Universal coverage a must for effective health-care reform

Some of the usual suspects are gathering to oppose universal access to health insurance. However, the health care professions and the private insurance industry are united in favoring mandated health insurance for all Americans. All major physician and nursing groups, the American Hospital Association, and the association of private health-care plans now support universal insurance.

The reason is clear: The lack of insurance is associated not only with higher disability and death rates, but also much higher individual hospital and medical-care costs for those uninsured. Unfortunately, many in the media (Post and Courier editorial May 17) confuse universal insurance with government-run health care. Mandated auto insurance has not led to government-run repair shops and universal health insurance does not lead to government ownership of health care delivery.

The 50 million or so Americans without adequate health insurance are mostly employed, mostly married and mostly work in the service or small retail economy. Some are recent college grads who are no longer covered by family policies. Many could contribute most or part of their insurance costs if health insurance was available at competitive rates. Who pays for their health care now? All of us who are insured bear the burden of these costs for the uninsured because emergency facilities and hospitals are required to provide needed care to all by law as well as by our faith traditions. Those excessive costs, if unreimbursed, contribute to hospital rates which are paid by a shrinking number of insured persons. Insuring all reduces the individual cost is an adage of the industry.

Mandated health insurance was originated by Otto Von Bismarck (he was no socialist) in Germany in the 1890s to ensure a healthy military and effective work force. It was paid by a flat tax and has never been associated with government owned health care in that country.

Every advanced nation in the world, except the United States, has mandated health insurance though very few have nationalized the health delivery sector. Britain has done both, and though generally popular there, it is not proposed in the United States. There is some legitimate concern by private health insurers that they will not be able to compete with a government insurance option if one is made available for all under 65. Certainly, private insurers have not been able to compete effectively with Medicare, which has very low overhead, without the annual $12 billion subsidy currently received from taxpayers. Though Medicare has some very serious problems which need correction, overhead is not one of them.

My view is there should be a full array of private insurance options for everyone, and should a public option be made available it must be independent of governmental control and direction to provide a level playing field without subsidies for either private or public plans. Those currently insured would keep their plan unless dissatisfied.

All adults, or their employers, would contribute to the cost of insurance with a sliding scale for those with very low incomes and government paid premiums for the disabled. A mandated plan would provide basic care, and private supplemental insurance options would be available for individuals who want extra amenities or special access to certain medical care facilities.

No one would lose in such a system and it should drive serious changes in the health delivery system to reduce costs, enhance quality, and provide efficiency. We now have the most expensive health system in the world by some 50 percent or more, yet our health outcome measures are mediocre at best.

The United States deserves better, and universal insurance is a good place to start.

HAROLD J. FALLON, M.D.

Marsh Edge Lane

Johns Island