Making health care work

Money and a stethoscope.

Jeremy Hobson: The nation's second largest health insurance company, WellPoint, will report earnings this morning.

But LA Times consumer columnist David Lazarus says if you really want to see what's happening in the world of health care, should you look at what's happening at the nation's largest private employer: Wal-Mart. David, good morning.

David Lazarus: Good morning.

Hobson: So, first tell us what Wal-Mart is up to here.

Lazarus: Wal-Mart is basically scaling back its health coverage. Employees who work 24 hours a week or less -- no coverage for you! For everybody else, an increase in premiums in some cases as much as 36 percent. Wal-Mart is our largest private employer. They've got 1.4 million U.S. workers. If these guys can't make health care work, who can?

Hobson: So you're saying we're going to start seeing this at other companies. Other employers are going to start dropping or cutting back their health coverage.

Lazarus: Well, we're already seeing that. In fact, health coverage up 9 percent this year, according to the Kaiser Family Foundation, for family coverage. Clearly the trend is going that way with workers having to pay more and more of the load. Now, clearly our employer-based system is not working for us. And it's just a historical accident -- it must be said.

We got this system during World War II when congress imposed wage caps and companies in turn said, "How about if we offer health benefits as a perk?" And the system never went away. But right now with health care costs soaring, companies are finding it an unsustainable phenomenon.

Hobson: Well, if that's unsustainable and there's so much political opposition to going to a European-style single-payer model, then what are we supposed to do?

Lazarus: That's a good question. For reasons passing strange, a Medicare-for-all system is seen as socialism in the United States. So if not that, then how about we build on what's already coming down the pike. In 2014 under our reform law, we're going to see these 50 different state exchanges established where people can buy insurance there.

How about we create a national exchange that would allow people to buy insurance and have that insurance follow them no matter where they go in the country for a job. And most importantly if you lose your job, you don't lose your coverage.

Hobson: L.A. Times consumer columnist David Lazarus. Thanks David

Lazarus: Thank you.

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What about each of us taking more control of the care of our health by asking our doctors more questions? Ask about generic drugs, ask about alternative treatments that might be more affordable or support doctors who spend the time it takes with you to discuss your treatment plan. Though this will not solve all of the problems facing the industry, it will help you be more prepared and may lower your costs.

How about specifying exactly how this national exchange would work? This piece reminds me of another piece I recently watched (on PBS, mind you), where a class of students was asked a simple question: “How many of you believe that S.S. will be around when you retire?” The students were unanimously silent. That isn’t instruction; that’s propaganda. Look, if Americans erroneously believe that universal health care is tantamount to Stalinism, why not educate them with facts, analysis, and comparisons to other countries’ health care systems? From a strictly ideological perspective, let me say this: I don’t care what laws are passed, what the Supreme Court rules, how high stocks rise, how many mergers occur, or how poised high finance it to turn this baby into a cash cow in 2014. If anyone thinks I’m going to be paying a “competitive rate” (about $500 a month) for any sort of private health care rip-off, they can think again. I couldn’t do it if I wanted to. Let me offer this comparison: As a landed immigrant to Canada, I used to pay $37 quarterly for health care insurance (which included dental) in Alberta. During the debate two years ago, I wondered how much it had increased since, and looked it up. Well, it was $44 a month up until 2008, when it was folded into the tax system like all other provinces except B.C. It is now costs a grand total of zero to consumers as an out of pocket expense. Here’s the link and the rundown:

We do not have "healthcare" in America, we have a "for profit medical business" run for the providers and insurers, not the "consumers" - they are no longer "patients." Notice how it has become priced out of the reach of most consumers, just like the housing market before the crash. The medical biz better watch out - it's the next " bubble" .

Correction: how much should be paid.

The "for some reason" that Medicare for all is seen as socialism is because it would mean a single payer for health care bills. The payer, in this case the U.S. government, would decide who should be paid, who much should be paid, and what procedures will be paid for. An arrangement like that, by any other name, still represents complete government control of health care.

So, if not "socialism," what would you call it?

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