Single-Payer Healthcare

There's a great entry here on the Canadian health care system from the Health Beat Blog, which seems apropos given our current political chance to perhaps make some changes.

I'm no policy expert. But I do know my own finances. In our wonderful system that operates in a free market, this is what happened to me as a father of one to three children, depending on when it happened.

When I had employer-based insurance, as is typical, I had to pay a premium for my family of between $200 and $300 a month. I couldn't switch plans once I had chosen one even though I wanted to--so much for free choice of doctors. Once I became a student, I had to either sign up for student health--over $500 a month with lots of co-pays--or use COBRA, an obscure system whereby the newly unemployed person pays the 'full' cost of their insurance which in my case was $575 a month but at least I had the same doctor.

I was unemployed, paying $575 a month. Awesome. This is the system we currently have. Lost your job? Here's an extra $500 a month in expenses.

18 months later, we were eligible for Medicare. Cost: $0. Choice of doctors: well, pretty much any. In fact, my access to academic providers went up substantially, and I didn't need prior authorization. Wait times were similar. I got to keep the same pediatrician for my kids and choose pretty much anyone for my own primary.

Advantage, big bad government system. In both choice and cost.

But surely, doctors are paid better in the US? So you wouldn't want a government system? Well, I currently have $175,000 in loans from medical school. Partially because there were no social services whatsoever, so I had to borrow money to pay for health insurance. EVEN WHEN I'M WORKING the cost of health care per month will rise again to between $150 and $500 a month depending on where I work (let's say the American South is not 'service rich'). Do I want a good salary? Sure, but only because I have so many loans because I had to finance both my own education and pay exorbitant premiums for health care (under COBRA, above) while I was a student.

Is there any hope? There is one notable institution that supplies free health and dental care to all its employees. What? A medical institution that gives free health care to all its employees? They must be going bankrupt! No, actually. They thought about going to a plan before. Just playing for care without the administrative cost was...cheaper. Golly.

Pretty obvious to me. Government plan: free, better access. Employer plan: expensive, less choice. And that's even without any static for prior conditions and all that garbage, or mental health which is not always covered, and so on.

Oh, right, taxes. Well, let's see. Taxes might be higher with more services, it's true. From where I'm standing, however, government health care saved me on average $500 a month. That's $6,000 a year. Now, I'm no expert on taxes. But according to Wikipedia on taxation (granted they may have a bias) that's more than a person making $40,000 a year will pay for their TOTAL tax bill. So for me, going to a government plan actually more than paid for my taxes the years I was eligible. In other words--government health care helped my true out of pocket expenses go down, not up.

I don't know if this convinces you. It does me. Leave aside the small observation that all other developed nations have universal coverage, and that the nations with the largest tax burden and therefore, the largest support network also have the best social indices: that fabled land, Scandinavia.

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