The Healthcare Debate: A Consumer’s Perspective
By V. Susan Hutchinson
When you say the words “healthcare in America” it stirs up a lot of emotion in some people, especially if you have a “pre-existing condition” and have been battling the current system for decades.
I am one of those people.
I don’t usually write from first person experience, but watching the 2nd Democratic Presidential Candidate debate resulted in my screaming at the television and I felt compelled to address what I was hearing.
Although all of the Democratic candidates talk about healthcare in the context of the financial burden to the consumer, some want to tie the costs to quality of care. John Delaney (D-MD) said “My dad the union electrician loved the health care he got from the I.B.E.W. He would never want someone to take that away.”
Newsflash John Delaney: Premiums are calculated based on the amount of coverage you can afford. That’s why there are different plan levels. A healthcare system where there are no premiums means everyone is covered for everything. You are also implying that if union workers go from their current private insurance to a publicly managed system that somehow the quality of their care would be compromised. This is the old adage “you get what you pay for”.
And it doesn’t apply to healthcare.
The Reality of a Publicly Managed Healthcare System
I have been covered under American insurance companies through various jobs throughout my life paying premiums, meeting deductibles and sometimes out of pocket maximums. As I have had a “pre-existing” condition for several decades, my out-of-pocket costs have been higher than the average person, so I reach my deductible every year.
I worked in the UK from 2005 to 2011 and was covered under the National Health Service (NHS) there. I never had to wonder if what I needed was “covered”. Was there a difference in the quality of care I received because I was now paying through my taxes instead of lining the pockets of some insurance company CEO? Are the doctors there less competent than the ones in the United States?
Of course not. I still had access to the same drugs and my specialist there was just as good as the one I saw in California. The only difference: I paid taxes instead of premiums and no longer had deductibles or maximum out-of-pocket costs. I also got my medication at no cost there, compared to $100 a month in the U.S. — and that was only because the insurance company included a good drug plan.
Conservative Attacks on Medicare for All
Republicans and conservative groups continue to claim America needs to depend on insurance companies to cover high healthcare costs because the alternative is too horrible to contemplate. The right wing group One Nation America has paid for commercials that make Medicare for All, or any other socialized medicine structure, look like it is the worst thing since the holocaust.
This ad resulted in me screaming at my television, too.
The propaganda spewed from these groups is intended to scare voters into thinking that once insurance companies are out of the picture they will die waiting for care or the quality of care will significantly decrease.
In my experience under the UK’s NHS, yes, you may have to wait a few months for non-life-threatening surgery, like a knee replacement; however, if there are cancellations, your surgery date can move up, but never back. If you have an urgent medical need there is no delay. People are not dying waiting for heart surgery there or in any other country where they have publicly managed healthcare systems.
Conservatives are playing on the American expectation of never having to wait for routine service; they want everything right now, at their convenience. And, any compromise is unacceptable even when talking about a system that can control the ever-rising cost of healthcare and possibly lower your out-of-pocket costs.
The Healthcare Coverage Shell Game
Then there are the candidates who want a “phase-in approach”, saying people need the option of private insurance in addition to a Medicare for All type system.
Basically, what they are saying is they want the consumer to decide whether to keep their current scheme or go with a new one. What they are actually saying is that you will have a choice of possibly paying more through private insurance for the same quality of care. It also is not clear when they talk about how your costs will now come from here (taxes) instead of there (premiums and co-pays) as part of the Medicare for All plan.
They make it all sound like a shell game and it’s very hard to follow.
The candidates need to get a lot more detailed when discussing their platform on healthcare costs.
- Please give us some examples of comparisons between what various people pay now versus what they would pay under your proposal.
- We need to see different types of healthcare consumers represented: healthy individuals, families with children, people with health challenges and seniors.
- It’s easier for voters to understand your plan if you have a graph or chart that they can follow and apply to their own situation.
Healthcare coverage, and its associated costs, may decide who gets to be on the November 2020 ballot. The candidates need to do better and more clearly communicate their ideas so consumers know how they would be affected before they cast their ballots.