Thursday, February 16, 2012

Is it time to end employer sponsored medical insurance?

It has been more than a little hard to follow the politics of the healthcare reform "debate" over the last few years. Sponsors of reform have been treated to accusations of death panels, the President has been portrayed as a Nazi and republicans have uncharacteristically complained that money saving measures were an attempt by President Obama to "gut Medicare". Now, the strangest twist of all may be the new proposal from Sen. Roy Blunt (R) Missouri. Simply stated, the "Blunt Amendment" would allow employers who provide insurance coverage and insurance companies themselves to refuse coverage of any health care service required under the new health care law if they feel it violates their “religious beliefs or moral convictions.”  Wow. 
Unfortunately, this phenomenon is uniquely American
Coverage of contraception services, for example, has been a settled issue in the majority of our states, supported by both democrats and republican legislators for almost 40 years. Other countries, even predominantly Roman Catholic nations such as Spain and Italy, also provide contraception coverage, and they do not have the conservatively devout trying to end the coverage! The difference is that our way of doing things revolves around the unique way that medical insurance is sponsored in the United States, and that is our reliance on employers to sponsor private insurance options for their employers. 
As I witness this debate, I can't escape the feeling that the only way to end this kind of messy politics may well be to end our dependance the private insurance system itself. We can't have it both ways. If private employers and plans can pick and choose conditions and services to pay for, then the rights of those covered to follow their own conscience and make their own choice is impossible. Diseases felt to be due to an unhealthy lifestyle, for example, might join contraception as prohibited items to cover. The result would be chaos and anything but a just and equitable situation.
It would be ironic in the extreme if the immoderate rhetoric used by the extreme right to oppose efforts to improve our system actually led us to a true national health insurance system such as Medicare for all. President Obama's efforts to compromise on this issue for the passage of the Affordable Care Act may still lead us to a government plan.