If “Affordable health care is a basic human right.” one problem is defining “affordable”. I could afford a Ferrari today, but it would require that I sell my house.
So how do we define what is affordable? Let’s look at Canada. I suppose we could look at France or any number of industrialized modern democracies, but what the heck, eh? It’s Canada.
The average Canadian “pays” $3,961 per person for health insurance. Since some pay nothing, like children, let’s look at a family. The average Canadian family is 2.9 people, meaning that the average Canadian family pays $11,486.90 per year for health insurance. The average Canadian income (mean) is $76,580. So this means that the average Canadian family pays 15% of their income on health insurance. They consider that affordable. I agree.
The typical American family income was $53,657 last year. 15% of that is $8,048.55 per year. Annual premiums family health coverage reached $16,351, or slightly higher than 30%.
Here is my proposal and the candidate who pledges to fight for “Health Care as an affordable human right” is free to take it.
We allow the “free market” to sell insurance. Anyone paying more than 15% of their income gets to write that off on their taxes and/or receive a tax credit to makeup the difference and make it “affordable”. Anyone paying less than 15% of their income pays a surcharge equal to that savings to the government to fund the aforementioned and truly make this human right “affordable”. The average American family will see a saving of over $8,000 in their pockets. Watch what that does to the economy. Yeah, the hedge fund managers and CEO’s won’t be happy, but whose side are you on?
And I am really glad Bernie and Hillary are keeping it in the conversation. Even their argument keeps it on the radar, while the GOP isn’t bothering to talk about it anymore, other than in the context of a fairy tale repeal effort for their base. It’s not a settled issue by any means. I am very intrigued by Maryland’s price controls and a multipayer system as a way around the logjam that single payer seems to run into.
When doing comparisons like this, I think it is crucial to keep ALL the costs on the table while doing the comparison.
Specifically:
1. We also need to know out-of-pocket health care expenses for the Canadian and American family. One of the worst aspects of the current US health care system, even after ACA, is that the insurance companies are shifting more and more costs to consumers. Deductibles are going up. Co-pays are going up. Health care expenses that used to be covered no longer are. Certain health care items, even if reimbursable, are so tedious to be reimbursed for that people buy them out-of-pocket to avoid the hassle.
2. We need to know what portion of families are covered in each system. The most expensive health care in America is emergency care in the ER provided to families without health insurance for disorders that would have been prevented for a tiny fraction of the cost had the family been seeing a health-care provider. For example, a parent brings their child to the ER with an abscessed tooth that needs to be immediately removed because of the raging systemic infection, when regular six-month cleanings by a dentist would have avoided the problem entirely.
Elizabeth Warren has pointed out that too many personal bankruptcies are caused by medical expenses, and too many of those personal bankruptcies occur to families WITH health insurance policies.
I agree with where you’re going — I think it’s crucial to not get distracted by the many ways that insurance industry lobbyists will attempt to hide the true costs of what we are doing today even WITH the ACA.