Do it now: A plan for universal health care

Thursday, August 6, 2009 | 10:55 a.m. CDT; updated 11:14 a.m. CDT, Thursday, September 3, 2009

There are certainly a lot of questions and roadblocks thrown in front of HR 3200 and HR 676. (See “Do it right now,” July 31 Missourian.) As a reminder, my support is for the universal health plan, HR 676.

On July 24, 2009, Shawn Tully, editor at large for, wrote “5 freedoms you'd lose in health care reform.” Let me try to respond to each and then the make-or-break question: How to pay for all of this.

1) You’d lose your “Freedom to choose what's in your plan.” — Yes and no. With a standard plan designed and administered under either proposed bill, you have no choice in the basics.

That does not prevent private insurers from developing and selling supplemental insurance policies much as Medicare Supplements are developed and sold today. If the government keeps a hands-off approach to these supplements, there could be an unlimited number of combinations and customized programs available.

2) You’d lose your “Freedom to be rewarded for healthy living, or pay your real costs.” — Here, Mr. Tully uses an old propaganda tactic of fear and danger to make his point. There is little real proof.

Other than small discounts for “healthy living” that barely make a dent in the annual premium increases, discounts are few and usually limited to corporations for a percentage of the employees who quit smoking or lose weight. However, individuals rarely see the paper on which these suggested discounts are written.

In fact, a well-designed and promoted national health care system will provide treatments for obesity, smoking, drug addiction, mental illness and more, reducing the expenditures of the programs in the long run.

3) You would lose your “Freedom to choose high-deductible coverage.” — Isn’t that part of the reason we are in the situation we find ourselves in today? Most Americans cannot afford the high deductibles and co-payments on top of the premium. Out-of-pocket expenses have put too many in bankruptcy. Businessman Ben Franklin would say, “Continuing to do the same thing over and over again and expecting different results is a sign of insanity.”

4) You will lose your “Freedom to keep your existing plan.” — OK. This one I will concede for HR 676, but not the President’s plan. The President has specifically said in press conferences and public meetings that if you like your current coverage, keep it.

5)    You will lose your “Freedom to choose your doctors.” – Maybe. In HR 676, a participating provider must be either not-for-profit or a government agency. Today, many hospitals and HMOs meet the nonprofit criteria. Like most Blue Cross Blue Shield companies, a provider can create a nonprofit arm of their for-profit company.

Finally, how can we pay for this plan? Easy.

According to the Missouri Economic Research and Information Center, as of June 2009, there are 5 million Missourians under the age of 65. That number represents, I believe very significantly, a possible $250 million per month for universal health care for Missourians, or $3 billion for the state annually to keep our citizens healthy. Nationwide, that could be as much as $163 billion a year. That is more than what is needed for a universal plan.

So how did I, the world’s worst economist, come up with these numbers? Simple math.

First, let us reduce the current national average health insurance premium of $12,925 annually to $50 a month per person or $600 annually. That would bring each citizen and business that pays for health care as a benefit an average savings of $12,325 annually. Annualized, that is $3.4 billion. In addition, Medicare taxes (1.45 percent) can be reduced or eliminated.

Every citizen (or employer if they choose to provide health care) will pay the premium. No exceptions, no finagling, no breaks. Period. At age 65, (estimated at 38.5 million) citizens no longer have to pay into the fund.

Additional savings might come from lower malpractice insurance premiums and fewer purchases of unnecessary and duplicate equipment, and they might allow the hiring of additional Licensed Practical Nurses, Certified Nursing Assistants and other caregivers to ease the burden on the doctors and nurse practitioners.

Give me a better reason not to support universal health care.

David Rosman is an award-winning editor, writer, professional speaker and college instructor in communications, ethics, business and politics. He welcomes your comments at


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John Schultz August 6, 2009 | 11:45 a.m.

David, claim #1 is absolutely correct, no matter what you wish. If the federal government mandates a public option that includes coverages A through J, you would not be permitted to choose a cheaper plan that offered less coverage. New Jersey's additional insurance mandates cause it to be several thousands more expensive than a Kentucky policy, for instance (scroll about halfway down the link below to see the discussion and numbers):

As for the third claim that you dismiss, as a former health savings account (HSA) user, I find the outlawing of high-deductible plans to be a bad move. These plans are great choices for healthy people or those with small yearly expenses. My previous employer put money into my HSA account each paycheck and I could either use my associated debit card or checkbook to pay bills or reimburse me expenses. That money also rolled over year-to-year, earning a small amount of interest, and I could choose to invest the balance if I wished. The big thing that had me switch from the PPO plan that was also offered is that the premiums were LOWER. It was a win-win-win all around, yet Democrats want to axe that option.

I will have to mull on your numbers more later, but would be curious if anyone has current numbers for estimated health care costs in Missouri.

(Report Comment)
Tim Dance August 6, 2009 | 11:28 p.m.


Market failed, had 15 years to prove to the country about the virtues of the market and health care. You HSA are a joke, only the very healthy would even remotely benefit. Anyway profiting off of the suffering is immoral and our system is a cruel one. John we will win this time, people are not buying your libertarian BS anymore. Universal coverage for all!

(Report Comment)
John Schultz August 7, 2009 | 10:11 p.m.

Tim, did you even read what I said? I said that HSAs were ideal for people who have good health. Freaking DUH! Thank you for telling me something I already knew and stated. But yet Obama and the Democrats want to OUTLAW something that is working for millions of HSA customers. Sheesh!

There hasn't been a free market in health care since Medicare and Medicaid, let me know when you can acknowledge that fact and then maybe we can talk about how LESS government just might make the system better.

(Report Comment)

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