contrast, Sen. John McCain, like the other Republicans who competed for the nomination, offers little change from the dismal health care policies of the current administration.

McCain’s top priorities are tax credits to encourage the uninsured to buy insurance and increased corporate competition to limit rising costs. But once-a-year tax credits are of little help to those already facing financial difficulty in an imploding economy at a time when health care insurance premiums alone now average over $12,000 per family

There’s also no evidence that more competition will constrain costs. Premiums have jumped 87% over the past decade far outpacing inflation and wage increases.

Insurance companies don’t compete by delivering more care or lowering prices. They compete by harvesting more customers and reducing their costs. The way they cut their expenses is by paying fewer claims, and call care delivered a “medical loss ratio.”

They’ve also developed a massive bureaucracy of claims adjustors and reviewers to justify and carry out the denials of care. This explains administrative costs for private insurers that hover around 30% compared to just 3% for publicly-run Medicare.

Rewarding those same insurers with millions more customers will not change their behavior. It merely entrenches a dysfunctional system. And it distorts the role of our public officials who should protect people, not become insurance agents.

“I would rather pay more in taxes, or better yet, make the rich pay their fair share, so we could think that the American dream has not died. It has for us. Moving to Canada is looking better,” Detmers writes.

What Canada has is a very different approach, a system that guarantees everyone uniform, quality, universal coverage based on need, not ability to pay, sort of an expanded and improved Medicare for all.

It eliminates the waste and bureaucracy reflected in administrative costs.

Perhaps most important, it takes decisions about health out of the hands of insurance companies and their built-in economic incentive to deny care.

Registered nurses value every patient we touch. We witness lives lost, care denied, and families ruined by big insurance corporations.  Nurses know the kind of system Detmers is talking about is the only effective cure for our broken healthcare system.

Surely that’s the real reform all Americans deserve.

Deborah Burger, RN is a member of the Council of Presidents of the 80,000-member National Nurses Organizing Committee/ California Nurses Association.