Universal Health Insurance & the Constitution 3/9/10

So. Is it constitutional or not? Yes, it is. And here's why.

Related to health insurance, take into account these excerpts from the U.S. Constitution:

Preamble

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

Article I - The Legislative Branch; Section 8 - Powers of Congress

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States

Welfare means the "health, happiness, or prosperity; well-being" of "We the People". Given that, because of the "adverse selection" dynamic described below, health insurance that covers everyone is necessary to prevent system failure. Therefore, it's necessary to "provide for the ... general Welfare of the United States". 

Note that "Union", "Justice", "Tranquility", & "Welfare" are capitalized to emphasize their importance. But despite the perhaps more obvious need for defense, "defense" was not capitalized.

The current health insurance bill is not even close to a "socialist" bill. It's a bill that's very much like Republicans have proposed AND the blueprint for it was written by a former insurance company executive. So naturally, it still uses private insurers. For it to be "socialist", the government would have to hire all the doctors and own all the hospitals ... as in the "socialist" military and VA.

Beyond that, even a single-payer universal health insurance bill wouldn't be "socialist" except for handling of insurance claims, which would take the profit motive that insurance corporations have to deny coverage & claims out of the system. Universal coverage would be pragmatic, rather than simply socialist, because it prevents system failure, just as our privatized system has been failing. All other industrialized countries have recognized this.

Nowhere in the U.S. Constitution does it mention capitalism or socialism, which are economic systems. The Constitution is a document that defines our political system, which is a different thing entirely.

The current bill continues to depend on private insurance corporations was passed by a majority in Congress. This is a problem for Republicans because they have never believed in democracy as noted at The Conservative Mind.

Added 2/15/10: The Daily Show on the nightmare that is universal health insurance in Hawaii:

The Apparent Trap 2/11/10. Republicans want Hawaiians to know that their 40 years of government-run health care will not work.

"With only 4 decades of testing America simply cannot afford to join this dangerous experiment."

Republicans are leary about attending a televised summit on healthcare reform, thinking it might be an apparent trap. In comments they show their obvious ignorance of the fact that what they fear is the reality of what's been in Hawaii for 40 years.

Added 12/3/09: New study finds 45,000 deaths annually linked to lack of health coverage, 9/17/09, David Cecere, Cambridge Health Alliance
Uninsured, working-age Americans have 40 percent higher death risk than privately insured counterparts

Nearly 45,000 annual deaths are associated with lack of health insurance, according to a new study published online today by the American Journal of Public Health. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993. ...

Harvard's study comports with studies that report similar findings. Dying for Coverage: New State Reports from Families USA, March – April  2008.

David Frum, a "conservative", refused to acknowledge the Harvard University study when debating David Sirota on CNN on the Afghanistan occupation and whether continuing it would save as many lives as would all Americans having health insurance. Don't like a result? Ignore it.

Comment 2/14/10: I've been thinking about this and have realized that not implementing single-payer health insurance amounts to mass murder.

Added 10/30/09: What Insurance Companies Love: Money! Money! Money!, Influence!, Bogus Reports!, Employees Who Figure Out New Ways To Deny People Coverage!, Market Domination!
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Christ driving money-changers from the Temple, Rembrant van Rijn, 1626

Privatized health insurance doesn't work. Why is that?

First, it's fatally flawed because of adverse selection. Added to that fundamental flaw: it makes our economy less competitive, discourages U.S. innovation, costs the U.S. twice as much per capita, puts low-level corporate bureaucrats between patients and doctors, has obscene CEO pay, misrepresents profits & exorbitant overhead costs, bankrupts Americans, and leads to the deaths of 100,000 persons/year because the U.S. system isn't as good as that of France. See the details below.

A "public option" is a good first step, but it doesn't go far enough. The only workable approach is a single-payer health insurance system ... a "Medicare for All" system.

Here's an important point for those who have an irrational fear of collective solutions (gasp, socialism). It's not simply socialist to implement a single-payer health insurance system that works and scrap a privatized health insurance system that does not work. It's pragmatic. See Health Care Dynamics.

The California Nurses Association understands it's a useless industry:

"Our legislators should ... stop coddling a useless industry whose sole function is to make enormous profits from the pain and suffering of patients while providing little in return," said DeMoro.

Also see: US Healthcare History: Our Very Own Killing Fields

Top 20 Lobby Expenditures Equals Over 1 Billion Dollars in the Last 2 1/2 Years 8/5/09. Enormous sums have been spent on health reform lobbying to influence legislation to be in their financial favor in order that the public not know why single payer health insurance is necessary. Excerpt:

That’s simply a lot of money. And the phrase “Return on Investment” immediately comes to mind. Presumably there is one, or why would they persist? One of the finer things that one can say about someone is that they “Speak Truth to Power.” Speaking money, however,  seems the preferred means of communication.

