The health care hurdle

Workers in most developed countries can be excused for being baffled by the hue and cry in the US Congress concerning health care. Most of these countries have affordable health care built into their economic systems. Their response is likely: “What’s the big deal?”

Here’s the big deal, of particular importance as Congress heads home for its summer break—without passing a health care bill.

First, the overall cost of health care. The US ranks just above the bottom of the list of developed countries in terms of the quality of its health care outcomes. It ranks at the top of the list in terms of the cost of its health care. Clearly some Americans get excellent health care but millions get none except for occasional visits to expensive Emergency Rooms. Whether they know it or not, Americans with good health care plans (e.g., Congress people) are paying the bill for those who don’t have it. If health care is required for all Americans, and the total cost of care remains the same, then the cost of care for the average American must go down. So universal health care is a must.

Next is the issue of portability. If you can easily continue your health care coverage when you switch jobs, or if you are temporarily out of work, your stress levels are likely to be significantly lower. I know. In my transition from salaried employee to independent consultant one of my major worries was about health care. Your health insurance costs as an individual, rather than as a member of a large group, are considerably larger. This is because (remember the preceding paragraph) individuals do not have the bargaining power of large groups; hence they assume the larger part of the burden of supporting those who have no health care. This can be a crucial factor for people who are starting small businesses—and that includes many teleworkers. So portability is a must.

Finally, cost containment is crucial. The first two premises above spread the load and cover the ups and downs of individual lives in the short run. (If I were a cynic I’d estimate that most members of the House, with their two-year terms of office, are concerned solely with the short run.) But the overall annual increase in cost of health care must be contained to be no greater, and preferably less, than inflation. This requires serious elimination of waste and duplication throughout the health care industry. That includes physicians, hospitals, pharma and the health insurance companies.

Of course the details of how this can be done are quite complex but the overall goals have to be kept in mind. Please remind your congresspeople during their summer break.

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