Privitizing healthcare (only the healthy need apply)

Paul Krugman offers a terrifying scenario in today's column, "Health Care Destruction:" the privatization of of health care that puts coverage completely out of the reach... of those who are sick.

Seriously. This would be the McCain 'health care plan.' Its no wonder he rarely talks about it in public.

If you have any pre-existing health problems (this would include McCain and his melanoma -- but he's a multimillionaire, so what does he care?) insurance companies won't have to cover you. If you currently have health care benefits available to you through your job -- and McCain is elected president -- get ready to lose them. He plans to remove health care tax breaks and incentives for employers who provide it.

So you doubt that McCain would do this? You doubt that a Republican would flinch from privatizing health care across the board? Been watching the privatization of schools in New Orleans? Works out fabulously for wealthy, private industry. But it seems that there is a slight glitch in the deal: educating the kids (those who are actually allowed in.)

Anyone that doubts that the GOP would hesitate to privatize anything and put it in the hands of their business buddies hasn't watched the gutting of New Orleans post-Katrina. Disaster capitalism at its best -- coming to a nation near you. Oops -- coming to your nation. Sorry.

Take a hard look around at the wreckage the GOP has left in its 8-year wake and tell me again how sure you are that McCain won't come for what little insurance coverage that you now have.

By the way, I know what it is like to be 'out on my own' without collective coverage through a large employer. Large employers have your back when insurance companies try their usual tricks to avoid paying a claim. If you are on your own... you have a choice between paying all of your medical bills yourself to avoid the hit on your credit when the bills go unpaid, or fighting un-winnable battles with insurance companies who lie to your face and seemingly hold all the cards.

When I owned and operated my own business, I was at the mercy of an insurance company that felt no compulsion to actually pay my bills - even after promising compensation and sending me to strange doctors and a remote hospital for a necessary health screening. I followed their instructions and filled out all of the required paperwork... and they never paid a cent. Every time I called, representatives swore that the bill would be paid.

Meanwhile the medical bill went into collections. The insurance company assumed - and assumed correctly - that I would find some way to pay the bill myself when faced with the loss of my own credit rating (credit I desperately needed for my business.)

Insurance companies are lying, cheating bastards... SiCKO didn't do them justice. Your only protection is your employer and the clout they bring to the table with their large contract. When you go it alone, you lose. Period.

And this is what McCain wants for America... for the lower 95% who can't simply pay medical costs out of pocket.

Krugman, NY Times:

Most Americans under 65 currently get health insurance through their employers. That’s largely because the tax code favors such insurance: your employer’s contribution to insurance premiums isn’t considered taxable income, as long as the employer’s health plan follows certain rules. In particular, the same plan has to be available to all employees, regardless of the size of their paycheck or the state of their health.

This system does a fairly effective job of protecting those it reaches, but it leaves many Americans out in the cold. Workers whose employers don’t offer coverage are forced to seek individual health insurance, often in vain. For one thing, insurance companies offering “nongroup” coverage generally refuse to cover anyone with a pre-existing medical condition. And individual insurance is very expensive, because insurers spend large sums weeding out “high-risk” applicants — that is, anyone who seems likely to actually need the insurance.

So what should be done? Barack Obama offers incremental reform: regulation of insurers to prevent discrimination against the less healthy, subsidies to help lower-income families buy insurance, and public insurance plans that compete with the private sector. His plan falls short of universal coverage, but it would sharply reduce the number of uninsured.

Mr. McCain, on the other hand, wants to blow up the current system, by eliminating the tax break for employer-provided insurance. And he doesn’t offer a workable alternative.

Without the tax break, many employers would drop their current health plans. Several recent nonpartisan studies estimate that under the McCain plan around 20 million Americans currently covered by their employers would lose their health insurance.

As compensation, the McCain plan would give people a tax credit — $2,500 for an individual, $5,000 for a family — that could be used to buy health insurance in the individual market. At the same time, Mr. McCain would deregulate insurance, leaving insurance companies free to deny coverage to those with health problems — and his proposal for a “high-risk pool” for hard cases would provide little help.

So what would happen?

The good news, such as it is, is that more people would buy individual insurance. Indeed, the total number of uninsured Americans might decline marginally under the McCain plan — although many more Americans would be without insurance than under the Obama plan.

But the people gaining insurance would be those who need it least: relatively healthy Americans with high incomes. Why? Because insurance companies want to cover only healthy people, and even among the healthy only those able to pay a lot in addition to their tax credit would be able to afford coverage (remember, it’s a $5,000 credit, but the average family policy actually costs more than $12,000).

Meanwhile, the people losing insurance would be those who need it most: lower-income workers who wouldn’t be able to afford individual insurance even with the tax credit, and Americans with health problems whom insurance companies won’t cover.

Read the rest...

Here is an excellent presentation out of New Hampshire: