Here is my 4th and final napkin in the health care series. (For now, anyway.) This napkin illustrates the impact upon us of each of the plan types, and offers three concluding questions.
This is the cover of the 4th and final napkin.
This napkin shows how the various insurance reform options will effect me.
In review: there are three main options in debate. All of them mandate universal coverage for all Americans; the difference is the degree of government-backed coverage they provide.
We should note that earlier in the debate there was a 4th option. Sometimes referred to as "single-payer", this option proposed a single national health insurance plan.
This option was not supported by the White House and is effectively off the table for any debate this year.
So what do these 3 options really mean for me?
If I am presently employed and covered, I will pay more for insurance under all proposed plans.
So why should we reform insurance? Because health care costs are already bankrupting the country and if we do nothing now, it's going to cost much more very soon.
At this point in the debate, the actual additional costs are unknown. What is known -- what we can try to influence -- is how the money will be taken from our pockets. Will we pay higher premiums to private insurers, lose our existing health care tax benefit, or pay more direct taxes?
An additional aspect of the various plans we need to be aware of is whether our employer continues to pay our insurance premiums on our behalf to a carrier they select (called "Defined Contribution" in the secret code of the insurance industry), or do they pay us in health care vouchers that we can spend on any insurance program (called "Defined Benefit"). The difference means an additional $250 Billion in revenues collected annually by the government to cover health care with no impact on our compensation and employer costs.
The good news is that under any option our health care at least shouldn't get any worse. All plans in debate allow us to keep existing coverage and providers as long we keep the same employer. And all plans will ensure that more Americans have health care insurance, which is the whole point.
Although today's debate is more about insurance than health care, there are several ideas to address on the "provider" side of the equation to help drive down costs: reforming malpractice will save the entire system money. The pharmaceutical industry has many opportunities to assist in minimizing costs. New technologies (most of which are expensive up-front to enable) could well create efficiencies that save huge amounts of money. These are all worth debating, but none of them are at the core of today's debate. For now, it's about insurance.
When all is said and done, there are really only three essential questions we need to ask ourselves in order to know how we should individually feel about insurance reform: first, should paying for our health be a profit-driven business? Second, since change is coming no matter what, how do we want to pay for it: as profits for insurance company shareholders or as taxes to the government? Third, will we be better off by continuing to shout at each other, or by listening and thinking?
Two things to remember: one, it is neurobiologically impossible to shout and think at the same time. Two, there are influential parties in this debate who do not want us to listen or think. Ask yourself who stands to gain the most by encouraging us not to think, and you'll know which option you are for.
Tony and I thank you for staying with us this long, and sincerely hope these four napkins have made things at least a little clearer.
