Health insurance ALREADY can be taken away

Bill Knight column for 12-5, 6 or 7, 2019

Decades ago, I edited a weekly newspaper owned by a record chain whose owner was mulling over providing health-insurance coverage to full-time workers. Then, in a matter of weeks, I had to go to emergency rooms.

I’d injured my ankle in a summer softball game and went to a hospital, then that fall I cut my index finger in a kitchen accident and got stitches at another ER.

I was lucky, not just because the mishaps and treatments were relatively minor, and not because I was covered by health insurance (the publisher decided to not offer insurance), but because the medical procedures in the 1970s were not yet essentially unaffordable.

Today, health care is expensive, from ambulance rides and medical care to hospitalization and insurance costs, and most progressive politicians are increasingly responding to such concerns felt by citizens they represent. However, conservatives and also centrist Democrats are stoking some Americans’ fear that “health insurance will be taken away” if some form of universal health care happens. (I write “Americans” because the United States is unlike most industrialized nations, which provide such health coverage.)

However, whether it’s Republicans’ repeated attempts to kill the Affordable Care Act or employers or private insurers changing or eliminating plans, Americans ALREADY can have health protections ripped away.

A Kaiser Family Foundation poll this year showed 56 percent of Americans favor “a national health plan, sometimes called Medicare for All,” but attacks on plans proposed by U.S. Sens. Bernie Sanders, Elizabeth Warren and others focus on costs and eliminating insurance for those covered on the job, implying that Americans want something for nothing.

The half of the country covered through their employers get something, but they do pay, through premiums, co-payments, deductibles and other expenses.

Some background: During World War II, Congress passed the Stabilization Act of 1942, letting President Roosevelt freeze wages for all workers EXCEPT that “insurance and pension benefits” could increase. So, as employers sought to cope with the shortage of workers, they recruited and retained employees by offering health care (which was promoted by insurers, unsurprisingly).

In the ensuing 77 years, workers’ employer-sponsored insurance has deteriorated due to declining coverage and spiraling costs.

Today, according to Kaiser, workers’ share of their employer-based health insurance for a family costs more than $7,700 annually. That’s up 18 percent in the last five years, rising much faster than inflation and wages.

To the point of “taking away” coverage: Companies drop or trim health insurance all the time, hiking deductibles, required co-pays, workers’ share of premiums, etc. Such decisions look good on corporate balance sheets or returns to shareholders, but if you have pre-existing conditions or are seriously injured or ill and coverage is limited, you’re out of luck.

(True, you can leave your job if you’re unhappy. But the same goes for workers subjected to sexual harassment, which should still be illegal.)

Plus, you have no say in such employer-provided insurance changes unless coverage is part of a personal-services or union contract.

We do pay for health-care coverage, and most of us have no voice.

There could be a political argument made for slow reform, but if expanded coverage occurs as an opt-in choice, there should also be a mandate for people to financially benefit by getting refunds or raises commensurate with the cost savings that employers would get.

Besides gaining at least some measure of input, through the ballot box, Americans gaining universal health care makes financial and social sense. Out of the nation’s population of 329 million, 37.7 percent of Americans already are served by either Medicare (59 million) or Medicaid (65.3 million), totaling 124.3 million, according to the U.S. Centers for Medicare & Medicaid Services, which adds that another 9.6 million kids are covered through CHIP (the Children’s Health Insurance Program). Also, 9 million people are covered through the Veterans Health Administration, the VHA says. That's a total of 142.9 million – 43.4 percent! Why not join the rest of the industrialized world and cover the other 56.6 percent – AND have better health care and save money (savings from no co-pays, deductibles, etc. soften the taxes we’d pay).

That question is the real takeaway.