Healthcare insurance is not a difficult concept to understand. However, if we use the Democratic presidential candidates’ bickering over the details of their so-called “plans” as a measure, we only get confused. Their fallback on Republican talking points in the recent “debates” was both disgusting and counter-productive. Obfuscation of the obvious would seem to be the goal, especially for the corporatist Democrats.
First, think about the core concept of insurance. People contribute to a pool of money designated for use to alleviate an emergency of any one or more of them. Early ethnic immigrant groups in the U.S. did this informally by creating mutual-aid associations. Then, larger entities called “mutual assurance associations,” similar to credit unions, formed for the same purpose. Most of them eventually converted to the form of a corporation and sold policies to customers, instead of members sharing costs and benefits. They became businesses, focused on profit prioritized over service.
Health versus Profit
Now, consider the difference between the goals of a for-profit business and a mutual-aid association. They have different priorities and commitments. Frankly, I would rather be a member than a customer. Who needs an intermediary skimming money off the cash flow between people and the pool of funds meant to cover healthcare expenses? That is precisely why American medical care costs so much more and achieves inferior outcomes than medical care in most European nations.
Think about all the forms you have to complete and the nearly incomprehensible “Explanation of Benefits” your medical insurance company sends out to explain all the ways that one thing or another is not covered. In contrast, a person in Finland goes to a medical facility and is treated – end of story. Yes, Fins pay higher taxes, but their total costs are much lower than ours are because they pay nothing at the point of service. And, their anxiety over healthcare is nearly non-existent. Europeans do not go into bankruptcy over medical debt. As a doctor told an American patient in France when he asked where to pay his bill after seeing a doctor in a health clinic, “You Americans view medicine as a business; we treat it as a profession.”
Universal Desire versus Corporate Control
It is clear that most Americans want universal healthcare insurance. They don’t like their insurance companies but often do like their doctors. Yet they may lose their doctor by a forced change in their insurance status, usually when changing jobs. One right-wing corporatist talking point is that with a “government takeover” of medical insurance, you might lose the insurance you like. However, the fact is that Americans want access to quality healthcare, and almost none give a hoot whether insurance companies fade into the background or die out entirely. One of the biggest problems with “modernity” is the over-complication of life through intermediation.
Even Bernie Sanders does not quite get the underlying point. Universal means universal. It is not necessary to “ban” private insurance plans. If everyone who lives in this country had unconditional automatic coverage in a universal healthcare insurance system, most corporate insurance would fade into obscurity – a victory over intermediation. Private medical insurance would become a small specialty for mostly the very rich, who might want “concierge” coverage, another luxury with which to display their wealth. Go ahead; knock yourself out!
Yet, most of the Democratic candidates flounder in the trap of the financial elites who still control the party by playing into the fears they try to maintain in the minds of the public. Even with all its imperfections, it is clear that the voting public wants to keep the Affordable Care Act, unless we replace it with a system of universal coverage, like “Medicare for All.”