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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

A Modest Proposal To Promote Wellness, Save Money and Fix the Health Care System: Eliminate All Employer-Based Health Insurance

Monday January 30, 2006

As medical treatment costs rise and several once great American companies fail, in good part due to bloated employee entitlements, the popular post WW II benefit of subsidized health insurance has come under scrutiny. Scrutiny is fine and well justified. However, what is needed now is an end to scrutiny. No more time-wasting scrutiny is needed or justified. What seems abundantly clear is that employer-based health insurance, the payee for the health care of 64 percent of Americans under 65, must be eliminated. In its place, America needs a universal coverage plan. The latter should be designed to provide basic medical benefits for all, with compelling incentives for citizens to stay well in the first place. 

General Motors faces a one billion dollar increase in medical costs (for a total of $7 billion) in 2006. Currently saddled with the medical bills for 1.1 million workers, retirees and family members, GM paid just under six ($5.8) billion last year for this devastating entitlement. How can GM carry such a load and still compete with Toyota and other foreign automakers with no such burden? The answer, of course, is that it can't. Neither can other US companies facing similar if less spectacular medical entitlement burdens compete globally with firms located in countries that offer universal medical care.

There is also the fairness question, though what seems fair, of course, depends on where you stand. Few of us can be objective about fairness if our interests are affected by the choices. Still, many might see a problem in the fact that half the tax subsidy for company-paid health insurance goes to families earning in excess of $75,000 a year; a quarter of that accrues to families with incomes over $100,000. annually. As you might expect, most (two-thirds) of the 45 million without health insurance last year (or 18 percent of the 65 and under population) made little more than the amount the federal poverty level, according to a report by the Kaiser Family Foundation. 

Here are some additional facts to consider when pondering the idea that company-sponsored health insurance (in fact, medical benefit payment plans) should be eliminated by the creation of nationalized health care for all. 

Of course, my idea to phase out employer-based health coverage will encounter stiff resistance from the health insurance and pharmaceutical industries. After all, these industries currently rake in billions as middlemen and middlewomen between patients and caregivers, a "service" that contributes nothing to overall care or better health status. The drug industry gave us the "Harry and Louise" campaign in 1993 -1994. These attack ads helped sink Hillary's health reform plan. I can imagine the awful things that Harry and Louse would say about me, but somebody's got to speak up. (By the way, while Hillary's plan was pretty awful, its shortcomings were not addressed in the scare-tactic "conversations" dramatized by actors who played Harry and Louise.)

Another problem with employer-sponsored medical insurance is that the subsidy promotes wasteful medical spending. The well-to-do gain low cost coverage in such high amounts that they feel entitled to a "more is better" way of thinking. This, in turn, leads to more use of the system than is usually appropriate, which, naturally, adds to the unstoppable inflation of medical costs. As often noted here and elsewhere, no nation spends as much for medical care -- $5,400 per person per year a few years ago, undoubtedly much higher now. 

Well, what do YOU think? Do you believe the country would be better off without employer-based health insurance for a privileged few in favor of a restructuring that grants basic medical access for all? I'd be delighted to hear from you.

Be well. Always look on the bright side of life.

Domain: purpose
Subdomain: applied wellness

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