Dave’s Desk@Ditch: An Alternative Choice
With the recent elections having come and gone, it has become rather obvious that we as a country, in our relatively short existence, have some serious issues that require immediate attention. Not to be too hyperbolic, but our republic’s survival is dependent upon their resolution.
Many of these issues have been in abeyance for decades now, literally pushed to the side or tabled altogether, depending on which political party is holding the reins and by how great the margin. Others are of a systemic nature — pitfalls of a flawed, capitalistic society that continues to leave tens of millions behind in its wake. Add to the mix an indiscriminate virus causing a worldwide pandemic, and you’ve got “the perfect storm,” one in which an overwhelmed, for-profit health care system is on the brink of collapse.
One obvious flaw in our existing health care structure that’s receiving much attention these days is that it ties medical benefits directly to one’s employment. The shortcomings of this approach have illuminated just how precarious such an interdependent relationship can be, with millions of Americans losing both job and benefits simultaneously once Covid-19 hit our shores. Employers (primarily small businesses), find themselves no longer able to absorb the expenses associated with such plans, forcing countless newly-unemployed individuals and their families to look elsewhere.
In a recent opinion piece, Jeneen Intelandi of The New York Times wrote: “Nothing illuminates the problems with an employer-based health care system quite like massive unemployment in the middle of a highly contagious and potentially deadly disease outbreak. For one thing, uninsured people are less likely to seek medical care, making this coronavirus that much more difficult to contain.”
She later adds, “The people most in need of employer-sponsored health benefits are the same ones who can least afford to return to work at the moment.”
Our archaic system was hardly a model of perfection since long before the pandemic, with its origins reaching back to the mid-1900s as an incentive to keep a tight wage market in check during World War II. Employers began using the added benefits as a means to entice and retain a talented workforce on the home front. Subsequently, as medical costs began to increase and services became highly specialized, employers would eventually shift more of the financial burden upon the employees, defeating its intended purpose.
Clearly, a significant “built-in” obstacle to the existing network is that it traps many individuals in workplaces they’d prefer not to stay, for the sole purpose of maintaining their health benefits. Not only does this situation produce a disengaged staff, it suppresses one’s ability to consider self-employment, entrepreneurship or explore the possibility of a completely new career path altogether.
My personal experience of taking the proverbial “leap of faith,” came when I made the conscious choice to leave a tenured elementary school teaching position in order to pursue a small business venture I’d created from scratch a few years prior. The constraints of channeling most of my creative output into weekends and summer break from school, all-the-while building a loyal customer base, became far too restrictive for me to remain. How was I to realize the true potential of this undertaking without completely going “all in?”
As the saying goes:“timing is everything.” No sooner had I left the comfort of a secure employment situation (mind you, carrying an $800 per month COBRA medical plan in order to maintain consistency in benefits), when the financial crisis of 2008 came crashing down like a massive tidal wave. All sales from my business literally dried up overnight, with little income, or unemployment compensation to rely upon. It would take me years to financially recover from this life-altering experience, relying heavily upon the generous support from family and close friends.
Millions of Americans have lost their life savings and fallen into financial ruin due to skyrocketing medical costs. It’s a completely preventable problem that other countries of means have figured out, but because our system puts profits before people and wealth before health, we continue to needlessly suffer.
Deb Gordon, senior fellow at the Harvard Kennedy School co-authored a piece in The Hill where she sees the current crisis as the perfect opportunity for change: “Covid-19 reveals urgency for a new approach, yet consumers fear losing what they have. Time and again, voters have favored incrementalism, craving familiarity. But now, the pandemic has shaken the foundation to which many Americans have clung. Instead of timidly repairing that foundation when the dust settles, we should boldly sever those ties once and for all.”
Indeed, the time has come to bring all options to the table. It doesn’t need to be a zero-sum outcome, forcing those who prefer their current plan to abandon ship against their will. But for a significant portion of the remaining populace, there needs to be an alternative choice, one which is inclusive, portable, comprehensive, and offered at a reasonably stable price for folks of all income levels, because, literally, our lives depend upon it.
In response to Dave’s Dec. 15 column, I want to add that I think health care can be a tiered choice. I do agree that we need a better system, but I don’t think universal health care is the right one. Years ago I read a proposal by a doctor that allowed for a three tiered approach similar to the HIP health care system I had used in the 80’s on up to a few years ago: urgent care w/ appointments the same day, appointments with specialists in the system, and a hospital plan at the system’s hospital. This worked well and I paid in monthly premiums. It still allowed for a patient to use doctors out of the system, as long as the service was not provided.