EDITORIAL: Wednesday Is health insurance a right?

July 12--The big debate over health insurance involves government's role.

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The purest government-run health insurance involves the military. The Veterans Affairs is entirely government-run.

Then there is the blend of government and private medical services through Medicare, Medicaid and TriCare.

What about the health insurance we receive through our employers?

Actually, the government has a $250 billion stake in the health insurance we receive from our employers through tax credits.

That's the federal government's third largest health expenditure behind Medicare and Medicaid.

Everyone who receives health insurance at work benefits from this, including members of Congress, reports The New York Times.

This tax credit, hidden from most employees, contributes to the high cost of health care.

Cost often is not a factor to either the patient or the physician because it is wrapped into an insurance package. Even if an employee wanted to shop for prices for health care, the system makes it difficult.

So the system provided incentives for employees to use more health care than if the money were coming directly out of their pockets.

The connection between those tax credits and wages is real. In recent years as costs of health care surged, employers traded health benefits for wages.

Yet the value of those tax credits is not included as income for purposes of payroll or income taxes. That's a subsidy.

The tax exclusion reduced the cost of health insurance by about 30 percent, reports the Kaiser Family Foundation, a huge benefit for people with a job that includes health insurance.

Do something about DRUG PRICES

The health care market often works against consumers.

A prime example is the difficulties involving generic prescription drugs.

Once a drug loses its patent protection, it goes into the generic market where prices should drop substantially.

Last year consumers saved $253 billion on generics, reports The Wall Street Journal.

Still sometimes the system is abused -- and sometimes it simply doesn't work the way it's supposed to.

Once the profit potential has declined, it sometimes takes awhile to bring generic versions to market.

When just one generic drug is on the market, consumers save just 6 percent.But when three generics are available, consumers save 56 percent, according to an analysis done by the Food and Drug Administration.

Under President Donald Trump's administration, the FDA is trying to speed up the generic market. The FDA will expedite the approval process for new generics, a good move for consumers.

MEDICAID

The cost of Medicaid has been vilified, especially in Florida. Actually, the program is a low-cost model with reimbursements so low that many physicians decline to accept it.

According to an article in the New England Journal of Medicine:

--Medicaid costs about 22 percent less than private insurance when adjusted for risk.

--Per capita spending for Medicaid has grown more slowly than either Medicare or commercial insurance.

In Republican-dominated states like Ohio and Indiana, there are work incentives and patient co-pays.

In Florida, Duval and neighboring counties were the first to have Medicaid turned into a managed care model.

If this were really handled like insurance, consumers would receive government help to create health savings accounts to be used for most routine expenses along with catastrophic insurance for major procedures.

the GOP plan is underwhelming

The plan proposed by the Republicans is different but no better than Obamacare.

Better off: The young, people with higher incomes or consumers in low-cost areas.

Worse off: Older people with low incomes or who live in high-cost areas.

Here is one example from a Congressional Budget Office report: A low-income elderly consumer would see premiums rise from $1,700 to $13,600.

In contrast, a 21-year-old would see premiums decrease from $5,100 to $1,250.

OPIOIDS and the AMERICAN DREAM

In much of the nation, the pursuit of happiness is like a nightmare.

Opioid addiction diagnoses are up nearly 500 percent in the last seven years, reports the Blue Cross Blue Shield Association.

This is based on an analysis of claims of 30 million people from 2010 to 2016.

The amount of prescription opioids sold in the U.S. increased fourfold since 1999 even though there has been no change in the amount of pain reported by Americans.

But the number of deaths from opioids increased fourfold as well.

"An epidemic of deaths of despair" is the way the Guardian described it.

Mortality rates have been rising for one group: middle-aged whites without college degrees. In short, Trump voters.

Families that once could have a decent living without a college degree are now forced into several low-wage jobs without health insurance.

The result: suicide, overdoses and substance abuse.

This is a shocking outlier since mortality rates have been falling elsewhere in the U.S. and in other developed nations.

A study by two Princeton economists shows a "gradual collapse" of the white working class. Its health -- both mental and physical -- has declined along with the disappearance of good jobs.

And the current opioid epidemic is only making things worse.

"For many Americans, America is starting to fail as a country," said James Smith of the RAND Corp.

This should not be a partisan issue.

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