All Americans should have access to affordable healthcare and no one should be denied coverage by health insurers because they are sick. It’s a great ideal, but how great an idea is it in reality?

Time to buy some full coverage insurance!

Under the latest Senate bill, all Americans will be required to buy health insurance or else pay a penalty. In exchange, health insurers will not be allowed to deny people coverage based on pre-existing conditions or charge those people any more than they do everyone else. Okay, so the idea is to increase the amount of people paying in so insurance companies can afford to take care of the sick people. Nice idea (although I question the constitutionality of forcing people to buy a product they do not want, but that is fodder for another day).

However, the penalty in the Senate bill, according to The Miami Herald, is only $750 per person up to $2,250 per year, per family.

Imagine you are a young, healthy twenty-something working a decent job. Now, you could either pay $150 a month for health insurance with a $1,000 deductible, or you could just pay the $750 penalty at the end of the year. Which do you think most healthy people are going to pick?

Besides, if you do get gravely sick, you can just go buy some coverage and pay the premiums and deductible (also a capped affordable amount) and have the insurance company pick up the rest of the tab for treatment. If you have a serious, chronic disease, this could easily cost the insurer hundreds of thousands a year. Again, you can’t be denied coverage for the pre-existing condition, nor be charged more because of it.

Of course, this goes completely contrary to the whole idea of insurance, which is to, you know, plan ahead and pay into a joint fund in the event that you may get sick in the future. Insurance premiums are going to go through the roof for companies to foot this bill, as most people will not start paying in until they actually get sick. Either that, or insurance companies will just exit out of the market altogether and cut their losses.

Let’s take some of the emotion out of the equation and think of this another way. What if Congress proposed a similar initiative involving car insurance?

Now, insurers cannot charge you more for full coverage than anyone else is charged, even if you have a poor driving record and lots of tickets. Better yet, you can just pay a small government penalty rather than buy insurance.

However, if you get in a serious wreck, you can just go down to the insurance company and they will have no choice but to write you a full coverage policy even though your car is already totaled. You pay a couple grand in deductible and a month of coverage and they pay the price to replace your car. How does that make any sense? Yet that is essentially what we are proposing with healthcare reform. How is that sustainable in the long run?

Affordable healthcare for everyone where you can’t be denied coverage is a great ideal, but implementing it is ultimately unsustainable and thus illogical. We need to go back to the drawing board and come up with a real solution to this problem.

Government: “You charge WAY too much and you treat your customers like dirt!”

Health Insurance: “Okay, let’s compromise.  I’ll treat them a little less like dirt if they agree to pay me more money.”

Government: “Awesome!  Helloooo reelection!”

It occurred to me while watching Meet the Press online that I was insane for watching Meet the Press online.   Then it occurred to me that the above dialogue basically explains what, if anything, we’re going to get out of this mess.  If you want a long (but really good and readable) explanation, you should read this article by Rolling Stone’s Matt Taibbi.

The President has all but said (and will say Wednesday night, I predict) that there will be no real public insurance plan, the much bally-hooed public option.  If there is a public option, the blue dog democrats have assured us that it will pay out at rates similar to private insurance (instead of lower medicare plus five rates) so that the playing field is level with insurance.  That also means the public plan would be pointless.  It’s like saying, to level the playing field, homeless shelters have to charge the same as hotels.  Whenever anyone mentions blue dog democrats, imagine a blue dog humping the leg of a health insurance CEO.

But never fear!  There is more to health insurance reform than the public option, right?  That’s the line the White House has been pushing for weeks.  They love mentioning how the bill will keep you from getting turned down for preexisting conditions, and insurance companies won’t be able to kick you off the rolls if you get sick, and they’ll cap out of pocket expenses, and they won’t be able to arbitrarily raise premiums multiple times in one year, and you might even be able to keep your insurance if you “switch jobs.”  In other words, the health insurance companies are going to have to treat people like human beings instead of bloody sacks of cash to be drained up and thrown out.

How is this real change?  Gee, you make the industry that has caused this health care crisis stop a few of it’s more egregious, blood-sucking practices.  Hooray!  A major victory!

But there’s more!  There’s also an individual mandate looming overhead, meaning everyone MUST by health insurance or face a tax penalty.  Health insurance, welcome to 47 million new customers, courtesy of uncle sam!  Forty-seven million Americans, welcome to fly-by-night health insurance, much like the craptastic state minimum car insurance advertised late at night on the CW (not that I watch it).  The only difference between that kind of insurance and no insurance is that you pay to be uninsured.

THIS is reform?  Creating a windfall for the industry that screwed things up?  Exponentially increasing the overhead and the paperwork logjam that is strangling health care?

