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ONE HEALTH CARE POLICY – INDIVISIBLE – WITH BENEFITS FOR ALL

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William John Cox
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"The poorest man would not part with health for money, but the richest would gladly part with all their money for health." ~ Charles Caleb Colton (1780-1832)

President Bush likes to brag that he pays no attention to public opinion polls and that he doesn't read the newspapers, so he may have been unaware that at least 72% of Americans favor government guaranteed health care. However, the November elections must have sent a message that the mood of the electorate has shifted, and that perhaps he should mention the health care crisis during his State of the Union Address. However, what President Bush actually said was yet another feeble attempt to reconcile the demands of his neocon controllers with the desperate needs of those he pretends to care about, but for whom he is incapable of empathy.

Bush started off with a good sound bite, "A future of hope and opportunity requires that all of our citizens have affordable and available health care." (Applause.) He then proposed a $15,000 tax deduction for families whose employers provide health insurance or who purchase their own insurance. He also offered federal funds to states to help them make "basic health insurance available to all of their citizens." Sounds good, but what's up?

In a radio address three days earlier, Bush had criticized workers who have been "encouraged" to "choose overly expensive, gold-plated plans." His "fix" of the "problem" is to increase taxes on these "unwise" health plans that cost more than the proposed standard deduction. It doesn't sound like he wants all of us to have the quality of health care his family wealth has ensured him throughout his life, or that we, the taxpayers, are providing him while he lives, rent-free, in our White House. Noooo. He's talking real basic health care here - co-pays, high deductibles and limited coverage.

Let's see, the minimum wage is now $5.15 an hour and Bush opposes any increase, so that's $206 per week, or $10,712 per year (before taxes). Assuming a two-income family and a $15,000 deduction, Bush wants them to purchase "available health care" by using the taxes saved by the deduction. Does he really think that low-income workers can buy their own insurance with what they have left over after securing shelter, food, clothing, transportation and other essentials for their family? Or is he just flapping his lips, mouthing the words rolling down the Teleprompter?

A Crying Shame. For the amount of money we spend, American citizens should be receiving the greatest health care in the world. At an average cost of $6,280 per person, health care eats up 16 percent of our national output and is double that of other developed countries.

Employee medical costs contribute to the high price we pay for all goods and services. For example, General Motors spends $1,500 on employee medical benefits for every car it manufactures. Because health insurers operate as near monopolies, they are able to raise rates at will, and the high prices charged by pharmaceutical companies are protected and encouraged by law. Health costs continue to spiral upward, and it is estimated that at the present rate of increase, health care may consume as much as 46 percent of our gross domestic product by 2050.

Consistent with the rise in employer costs, workers are now personally paying 36 percent more for their share of health care than they were when the current administration took office in 2000, which is almost triple the 12.4 percent concurrent cost of living increase in earnings. In just the last four years, the proportion of workers receiving workplace health benefits fell from 65 percent to 61 percent. This resulted in 5 million fewer jobs providing coverage, primarily in small businesses.

In 2001, the first year of the current administration, the percentage of working-age Americans with moderate to middle incomes without health insurance was 28%. By 2005, the rate had jumped to 41%. Less than half of those earning below $20,000 had any insurance. People without insurance suffer a 25% higher death rate.

It is a goal of the current administration to eliminate employer-provided health care altogether and to require everyone to purchase high-deductible "catastrophic" insurance policies to cover major medical needs. Bush wants to force us to pay all of our routine medical costs with payroll deductions set aside in tax-sheltered health savings accounts. No "gold-plating" here, just real basic health care.

Workers cannot bear the present weight of health care, much less take on more. The health care burden on the working and middle classes has resulted in a 23-fold increase in bankruptcy filings from 1980 to 2001, directly as a result of medical bills. Most of these filings have been by hard-working people who had medical coverage when they got sick and then lost it. Currently, about half of all bankruptcy filings in the United States occur because of health-related expenses.

Many of us have toiled as wage slaves for decades because we were assured that we would receive lifetime health benefits from our employers upon retirement. A 2004 survey revealed that ten percent of large private employers ended all subsidized health benefits for future retirees that year, and they were planning another 20 percent reduction over the next three years. At the same time, 71% of surveyed firms had increased retiree contributions to premiums in the past year, and 86% planned to increase such contributions within the next three years.

