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Health care reform deserves support

| December 29, 2013 6:00 AM

I am on Medicare (at $104 per month) and pay extra from a private insurer for a Medicare Supplement Plan, Type F (at $180 a month). What a blessing! I recently had the misfortune of a blood clot in my lung and then, immediately following, pneumonia after a simple operation. I did not worry about huge medical costs that could bankrupt my wife and me — unlike the 600,000 U.S. citizens that have been driven to bankruptcy by medical bills each year, even people who had health insurance.

If I had no insurance or even if I had my former employer’s insurance, my Scotchman’s tendencies would have “influenced me” not to go from the ER to the ICU where things get very expensive. I would have likely gone home and died because I fear debt.

Every citizen should have this blessing. My wife, who is not yet Medicare age, will pay under the Affordable Care Act in Idaho about $5,640 or $490 a month this coming year for a “Gold” insurance plan from Blue Cross. (We are not eligible for any subsidy under the ACA, also called “Obamacare.”) I will pay $3,600 annually or $300 a month for Medicare A and B and for Part D Prescription drugs and Type F Medicare Supplement plan from private companies. But, I will not have to pay for any other medical costs. My wife will pay another $1,000 (the deductible) before coinsurance kicks in and of course she will have co-pays and co-insurance.

Not so by the way, if my wife had signed up for a comparable “Gold” plan ($1,000 deductible, 80/20 coinsurance) from Blue Cross last year, before the Affordable Care Act’s Exchange opened, she would have paid anywhere from $829 to $2,430 a month depending on what tier Blue Cross placed her. Blue Cross used to have 32 tiers that represented how likely they — not your doctor — thought you would incur costly procedures for them. Under Obamacare, that tier rating or underwriting is gone!

Obamacare is the first step making it possible for everyone to have medical insurance, through the Exchange or Medicaid. First time in America! And, the insurance companies can no longer stop you from getting insurance by pricing you out - e.g., “Yes, you can buy our insurance at only $2,430 a month.” Right!

You can now change jobs without losing insurance coverage. You can lose your job and still get insurance. You don’t have to be a victim to employers that purposefully keep your hours under their cutoff for health care benefits.

And, the insurance companies can’t put caps on the costs you may incur for a major need to repair a heart attack or to battle cancer.

Those changes alone are worth ALL the hassle of getting Obamacare’s website going and waiting for Idaho to get its act together on its web site and on Medicaid.

But, in my opinion the ACA is just the first step: We need a single payer system, like Medicare for all citizens. Is this socialism? No.

The military’s Tricare medical system is the ONLY socialized health care system in the U.S. Most everyone else is subsidized. Everyone who gets health insurance from an employer is subsidized by all U.S. citizens through the tax credits employers get. The health care of the nation’s 22 million city, county, state and federal employees (from your local councilmen and county commissioners to our congressmen) is also subsidized by all of us through our property, sales and income taxes.

We can pay for Medicare for all citizens by removing private insurance companies from the medical equation and by having EVERYONE, including even corporations who the Supreme Court said are now “people,” pay a progressive tax on Medicare.

Keep it at 3 percent for people whose only income is a small monthly SS check, increasing progressively through all levels of income to 15 percent or possibly higher for the wealthy on their income including capital gains income. For a perspective on those percentages: At my last employer, 13 percent of my total earnings went to health insurances (Medicaid, Medicare and Regence Blue Shield paid by me and the employer).

The president’s new law now allows insurance companies to take only 20 percent of our annual premiums for administration and profit when many companies were formerly taking 30 percent plus. Why not spend only four percent like Medicare does on administration? With the 16 percent savings, there could be money to ferret out Medicare fraud or to pay the health service providers more.

If we had Medicare for all, think of the relief to businesses that do pay huge monthly insurance premiums. Think of the relief to the working poor who could now get a terrible cough diagnosed and not have to go to a free clinic, if available, or the ER when it is too late.

In the meantime, support the ACA because it is for many people a huge benefit; my sister-in-law who has fibromyalgia (a pre-existing condition) can now buy insurance; my 31 year old and 19 year old nephews can now afford catastrophic health insurance for under $40 a month. Support it because it may lead someday to Medicare for all citizens.

STEVEN DRINKARD

Sandpoint