It was bound to happen. Less than 24 hours after arriving at the home of my in-laws in rural Southern Maryland – the first time I have been back to the U.S. in a year – the discussion turned to the health care debate. No I didn’t start it and no I had no intention of agitating the family discussion but it happened anyway.
The conversation began when my niece, who lives in up-State NY and is pregnant with her second child, began talking about the fact that her husband, who is university educated and works two jobs just to make ends meet, had to reduce his hours in order to keep his income at a low enough level for them to qualify for Medicaid. You see, neither of his jobs offer him health insurance and they can not afford to buy private insurance in the open market so Medicaid is their only option. But it was when she mentioned that the cost of purchasing insurance on the open market was around $500 a month that the conversation got moving.
My mother-in-law, who buys her medical benefits from the U.S. government as a retired Federal worker was amazed at the cost. I took this opportunity to let her and everyone else know that prior to moving to Canada three years ago I was paying $12,000 a year to receive health coverage for my three person family through my employer and that was just the cost of my premiums and did not include any out-of-pocket expenses for co-pays, prescriptions or other services.
Now I count myself as one of the lucky ones who was able to purchase this insurance through my employer and could afford to do so. But in fact the cost of this coverage was nothing short of criminal. To put things into perspective, I now live in British Columbia where health coverage is guaranteed for all residents under the Provinces’ Medical Services Plan (MSP) and my premiums for this basic coverage are less than 10% of the cost of my former U.S. based private insurance. In B.C., MSP coverage costs are as follows:
From January 1, 2010 to December 31, 2010 monthly rates are $57.00 for one person, $102.00 for a family of two and $114.00 for a family of three or more. Effective January 1, 2011, monthly rates are $60.50 for one person, $109.00 for a family of two and $121.00 for a family of three or more.
Like many Canadians, I am employed by a corporation (in my case it is a large U.S. corporation and is the reason I reside in B.C. in the first place) that covers these premiums but in fact all B.C. residents are required to purchase MSP coverage. Those who are unable to afford these modest premiums offered a sliding scale of regular premium assistance. So in the Canadian model my niece and her husband would not only be able to afford basic coverage, based on their income they would receive a discounted/assisted rate.
Now I am not going to claim that this system is perfect, it lacks some of the personal coverage options we have come to expect in the U.S. system, but it sets a fundamental stake in the ground when it comes to the health of Canadian residents and says loud and clear that in Canada health care is not only considered a right, it is the responsibility of this government to ensure it’s people are able to receive care regardless of their employment situation.
So as the conversation progressed I had to ask the question, why was the U.S. unable to have an honest debate about health care costs and coverage? Why did Republicans and conservative Democrats alike cower under the guise of a public option that would have provided similar coverage for low-income Americans? The answer in my opinion can be found in the following paragraph from Ezra Klein’s article from Saturday’s Washington Post comparing Massachusettes’ health care plan with the Obama plan that passed in the fall.
In Massachusetts, that market has worked better than expected. According to data from America’s Health Insurance Plans, the largest health insurer trade group, premiums for that market have fallen by 40 percent since the reforms were put in place. Nationally, those premiums have risen by 14 percent.In Massachusetts, that market has worked better than expected. According to data from America’s Health Insurance Plans, the largest health insurer trade group, premiums for that market have fallen by 40 percent since the reforms were put in place. Nationally, those premiums have risen by 14 percent.
The truth of the matter is that the entire discussion around health care reform in America was framed by the American health insurance industry. Had Obama been successful in passing a comprehensive health care reform package that included a viable public option then the profits of Americas for profit health insurance companies would have plummeted and of course this would not stand. So, sadly, the discussion became a circus sideshow run by right-wing political activists who freaked people out with lies about death panels and Socialism and government take-overs. And in the end my niece and her husband and millions of other hard-working American’s like them lost.
UPDATE: Funny, I was just catching up on my RSS feeds and found an interested bit from Jonathan Chait who has also chosen to talk about the health care reform debate this morning, give it a read.