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Ralph Nader > In the Public Interest > We Must Do Something About Health Insurance

HAVE YOU ever read about anyone of the giant health insur­ance companies taking on the gi­ant drug companies for their spiraling price increases? Other than lip-service ads, have you ever seen these insurance companies really acting on what they are complaining about — namely too much “seller” waste, ineffi­ciency, over medication, unnec­essary operations and other drains on consumers and taxpay­ers?

The news is usually otherwise. The news is the notice from your insurer telling you to pay more and more money or you won’t get your coverage continued. These increases are not paralleling in­flation. That’s kidstuff nowadays.

Consider the 61-year-old single female in good health who re­ceived the following notice last month from Blue Cross/Blue

Shield in Connecticut. Her “com­prehensive health care plan” had risen in price from $500 and change per quarter to over $700 per quarter over the previous 30 months. Then Blue Cross really got serious. From a quarterly payment of $746, this insurance company demands a raise to $1309 per quarter or a total of $5218 for a year’s coverage of one person with no dependents. To top if off, Blue Cross insists on a $2000 an­nual deductible.

A few years ago, I received a letter from Portia Mason of Tu­cson, Arizona. She has a medicare supplement with Blue Cross/Blue Shield of New Jersey “with which I am stuck because it is part of a pension group plan. The policy has gone from $628 per year in 1987 to $1479 pre year in 1989,” she writes. What’s more she adds, “Whenever I submit a claim I usually have a problem in collecting anything.”

The nation’s total health care bill in 1989 will reach $650 billion. The average family now spends almost as much on health insur­ance and other health costs as it does on food. There is no end in sight. The health industry’s cash register is in orbit at a seemingly unstoppable velocity.

Of course, everybody in the in­dustry blames everybody else. When health care providers, as they like to call themselves, talk privately and candidly, their ac­cusations against the “other guys” are sharp, precise and re­lentless. About the only time they band together is in public when they blame the patients who ex­pect miracles with the trimmings or those bad lawyers who drag malpractice into court arenas.

Could the medical industrial system be so much worse than the sum of its parts each of which claims innocence? When will the tragic violin string break? At the one trillion dollar a year level? When individuals pay $200 a week or families $300 a week for health insurance?

Those elected officials at the top — the White House and the Con­gress — do not feel these family budget-breakers. These officials are into socialized medicine —full payment for medical and dental services, pharmaceuticals and the finest that Walter Reed Army Hospital or Bethesda Naval Hospital can offer. But they know that the sounds of citizen discord are growing. They receive the detailed mail from the people who often include their bills and their premium payments attached to letters that say, “Do Something.”

Panic is spreading into unex­pected areas. Recently a man was laid off his $52,000 a year super­visory position in the printing business. He took a modestly paying job as a limousine driver even though he could have made as much or more staying home collecting unemployment and union benefits. Why? Because the limousine company paid his health insurance. Increasingly, a fringe benefit is determining em­ployment choices.

What about the Canadian health insurance system? There no 60 year old has to pay $5000 a year in premiums. Part of the taxes you pay in Canada funds a public health care system. You pick your physician and hospital and public insurance pays the bill.

Now there are complaints about hospital waits. But no Canadian is ever turned away from hospital emergency rooms because they aren’t insured or don’t have a blue ribbon credit card. Every­body is covered from maternity ward to nursing home and the tab consumes 9 percent of Canadian GNP. Our health care prices con­sume nearly 12 percent of GNP and 37 million people (many of them children are not covered at all while millions more are undercovered.

The time for action is here. But even more pressing is the time for thought and inquiry by millions of citizens. If our political leader had any wisdom, they would emulate Swedish leaders who call and help facilitate community-level discussions throughout Sweden which lead to a national reform or decision. This was the way Sweden decided to stop building new atomic power plants.

This is the way we should start the formation of health promotion and care policy in our country.