BY EDWIN E. VINEYARD

Perhaps a better title for this piece would be: “Health Care as Interpreted by One Dummy to Another.” Unlike many of our Republican friends who are already opposed to a new health care program without knowing its form or substance, we are trying to sort out the facts of the issue and of the legislation which has been proposed. Much of that is still in flux, of course.

First of all, we can’t afford NOT to have vast changes in our health care delivery system in the United States. Our system is killing us.

Our health care is more expensive than health care in other developed countries, and it delivers a lower quality of care to our total citizenry. It is the most inefficient system in the world. It is NOT superior.

We have 47 million Americans without health insurance. These are working people whose employers do not provide a health insurance benefit, and/or who work for wages insufficient to afford insurance.

The expense of our health care system is higher because so many uninsured and under-insured cannot pay their bills. The cost of everybody’s health insurance is higher to cover the costs for the uninsured. This is a form of indirect tax. Have you looked at your premium lately?

The expense of our health care system hampers our industrial competition in the global economy.

We cannot afford not to have a genuine overhaul of our system. Band-aids will not do. And it will cost money. Eighty-five percent of our people believe our system is fundamentally flawed and needs to be rebuilt.

Both Democrats and Republicans have offered solutions. A cost estimate has been made for proposals by Democrats. No cost estimate has been proffered for the Republicans’ proposals.

Since the Republican proposal, supported by the insurance companies, is seemingly simple, although vague, we can examine it first.

Essentially the Republicans propose to extend the status quo, except to make “affordable” private insurance available for more people to purchase. Subsidies would be provided to make it more “affordable” to some. They offer no way of paying for these subsidies, but former candidate John McCain has said previously that it would be paid for by taxing everybody’s employer provided health insurance. Experts contend that it may be more expensive than other proposals, drives up costs, and would require other taxes as well.

Other than this, the only Republican position has been to oppose anything that is proposed by Democrats, especially any proposal that would offer a government option in competition with profit companies. It appears they are more interested in the insurance companies than their voter constituents.

Republicans excuse this pro-company, anti-citizen position with scare cries of “socialism” and deficits. Cost estimates for the Democratic program run around $1.3 trillion over 10 years, about the same as the cost of the unnecessary war in Iraq. It is less than the $1.8 trillion cost of tax cuts for the rich. Doing nothing may cost more.

We are familiar with government-run programs for federal employees, Medicare, Medicaid, Veterans Administration, and the Indian Health Service. Actually government-run Medicare is 19% cheaper than the same benefits in the private insurance option to seniors, hopefully to be closed soon at a savings of billions per year.

As a current [premium-paying] beneficiary of Medicare, and a paying member of the State Employees’ Medicare supplement insurance, this writer can attest these do NOT have the problems that critics attribute to government-run, “socialist” programs.

The House Democratic plan currently proposes a comprehensive health insurance program which would cover 95% of the people. It continues Medicaid to those presently qualifying, and it offers a subsidy for those above that poverty level on up into lower-middle income levels. Its health care provisions would be basically that of present Medicare, including insurability for those with history of sickness.

Payments to providers would be along a similar schedule as Medicare. This government-run benefits plan would result in a savings in health care costs of 25% to 30% over the current system, and slow future rising costs.

The proposal would require employees to be enrolled in some plan or be assessed a payroll fee of 8% to go toward insurance coverage costs.

Democrats say that they will provide for funding, which will have start-up costs and then be self-sustaining. They note billions will be saved by cancelling the subsidies for private insurance alternatives to Medicare. Other changes in Medicare and Medicaid can save billions more.

Democrats are opposed to the taxing of all employer health benefits. Instead they propose to tax only those enriched, gold-plated tax-exempt benefits above the basic level. Such are provided by some companies to higher income staff. Workers with income levels over $250,000 might have their benefits taxed.

Without a government-run option, any health reform plan is likely to be unaffordable and impractical. If the scare tactics of the Republicans and their cries of socialism are persuasive, or the advertising campaign sponsored by the insurance companies [with your premium dollars], are successful in swaying opinion – the health care issue will be become comatose again.

A poll this week showed that 72% of the people support a government-run option like Medicare for all. Interestingly enough, 50% of the Republicans surveyed were supportive, and 90% of the Democrats.

We will all be losers if the Democrats fail to get on board, take charge, and push this program through, along with a method for paying the costs.

– Dr. Edwin E. Vineyard, AKA The Militant Moderate, lives in Enid, OK and is a regular contributor to The Oklahoma Observer. See his essay Rightwing Violence: Personal, Religious Freedoms At Stake in the 6.25.09 Observer, now available on-line to digital subscribers.