I’m not sure what you mean by this. If you mean the insurance industry will fight hammer and claw to prevent UHC, I’d say that depends on what you mean by UHC.
I’m a proponent of Medicare for All, and I think that if it was truly structured as Medicare for everyone, insurers would likely not fight it all that hard. Medicare provides Part A, which pretty much covers only hospitalization, at not addition cost to recipients. Part B, which covers doctors visits and the like, currently costs about $165 per month for most recipients.
Most however also have some form of supplemental insurance to cover costs Medicare Parts A and B do not cover. Based on the marketing insurers do to attract people to take the supplemental insurance their company provides, this pretty much has to be a good profit-maker. If insurers had to give up providing primary coverage and only provide secondary coverage, they may well determine they can make decent money with far less effort than currently.
Around here, anyone who owns their own home and has owned it long enough to substantially pay down or pay off the mortgage is easily in that category. And since the few doctors I’ve known here in Canada own really nice houses in upscale areas, they’re probably millionaires several times over.
Yes, doctors in Canada are paid negotiated set fees that are part of the mechanism that keeps health care costs under control, so there is less opportunity here for some hotshot exotic specialist to make a financial killing sufficient to buy his own private jet. The flip side is that everyone gets the medical care they need, health care costs are within the OECD norms, doctors have secure incomes without fighting insurance companies, and make enough in their independent practices to enjoy a high quality of life. Seems like a win-win for all concerned.
I think most of the responses talked about the lower societal cost of UHC, but your question appeared to be asking about the cost for an individual. And given that an individual usually pays only a fraction of the insurance cost (with the employer covering the rest), it’s possible that an individual might pay more in increased taxes in a UHC world.
That’s exceedingly unlikely for several reasons. One being the extreme discrepancy between US health care costs and those everywhere else in the world – once US costs are brought in line and the incredible insurance overhead eliminated, it’s almost impossible to imagine anyone paying more than today. Secondly, once relieved of the burden of paying employees’ health insurance, employers have a huge new potful of money that can be relegated to things like higher salaries, more benefits, or (as someone already mentioned) paying into a tax fund or health care fund at a rate very much lower than what health insurance costs them today. And one final factor is that not everyone gets employer health benefits – the self-employed, unemployed, and those with shitty jobs need health care, too. So do retired folks – and Medicare coverage is incredibly poor compared to UHC.
Thanks to all for the thoughtful replies, and I did mean the insurance industry earlier, and not health care.
I believe a lot of anxiety and stress would be lifted off the country as a whole if we had a non-profit system.
I seem to bring this up every time there’s a UHC thread here. UHC is insanely pro-business! I don’t understand how, in a society that places so much emphasis on the importance of private industry for job creation and general economic well-being, no one has been able to rally the business community to the UHC banner.
There are a few structural factors that make US healthcare so experience.
we pay doctors more than pretty much any other nation. This used to coax the best and brightest into medicine, but it’s no longer the hottest field, in no small part because of the frustrations American doctors have dealing with insurance.
we pay more in overhead than any other nation. Think before you assume that everyone wins if that goes away. That overhead represents a huge number of nice middle-class jobs. The nurses who act as gatekeepers to check that the insurance company isn’t being over charged, for instance. Administrators who make sure the paperwork is in order. People who work for the insurance industry…
we pay more for drugs than any other nation. US drug fees legitimately do fund most of the world’s drug r&d, too, so that’s not a total waste. But they also fund massive profits by the pharmaceutical industry. And the pharmaceutical industry has invested heavily in politicians, so it has a lot of clout. Why can’t Americans just buy drugs from Canada? Because that would cut into stuff company profits. Duh.
I don’t understand it either. Our firm pays 100% of the premium for every full time employee. It’s a ton of money. We do it because in our society, it’s the right thing to do, but UHC would be so much better for everyone.
