It is my real concern that unless a reasoned and reasonable alternative comes forth soon, in the not-too-distant future the United States will end up with government-run health insurance, overseeing healthcare delivery, to the exclusion of private insurance; i.e., socialized medicine delivered by an irreligious government. Facts support my apprehension.
In 1960, the average daily cost of a hospital admission was five dollars ($5.00). (Source: a gentleman, now deceased, who was executive director of the Blue Cross and Blue Shield Plan in Mississippi at the time.) That same year a basic hospital and medical group insurance plan paid through an employer had a premium of approximately two dollars ($2.00) per month. (Id.) In 1965, the original Medicare monthly premium was three dollars ($3.00). (According to MedicalNewsToday.com, Nov. 12, 2022.) The cost of hospital stays and insurance coverages, including monthly Medicare insurance premiums, are substantially higher today.
In 1972, a close family member’s hospital admission included planned newborn delivery and maternity care. A healthy baby was born. But the mother’s care needs deteriorated into emergency surgery, ICU and hospital recovery. The bill for the ten-day stay was nearly $900.
One Sunday morning last summer I went to a local hospital for a cut finger. The bill for that semi-emergency four-hour visit, including three waiting-room hours and surgery, was $2,478.51. Medicare and supplemental insurance, together, paid for my care at reduced charges. (Under an amended agency policy and rule that boosted payments to primary caregivers starting in 2021, emergency medicine providers, radiologists, and lab pathologists, among other hospital practitioners, receive substantial Medicare payment cuts for their services.) (Source: hfma.org., “Medicare shifts payments toward primary care physicians in PFS final rule,” by Rich Daly, published December 3, 2020.)
The consumer price index (CPI) is calculated by the federal government to measure change over time in prices paid by consumers for goods and services. The CPI was 29.6 in 1960. Last month the CPI was 297.0. (Source: tradingeconomics.com (visited 02/11/2023).) That ten-fold CPI increase means that it takes over $10.00 today to buy what could be purchased for a dollar in 1960. Using that calculation for a cost comparison with 1960, a patient admitted to a Mississippi hospital in 2023 should expect to pay $50.00 per day on average.
Although these examples are anecdotal, and my economic analysis flawed, I would welcome anyone to dispute that hospital and medical costs have grown at an extraordinary rate since the federal government got involved in healthcare. Stated otherwise, if the main reason for its involvement in healthcare has been to make healthcare more affordable it seems that government has failed.
The first step to national healthcare came about in 1965 with Medicare under Title XVIII of the Social Security Act. Designed for the same general category of beneficiaries as Social Security, people who had reached retirement age, Medicare’s initial purpose was to provide affordable health insurance to those who were 65 years old or older regardless of income or medical history. Government health insurance has been expanded over the years and, most recently, in 2010 when the Affordable Care Act was enacted. Since then, a couple of national plans have been offered in Congress. In 2019, a bill (S.1129) introduced by Senator Sanders of Vermont would provide federal health insurance to all U.S. residents regardless of medical history or citizenship status.
Those who favor limited government have generally opposed the idea of a national program. In addition to the liberty of free enterprise and prosperity that comes with competitive choice, they point out the historical record of government inefficiencies and waste in operating and regulating non-traditional governmental institutions such as healthcare delivery systems and insurance.
Insurance companies have further opposed national insurance for disregarding sound underwriting principles, including insurable risks, reserves to pay claims, actuarial calculations (statistics), and other diligent standards. They have warned that, rather than being affordable and reliable, legislated insurance is economically unsound, with the cost of healthcare uncontained and its delivery undependable.
If, or when, it comes into being, a national healthcare insurance plan will become the only plan (“one plan fits all”). And private healthcare insurance will not operate in the marketplace economy as we know it today. Rather, those companies will exist in the form of recognizable trademarked names, largely operating as subcontractors administering the government program following federal administrative guidelines, regulations and rules.
In my opinion, this is a bad direction. People would be wise to inform themselves about the economic, social, and, most important, health impact they and their families will experience should universal healthcare come to be realized. And then, speak up.
Chip Williams is a Northsider.
