Thursday, January 03, 2008

The health care equation - Oregonian Opinion

Chauncey Canfield: The health care equation - OregonLive.com: Oregonian Opinion

Posted by The Oregonian December 29, 2007 08:00AM


A baby is born with a congenital heart defect. Here's hoping his parents can maintain an unbroken string of medical coverage, because his ailment instantly became a "pre-existing condition" and is thus uninsurable. Similarly, if you wreck your car, you can't buy retroactive accident coverage the next day to pay for it.

The question no one seems to be asking is, "Why is insurance even part of the health care equation?"

Everyone is susceptible to catastrophic health issues from a complex interaction of genetic and environmental factors, risky behaviors and random dangers. It is morally bankrupt to limit access to quality, affordable care because of the vagaries of one's genes or employment status, yet this is what our employer-based system of private insurance does.

Insurance was developed to lessen the financial consequences of uncertain risks by spreading those costs over a population. But we know that everyone needs regular preventive care, so why do we "insure" against something inevitable? We don't buy insurance for our water or grocery bill, so why should we for office visits?

Preventive care also saves the system money overall. One major medical incident can easily exceed the cost of a lifetime of checkups and office visits. However, with employers changing their insurance providers almost yearly, the odds are very low that any patient they provide "well-visits" to today will still be insured by the same company in 30 years. What financial incentive do these insurers have to keep other insurers' patients healthy in the long term?

This is a strong argument for a single-payer system -- where the same organization sees the big picture costs and benefits for all of the participants in a balanced system of preventive and catastrophic care.

Corporations (and their fortunate employees) are already paying through the nose for any coverage they've managed to get. Eliminating the redundant, incompatible paperwork schemes of hundreds of insurers would allow more of these health care dollars to make it to the providers.

Removing "insurance" from the health care equation and allowing all citizens to participate in this system is the ethical and economic right choice.

-- Chauncey Canfield

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