June 23, 2009

To Editor of Seattle Times

Your editorial of June 22^nd identifies the importance of a public-health insurance option, and that “consumers” need an “affordable” choice. I rather doubt that most people, who are provided their god-given medical coverage by Microsoft or Boeing, view themselves as making profound consumer decisions for coverage whose monthly premiums range from zero to a relatively nominal sum relative to the amount that they charge their former employees in a COBRA. And certainly when we show up at an emergency room, and especially those that have no coverage, are they not facing just a Hobbesian choice? At this time, like when we choose an employer-based provider, we don’t typically go shopping for coverage for a heart attack or pancreatic cancer—unless we have a pre-existing condition. Then, as Paul Harvey used to say, we “know the rest of the story.” And after a few months when the federal subsidies for the employer-based COBRA are exhausted, what makes out-of-pocket expenses of $500 per unemployed person so affordable about this approach? Unlike transportation or education, this year with 10,000 employees involuntarily leaving Boeing and another 5,000 jettisoned from Microsoft, the stone-silence of these companies relative to the public option—let alone any option—is noteworthy relative to these unemployed people or their own “golden handcuffs” for the remaining employees.

Similarly the silence of Group Health, being promoted by Senator Cantwell as a model, is also striking. As the Northwest Federation of Community Organizations noted in January of 2008 in its article “Insuring Health or Ensuring Profit?: A Look at the Financial Gains of Washington State’s Health Insurers,” Group Health had the highest per-member-per-month profitability of the three dominant health insurers in Washington state. Now whether this organization or model should be the paradigm for our Senator and our country is questionable and certainly debatable. What cannot be debated is that in its IRS Form 990 for 2007, Group Health spent a total of $1.4 million out of $1.9 billion for “healthy communities programs . . .that promote the overall health and well-being of all members of the community.” In 2006, it spent $800 thousand for “Healthy Communities Programs” out of $1.8 billion. I can say that this is one taxation model and one approach to medical insurance and provisioning that I prefer to forego.

Without question the current Medicare and Medicaid programs as projected by the Congressional Budget Office will double in expense by 2017, raising their current approximate twenty percent of the federal budget to something closer to 35 – 40 percent. We need change here in just the way we are financing it alone, or we need drastic reduction in benefits. I have difficulty thinking that as the baby boomers retire they will support those who give us less. Likewise I have even greater difficulty imagining that the Group Health model that Senator Cantwell supports will make our society any more accountable for contributing to a compassionate, civilized society. Hence, do we really have any choice in the long-term but to begin the transition to the single-payer insurance approach?

Newton Simmons

Seattle