By PLS
I felt a twinge of guilt, believe it or not, when I realized that the cost of getting my knee back into skiing condition was going to be somewhat less than $10,000 (diagnosis, surgery and related costs, rehab therapy). My out of pocket costs, you see, have been very close to zero.
Having read and worried much about the inadequacies of our chaotic and underfunded national health care “system,” I wondered whether my being restored to A-1 trekking-around-the-world shape would deprive someone else of the care needed to get him/her hobbling from bed to bathroom and back.
Then I decided to do a little calculating. I wanted to determine exactly what I myself have contributed to the system to date—which, of course, I can’t do, precisely. I shred most of my financial records after seven years, and no one memorizes contributions to group health plans year after year.
However, I do know that I am now paying $96 a month and that the government roughly doubles that. So let’s say the career average would come to twice $75 a month, which means the Foreign Service Health Care Plan, a Mutual of Omaha plan, has been getting an average of $1800 each year from me, assuming I had joined the Foreign Service at age 25.*
Now let’s calculate what my contributions (plus accrued interest at 6% compounded daily) would have reached by now. My share would come to $393,414** (of which $196,707 would represent the current value of all direct deductions from my salary).
So $10,000 is a drop in the bucket. I’ve still got $383,414 left.
But wait! The numbers get better. I continue to pay $96 monthly, which means that I contribute $2304 annually for medical insurance.
And there’s more yet! An extra $25,516 will accrue as interest on my account this year.
So my contribution to the system increases by $17,820 even after my $10,000 knee repair is paid for! Far from being a drag and a drain on the system, I’m adding rather nicely to the total insurance pool.
Of course, I have to add a corrective here. What I’ve described is how the system would work if I had what is now called a health savings account. I could end up dead with a tidy unused amount to be inherited by my children.
But my kids have good jobs. They have their own savings and investment accounts. They have their own group insurance coverage. They don’t need what’s left from mine, so I don’t need a personal health care account.
What actually happens is better, it seems to me.
The money I don’t use up goes to pay for the health care costs of others in my group plan. In fact, everyone who works for the US government is eligible to join the system and get the care and medicine that’s needed when it’s needed (after paying reasonable deductibles and co-payments). Experts agree that this government plan is a model of fairness, efficiency and economy. Everyone from ambassador to janitor receives coverage at the lowest possible average cost.
A universal system would be comparable. Everyone covered. No cherry picking. No charity cases.
The results of universal care would be impressive. US demographics would improve, approaching those of other advanced industrial societies. People would live longer. Infant mortality would fall to less shameful levels.
And health costs would fall.
Most people don’t realize that administering America’s fragmented, exclusionary, privatized health care system adds some 30% to costs, three times the cost of health care administration in Canada and much of Europe. There’s also this huge cost: many US health care entities, including many health insurance companies and pharmaceutical companies, have in recent years consistently reported profits of 25% or more–after paying their CEOs and other officers salaries in the multimillions.
So let’s look at the numbers again. As things now stand, assuming I had amassed that hypothetical personal account amounting to some $400,000, nearly half would not, in fact, be available for my care. It would be dissipated on numerous superfluous levels of administration, on maximizing profits and on efforts to prevent any change in this system which, for a very few people anyway, is very lucrative.
Let’s be a little more specific about what happens to $200,000 of my $400,000 (speaking now in terms of the system as a whole). It helps pay the salaries of thousands and thousands of people charged with maximizing profits by keeping “high risk” types out of the insured category. It pays the salaries of thousands of people charged with maximizing profits by denying or minimizing benefits to the insured. It provides a super rich life style to a large cadre of high level corporate officials. It employs countless lobbyists at state and national levels to channel millions and millions of dollars to politicians who might otherwise be tempted to change this system into one that actually benefits all their constitutents.
Incredibly, some executives who benefit handsomely from a system intended to maximize profits, not health, are so corrupt and greedy that they bend the rules in order to squeeze even more millions of perks and personal income out of the system. HealthSouth is only one particularly egregious example .
There’s a better way.
Under a universal health care system, all the lobbying costs, all the CEO salaries and the lion’s share of the administrative costs would go instead directly into health care. Result: more people insured for the same amount of money.
Now that my leg is better, my hope is that the worry-free, excellent care I’ve received will, in the near future, be available to every American.
*These figures will do because I’m not trying to be strictly autobiographical. Contributions for some people with medical plans are smaller and others make larger contributions, but the operative principles are the same.
**Actually, in my case, the grand total would be somewhat reduced because I did receive some benefits for things such as allergy tests and allergy pills, mammagrams and pap smears, a broken arm, the birth of two kids and probably some even smaller stuff I’ve forgotten. But, all in all, a pretty minimal drain on the system.