From Harpers' Index, Sept 09:
Percentage change since 2002 in average premiums paid to large U.S. health-insurance companies: +87
Percentage change in profits of the top ten insurance companies: +428
        Source: Health Care for America Now

Why Single-Payer Health Insurance? Because privatized health insurance is dysfunctional. Worse, it does not even work; it cannot! It ...

Adverse Selection Stock & Flow Diagram

... Does not work because of adverse selection. Akerlof, Spence, & Stiglitz got the 2001 Nobel Prize for understanding the effects of adverse selection on markets with asymmetric information, but the impact of this still hasn't found its way into "conservative" minds or the Republican Party. This is natural law; society and government should take into account natural law.

The Adverse Selection Stock & Flow diagram: Cost per person increases as the the healthiest drop their insurance because they don't think it's worth the cost -- or as they simply can no longer afford it. And then more of the healthiest drop insurance as Cost increases. It's this reinforcing feedback dynamic that's been fundamentally responsible for the increasing number of uninsured (decreasing the number of insured).

... Makes our Economy less competitive: The U.S. competes with countries with single payer, which means their businesses do not bear the cost of health insurance. This makes U.S. companies uncompetitive.

... Discourages innovation: entrepreneurs are afraid to change or leave their jobs for fear their families won't get insurance or will be denied care for "pre-existing conditions".

... Costs the U.S. twice as much per capita:  The U.S. spends twice as much per-capita, but is last in health care system performance among a group of six countries including Australia, Canada, Germany, New Zealand and the United Kingdom.
America's Health Rankings Comparison to Other Countries

... Bankrupts Americans: Harvard Study 2/3/05: "Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001 ... Surprisingly, most of those bankrupted by illness had health insurance. More than three-quarters were insured at the start of the bankrupting illness." Article: Illness, medical bills linked to nearly two-thirds of bankruptcies

... Leads to the deaths of people without health insurance: A Harvard study estimated that 45,000 Americans die each year because they lack access to health insurance; uninsured Americans are 40 percent more likely to die than Americans who are insured. Harvard research study
Republican Sen. Kyl Not Sure People Die From Lack of Health Insurance

... Has higher Death Outcomes: The U.S. would have 101,000 fewer deaths if U.S. care were as good as that in France, Japan and Australia ... France, of all places!
France best, US worst in preventable death ranking  1/8/08

... puts low-level corporate bureaucrats between patients and doctors: They charge high premiums to determine who not to cover, what treatments to not cover, and how to terminate coverage for those who get sick.

... has Obscene CEO pay: For example, UnitedHealth's William McGuire's $1.6 billion stock options ... how many had to die to pay CEOs such exorbitant amounts?
Examples: UnitedHealth's William McGuire's $1.6 billion stock options, current UnitedHealth CEO Stephen J. Hemsley's $744 million in unexercised stock options by Peter Dreier 10/6/09, more examples at The Health Insurance Mafia Deserves a Good Screwing by Bob Cesca 6/10/09.

... misrepresents profits & exorbitant overhead costs: America's Health Insurance Plans (AHIP) -- the lobbying arm of the insurance industry -- maintains that "for every dollar spent on health care in America, approximately 1 penny goes to health plans' profits."

This is misleading beyond belief because health insurance provides no care, no research, no medicine; therefore profits should be compared to their revenue only, not total health care spending. In fact, the Health Insurance Industry Fudges Data To Downplay Its Astronomical Profits.

Health insurance companies only transfer money from those who need care to those who provide it ... all the time spending major percentages of revenue, not on health care, but on administrative or marketing expenses, taxes and profits. In fact money spent on health care is deemed to be "medical losses." The Medical loss ratio (MLR) is

... the fraction of revenue from a plan's premiums that goes to pay for medical services. The portion of health plan revenue that does not cover administrative or marketing expenses, taxes and profits.

In other words, spending on the insured is a LOSS to private insurance companies, not an investment in your health.

According to PricewaterhouseCoopers, "In 2007, the MLRs for national publicly traded health plans were estimated to be 81% ..." And a June 2008 report by Families USA found that "insurers in the individual market sometimes maintain medical loss ratios of only 60%, retaining 40% of premium dollars for administration, marketing and profit." That's 19 to 40 percent of insurance dollars NOT going to help pay the medical bills of the insured.

Actual Industry Profits: The top five earning insurance companies averaged profits of $1.56 billion in 2008 ... That year, CEO compensation for these companies ranged from $3 million to $24 million.

In the face of all this, how can we continue an irrational privatized health insurance system and not support a single-payer system? Continuing the current system betrays the nation.