Since we are spending a greater percentage of our gross domestic product on health care than any other major industrialized nation, you would think we should have the best medical care in the world, but we don't. Other countries provide more doctors, nurses and hospital beds for their patients, and we suffer an infant mortality rate well above that of the other industrialized countries. Only Latvia, among the 33 industrialized nations, has a lower survival rate for infants. At the other end of life, we are in the 29th place in the World Health Organization's life expectancy rankings. We die earlier and spend more time disabled than the citizens of most other developed nations.

Why is our health care system so lacking? The simple answer is that we have evolved a medical delivery system that allows the private medical care and pharmaceutical industries to rob us when we are sick and injured, when we are the most vulnerable, with a gun to our heads, while they pick our pockets. These industries are among the most profitable in our free-market economy.

A Healthier Choice. Let us envision a better way to provide health care, one that supports the premise that every child requires equal access to nutrition, education, and health care if we are to ever achieve our potential as a society; one that allows every worker to retain the benefits of his or her labor; and one in which we decide as a matter of public policy that it is just as important for us to enjoy good health as it is to be free from a terrorist attack.

As a part of a comprehensive health care policy, we should establish a National Health Academy, whose graduates become professional officers in a National Health Corps. Although the task would be gargantuan, the Health Corps could assume responsibility for the operation of all public health, veteran's and military hospitals; for every county hospital; and ultimately for most major medical centers across America.

We would secure a right to receive "gold-plated" health care through the National Health Corps, without having to pay enormous profits to insurance companies. Taxpayers could still choose to opt out of the system and to purchase their own coverage using the savings provided by a tax deduction.

Most of these hospitals should be dedicated as teaching centers to ensure that we have an abundant supply of highly qualified doctors, nurses and medical technicians and that we receive the very best medical care available in the world. Currently, U.S. medical schools only produce 17,000 graduates each year to fill 22,000 first-year residency positions. 25% of all doctors in the U.S. are graduates of foreign medical schools, and 60% are from developing countries where doctors are scarce.

The Health Corps should also be responsible for the operation of medical and dental clinics in our public schools. Health, vision, and dental care should be provided at neighborhood schools during and after classes, both for students and for their families. Very importantly, preventative medicine would help ensure that every child arrives at school ready to learn.

The Health Corps could assume responsibility for providing medical care within the military and for teaching medical corpsman skills to every military recruit. Properly trained and equipped, our military personnel could become revered lifesavers at major disasters such as that caused by the Indian Ocean Tsunami and Hurricane Katrina.

Rather than to naysay the possibility of effective national health care, envision the liberating effect such a project would have on American businesses. They would be finally freed from the cost of providing medical benefits to their employees and from the high cost of worker's compensation insurance.

The Health Corps could even establish medical, dental and vision clinics on the premises of major industries. The increase in productivity attributed to a healthy workforce could be enormous, and we would become far more competitive with all other industrialized nations, particularly those that provide national health care to their workers.

The birth of a national health care system would not result in the demise of private health care. We should be able to determine the average cost of national health care on an individual basis, and those taxpayers who opt out of the national health care system should be entitled to a tax deduction equal to the average cost.

Conclusion. Life is precious to each of us, and whether it is long or short, whether it is burdened by suffering, or it is blessed with good health is often a matter of fate. There were tremendous advances in medical care in the 20th Century; indeed they are our modern miracles. However, the availability of high-quality health care is all too often dependent upon one's station in society.

The wealthy and those we elect to represent us, including the president and the members of Congress, have access to medical care that many of us can only dream about. This is not right. All of us, particularly our children, must have the same opportunity to live life without pain and suffering for each of the days allotted to us by the Arbiter of Time.
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William John Cox authored the Policy Manual of the Los Angeles Police Department and the Role of the Police in America for a National Advisory Commission during the Nixon administration. As a public interest, pro bono, attorney, he filed a class action lawsuit in 1979 petitioning the Supreme Court to order a National Policy Referendum; he investigated and successfully sued a group of radical (more...)
 
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