Need single payer now
August 20, 2013
To the Editor:
I chuckled at the editorial "Getting it Good and Hard" in the Aug. 3 edition of the Caledonian Record. The heading is beautiful, though imprecisely timed. It should have been written before the era of Green Mountain Care Board, Vermont Health Connect, and Obamacare, such as it is. Then the heading would have been appropriate. We Americans have been "getting it good and hard" for decades now with all the evils of which we are all now so acutely familiar with a health insurance system that cares foremost about profit rather than people.
As the editorial mentioned, rates for the Vermont Exchange came out last week. They are, indeed high. They are high because the exchanges, the principle engine of the Affordable Care Act (aka Obamacare), are still private insurance. The deductibles, co-pays, high-deductible (Bronze) plan, and the rest of it that the editorial listed are all trappings of the private insurance system which, contrary to popular belief, is much more costly and less efficient than Medicare (http://krugman.blogs.nytimes.com/2009/07/06/administrative-costs/?).
One of the unique things with these exchanges (and which the editorial forgot to mention) are the subsidies to at least help off-set the sting of these premiums and the mandate of everyone being required to be insured. These, as usual, will vary by income levels; we as a nation simply cannot yet find a way to get ourselves to treat each other equally. It should also be remembered that all health insurance, especially private, rely on the young and healthy to subsidize the elderly or the sick. The exchanges are no different. Another benefit of the ACA is, finally, the beginning of the divorce of health care from employment. Why should business people have the added weight and competitive disadvantage of being insurance agents for their employees?
America spends the most of the democratic/technological world for health care with the least in return for it. Howard Dean not withstanding, the exchanges illustrate yet another reason we so desperately need single-payer now rather than later.