It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. So here’s the bottom line: if you currently have decent health insurance, thank the government. But to get that tax advantage employers have to follow a number of rules roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.Īnd it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. The vast majority, however, don’t buy it directly: they get it through their employers. Still, most Americans under 65 do have some form of private insurance. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance. Today, Medicare which is, by the way, one of those “single payer” systems conservatives love to demonize covers everyone 65 and older. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Most obviously, the government directly provides insurance via Medicare and other programs. How is that possible, when insurance markets work so badly? The answer is government intervention. Still, most Americans do have health insurance, and are reasonably satisfied with it. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend. Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential. You don’t know when or whether you’ll need treatment but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. The key thing you need to know about health care is that it depends crucially on insurance. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.Īnd that government involvement is the only reason our system works at all. It’s not just that many Americans don’t understand what President Obama is proposing many people don’t understand the way American health care works right now. It’s a funny story but it illustrates the extent to which health reform must climb a wall of misinformation. At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program but the voter, Mr.
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