To me that’s a bewildering line of argument. It explains why the health insurance industry is naturally opposed to anything like single-payer UHC, but it certainly doesn’t justify it. I have no problem with the value of the insurance industry in matters like home and auto insurance, but when it comes to health care, the whole premise of “insurance” is just completely wrong and counterproductive. The business of adjudicating, questioning, and attempting to reduce claims is anathema to the basic moral imperative of human health. So is the matter of being insured for benefits only in proportion to the amount that you’re able to pay for the insurance, if any, leaving millions with inadequate health care or none at all.
Those things make sense in the context of the insurance business, but that business model fundamentally fails on moral grounds when it comes to human health. When it comes to medically necessary procedures, insurance companies just have no moral right to be involved – it has to be a publicly supported unconditional human right where money must never be a barrier to access. Even worse, insurance companies are directly counterproductive to controlling the soaring costs of medical care, because they can not only recoup the costs in higher premiums, but use the fact to justify ever greater profiteering. See, for instance, this article on NPR.
So as I read it, your argument is that we should be careful about UHC because there is a segment of the economy that is both demonstrably useless and counterproductive that for some reason needs to be protected. No, it does not. These folks can be redeployed to other areas of insurance, to the administration of UHC, or to any other areas of employment they may be interested in that doesn’t negatively impact people’s health and their very lives.
I’m not saying it’s a moral win, any more than high drug prices are. But there are a huge number of people who are invested in the status quo. And just like closing all the coal miners might be good for the environment, but can be shitty for coal miners, who like where they live, and like being employed, there are a lot of people who are paid by all that friction that drives up the cost of our healthcare. It’s not just people who work for insurance. It’s hospital administrators. It’s nurses. It’s third party administrations. It’s government regulators. It’s a lot is decent jobs.
But that’s not all the costs of health care. Pretty much every plan has an annual deductible, which can be thousands of dollars, and most don’t cover 100% of the costs. There are also services that aren’t covered. All that adds up to a lot more than Canadians typically pay out of pocket.
It seems that employers care more about control than profits. Sounds weird, I know, but there it is. See also, Work From Home, which saves a lot of money, but reduces control over employees, and is also controversial.
The health care industry would like it because they wouldn’t have to care for the uninsured as currently required by the Emergency Medical Treatment and Labor Act signed into law by Ronald Reagan.
Everyone thinks there is universal health care in Germany and Switzerland and the Netherlands and other countries where there is a legal requirement to carry health insurance. UHC in a center-right country like the U.S. just means that it is required for you to carry health insurance. The Affordable Care Act, which subsidizes insurance premiums paid by the near-poor – hence the word Affordable – got us about halfway there, and would have gone further if the fine for not carrying health insurance AKA individual mandate was still in place.
On a board like this, there are a fair number of posters who want the government to pay for all health services. This would indeed be a big change for the health care industry. But that isn’t the current Medicare model, and isn’t something that could get through the U.S. Congress in the foreseeable future.
The US does not have a health insurance industry, and most of the people who think they’re happy with their health insurance don’t actually have health insurance. What we actually have is a health parasitism industry, that pulls in huge income, and then denies coverage for any excuse they can come up with. Any plan that involves leaving that health parasitism industry in place is doomed to fail, because the health parasitism industry is most of the reason why our costs are so high.
And yes, eliminating the health parasitism industry would mean putting all of the people in that industry out of work. I’m fine with that, just like I’m fine with putting bank robbers and the people who sell drugs in playgrounds out of work.
I can only imagine what you are getting at here, so I probably do not understand.
Just to check – do you want to close Aetna and keep Blue Cross?
And do you want to close all the for-profit hosptals while keeping the non-profits?
A lot of those for-profit hospitals are already closing, as explained in the for-profit hospital link in my last post. That’s a problem for communities, not a soluton. The people who work there are not bank robbers, although the remote ownership may sometimes act that way.
Aside from the C-suite, the solution wouldn’t be to unemploy the workers, but to mutualize (turn non-profit) the bad companies.