Welcome Home You Socialist Bastard

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.

7 Responses to “Welcome Home You Socialist Bastard”

  1. tas says:

    Klein used the group “America’s Health Insurance Plans” to get the statistic that MA health costs have dropped by 40%, and I’d like to know where AHIP got their figures from. I’m an MA resident right now, forced to purchase health insurance through my employer, and this plan costs $94 a month. I have a $2000 deductible that must be maxed out before my insurance company pays for any of my coverage — that’s right, no co-pay or help. All of my medical costs before $2000 are out of pocket.

    If I wanted to purchase a plan with co-pays that allows me to see a doctor, it would cost me around $230 a month through my employer.

    I recently moved to MA, but a decade ago when I had health insurance for RI (through MA employers), it cost me $45 a month, I have co-pays, and I could see a doctor.

    So, honestly, I have no clue what Ezra Klein or AHIP are talking about. And as far as I’m concerned, they’re wrong. Health care costs in MA are a huge problem right now, and they are set to increase next year.

  2. If I am not mistaken Klein made it clear in his pieice that the MA health care model was not designed to lower costs…

    The law does have its problems. In particular, it was not designed to control costs. “That’s one of the areas where the federal bill is just better than the Massachusetts bill,” Gruber says.

    That said, I think the cost to the individual is the primary complaint I have with the current U.S. model (pre or post Obamacare). It seems to me that big health insurers have successfully managed to win this argument everytime it comes up and their profits continue to soar along with your costs.

    • tas says:

      Klein implies that the plan was meant to cover more people rather than reduce costs. That said, perhaps “coverage” needs to be redefined because when someone is said to have health insurance, it’s implied that they have insurance to visit a doctor. I don’t. Plenty of people in MA now have “coverage” but still can’t see a doctor without paying out of pocket for the whole visit.

      • Which is utterly ridiculous. At least when I was paying $12,000 a year I could visit a doctor. Being covered but also being expected to have to pay $2,000 out of pocket before that coverage kicks in is basically catastrophic coverage and nothing more. It helps if you end up in the hospital but certainly doesn’t keep you from getting there in the first place.

        • tas says:

          Exactly. I’m also paying double the cost for catastropic coverage than I did for regular health insurance a decade ago.

          I think the biggest problem I have with Klein’s column is that when he implies we should check and see the progress Massachusetts has made, he doesn’t actually come to MA and talk with anybody. I can look up a few statistics on Lexis Nexis and tell people anything I want, but before writing about the state’s progress, I wish Klein would pick up the phone and interview whoever in the MA state AG’s office is responsible for the HCR progress report that said, “Can we expect the existing health-care market in Massachusetts to successfully contain health-care costs? … To date, the answer is an unequivocal ‘no.'” Then interview some Human Resources representatives at MA based companies. Compare that with the statistics you can get from anywhere, and then you have a story with more than just one side.

  3. opit says:

    There was a time when Ezra Klein and friends’ wonkery at his home blog was not much short of wonderful. Those days are long gone. Even so, I clearly recall commentary from a physician describing what the billing department at clinics faced when dealing with deadbeats well-versed in the use of small print, exclusion factors and ‘approved choices’ before medical staff had a chance to think they were doing ‘work’ for which they would be paid. The billing of innumerable sources evading payment and cherrypicking ‘clients’ who they would drop at the first sign of recurring liability and chronic conditions made it quite plain that what was going on was nothing more nor less than an institutional scam that also made accounting a higher cost than productive work at practicing medicine.
    ‘drinking liberally in new milford’ had good coverage both by articles and RSS – but I admit I haven’t checked in for quite a while.
    Single Payer proponents couldn’t get in the door when legislation was under discussion. Since then the only thing that has been proven is that there is no other reasonable option.

  4. Dennis Byro says:

    At least have the intellectual honesty to explain to your readers that you pay for your healthcare via provincial and federal Canadian taxes rather than implying that healthcare in Canada costs 1/10th what it costs in the U.S.

    Then it would be even more useful to compare tax rates, including sales taxes. Don’t know anything about BC but I know everyone who can do so in Quebec and Ontario flocks to upper NY state to buy things (and NY state has one of the highest sales tax rates in the states). So at least compare apples to apples.

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