But here’s the best part.  No denials for pre-existing conditions?  No kicking people off when they get sick?  Keeping insurance if you lose your job?  These all KEEP people on the insurance rolls.  Wow, tough reforms.  Really sticking it to the people that stuck it to us.  Insurance companies will get to pass these costs on to the public via the mandate, or subsidies from tax money that will support the mandate.  No wonder PhRMA, the drug lobby, is spending 140 million to SUPPORT reform.  They took a lesson from Wall Street about socializing losses and privatizing gains.

It’s a win, win, win all around for insurance, and lose lose for Americans.  We’ll pay more and get less.  And the added bonus?  This plan can properly be called “Universal Health Care,” forever sullying the name of the only system that makes sense, and the system every other industrialized country in the world has, and the system that veterans, the elderly, and the very poor have right now, single payer.

I recently read an article about a couple of kids who live near me, Sean and Cody Merrill.  They have Mucopolysaccharidosis (MPS), an exceptionally rare disease whose treatment costs $800,000 dollars a month.

Through an extraordinary turn of good fortune, their father, Eric, had insurance through work that covers all the expenses.  Most insurance policies, even “good” ones, top out at one million a year, which would cover less than a month for Sean and Cody.

But as the boys reach 18, they can no longer be covered as dependents, meaning they would either have to find their own insurance (yeah, right), or earn less than $600 a month to qualify for Medicaid.

Legislation is now before the House to help remedy this situation.  From the article:

“If the Ryan Dant Act passes in its current form, anyone whose medication costs more than $200,000 annually would be allowed to work and receive Medicaid benefits.

While that would include the fewer than 1,000 individuals with MPS in the United States, it would also cover thousands of others who suffer from diseases whose treatments are prohibitively expensive, such as hemophiliacs.”

Why does our mercy stop at $200,000?  Why not $180,000?  Why not $100,000?  Why not *gasp* everyone?

Sean and Cody are essentially in the same boat as millions of Americans without insurance.  For them, insurance is either prohibitively expensive or impossible to get because of pre-existing conditions.  The boys stand out because of the extreme cost of their treatment, but all uninsured Americans face the threat of crippling health care costs, poorer health, and shorter lives.

Are these kids any more or less deserving of medical care than the millions who are uninsured?  Although the news article frames their plight as a problem with Medicaid, it is also a failure of private insurance.  No insurance company would cover them with a pre-existing condition costing millions to treat each year.  If their father was uninsured, would they be less deserving of medical care?

The answer is yes.

We’ve collectively embraced an idea; our country is uniquely meritocrious, and the only difference between rich and poor is the ability to work hard.  Not only is this demonstrably untrue, but also carries with it a smug justification for the inequalities all around us.  Poverty, according to the American Mythos, is a moral failing on the part of the individual.

And so we do have rationing of care, right now.  Instead of recognizing health care and access to it as a human right (like nearly every other country in the world), we allow the insurance and drug lobbies to hold the health of the nation hostage to ever increasing extortion.  They decide who lives and who dies, and how much we pay for the privilege of their wisdom.  They are the “bureaucrats coming between you and your doctor” right now.  We have hospitals turning patients out into the street, a practice that should be a shame to any nation with a conscience.

But it’s not the fault of the hospital, it’s the natural outcome of a system that prioritizes dollars over health. For all the talk about personal responsibility, no one can seem to stomach an ounce of social responsibility.  Yes, we live in a society, meaning we have certain responsibilities to that society.  The uninsured are our people, fellow Americans, for better or worse. Our ideology has such a stranglehold on our discourse that advocates of a single payer system, which most other industrial countries have, are virtually absent in the mainstream media and such a program is ruled out from the start by our key legislators.

Does being an American have any meaning when your fellow Americans can so casually turn their backs on you in a time of need?  Perhaps the inscription at Liberty Island should read, “Give me your tired, your poor, your huddled masses yearning to breathe free, but after you get here, it’s every man for himself.”

Ultimately, you spend money on what you value.  We pay exorbinate amounts of money to health insurance companies to cover some people some of the time, while other countries spend much less to cover all the people all the time, and get better outcomes.  So when we spend all this money on health insurance, are we paying for our health, or the health of the insurance companies?

Right now, the Senate finance committee is considering allowing insurance companies to lower their payouts from 76 to 65 percent of medical bills, leaving their customers to pay the other 35 percent.  That’s after premiums, which are $3,900 for a family of four with employer sponsored coverage.

So the average hospital stay in 2006, which was $19,400, would require $2,100 more out of pocket.  It comes to a total out of pocket expense of around $6,800, for the insured, on top of premiums.  Considering the median household income in the US is around $50,000, it’s a devastating expense, sapping 21.4 percent of their gross income altogether.  Not to mention the impact on ability to work following an injury.

But we will break our backs to pay it, because we value our health and the health of our families.  What do the insurance companies value?