'Cadillac plans'

Pardon my soap box rant. I'm going to preface this by saying that I'm, if not a card-carrying Democrat, a leftist liberal that strongly supports health care reform. Working in the biomedical sciences field, I know a lot of doctors and academic researchers who know that the system is broken, who can't provide treatments because of inadequate insurance plans. Members of my own family are uninsured because they can't afford the insurance premiums on their working class salaries. They live day to day hoping that they won't get hurt or become ill, especially with something so tragic and expensive as cancer. The system needs to be fixed.

I'm not incredibly schooled on the intricacies of the current bill. I do know that some important things (public option) have been gutted, whereas others (outlawing a pre-existing condition clause) remain. I would be satisfied with a smaller bill that didn't fix everything, but just fixed some of the smaller problems. The government is in an incredible budget deficit, with frightening levels of debt. I shudder to think about what would happen to the US and the world if that debt were called in. We can't, and shouldn't, expect our government to foot the bill for our lives. (I know, I'm sounding like a Republican here). But the government can and should provide regulations for insurance companies.

What really is getting under my skin right now is this proposed "tax on Cadillac plans'. I've worked in both academia and for a non-profit society. These jobs are low-pay, but one of the perks has always been really great benefits, so much so that I just assumed that everyone's benefits were as great as mine. Apparently not. Now, in some convoluted effort to save money, Congress is trying to tax the really nice benefits packages that are out there. I'm not certain how giving companies, universities, and even nonprofits an incentive to provide crappier insurance is supposed to either save people money or provide them with better care, but apparently this is the plan. On top of this, the labor unions (who are justifiably pissed off about this) will likely get an exception. I know this is an elitest statement, but somehow it doesn't seem fair to me that someone with a high school education who works 40 hours a week on a redundant task for a for-profit industry for a decent salary should get an exception on this task while an academic researcher who has a PhD or MD plus years of additional training and works 70-80 hours a week for half as a much trying to develop cures for diseases that affect everyone should be penalized. Maybe it's my whole "hard-work should pay off" Puritan/American ethic or my underlying meritocratic tendencies, but the whole thing drives me crazy. It just doesn't make any sense to penalize companies/people who actually are trying to provide decent/affordable health care to their employees.

During the health care bill process, I went from an avid cheerleader to a staunch opponent, which I think reflects the opinions of many of my compatriots as our hopes for the bill were dashed with a harsh dose of political reality. I have market-driven economic leanings, and they're reflected by what I think should happen to the insurance system in the US. On the radical side, I would like to see health insurance be mandated to be a not-for profit enterprise (not govt run, just non-profit). This would drive down medical costs and cover people who weren't covered while at the same time not limiting the quality of care. I know there's no way this is going to happen. {And for those that think medical costs aren't driven by insurance companies, I defy them to explain how I (or my insurance company) was charged $1200 for a 1/2 hr ER visit with a benedryl shot for my son's last allergic reaction.}

More conservatively, I think people need choices. Perhaps insurance should no longer be provided by employers - instead they could just match certain amount of premiums. I realize that large corporations negotiate discounts based on volume, but there's no reason this couldn't be done equally as well or better by consumer groups with specific focuses and different care needs (young singles, families, the elderly). Maybe this is the "coop" system that's been floating around, I don't know. Having individual insurance needs met by a company's bottom line seems incredibly counterproductive. Although the statistics may say that only 1/1000 people needs this treatment, so it's not going to be covered, if I'm that 1 person, I want to be able to make the decision myself.

Anyway, I realize that this post is quite diffuse and lacks substance. Sometimes I just need to vent. I really wish the AMA hadn't shut down the first version that would have gone through during the New Deal Era. I'm sure they regret it as much as I do.