Public Single-Payer: Health Insurance the Way It Should Be

What do my wife and I do on New Year's Eve? Think up e-mails on the need for universal health coverage to send to Tom Daschle and the Obama Administration. Here's a message I just submitted through Change.gov. Mr. Daschle, pay attention!

To Secretary-Nominee Tom Daschle:

A friend of ours told us about the hard times her sister and brother-in-law have hit. She is recovering from breast cancer and still undergoing some treatments. Her husband just received a heart transplant Christmas Eve. He has lost his job, because, of course, he missed a lot of work. He has thus also lost his health insurance. Chances of finding an affordable policy that won't exclude either him or his wife are slim to none. His employer-based health plan covered the transplant, but how they'll pay for the follow-up medicines and treatments is anyone's guess.

It occurred to us that if insurance worked the way it was supposed to—a bunch of us pool our money to take care of the few of us each year who will need health care, in return for the promise that if something bad happens to us, we'll be covered—these folks wouldn't have to worry. If they were in my insurance pool, I'd never deny them coverage. I'd say, "You can't work right now? No problem, neighbor. Come in the pool, we'll cover you, and then when you and your wife are better and can contribute to the pool, we'll expect you to help us if we're in a bind."

Why can't we do that? Because we, the insurance purchasers who provide private insurance companies with their capital, aren't the real stakeholders. Private investors buy stocks in health insurance companies, creating a distinct and conflicting interest group. We join the insurance pool for it to function; private investors buy stock in hopes that it won't function (i.e., won't pay out for health care).

I want my health care dollars to go toward health care, toward helping my neighbors, not toward profit. Health insurance should be one giant public pool in which every American pledges to help protect every other American (and anyone else who happens to be our guest).

Single-payer not-for-profit health care: it's decent, it's practical, and it's how insurance is supposed to work.

As we see from the case of of the couple paying bills for breast cancer and a heart transplant, it doesn't make sense to tie health insurance to jobs. You don't deserve health care because you are a good employee. You deserve health care because you are human.

Similar conversation about both the morality and practicality of universal health coverage was on MPR's Midmorning with Kerri Miller yesterday. Give it a listen, then get hold of Tom Daschle yourself and tell him to do health care reform right.

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Update 2009.01.02: See more reader response at TPMCafé!