In Our Opinion
Just what does finding peace in the Middle East and the key to affordable health insurance have in common?
Not much other than each seems like an endless quest.
The debate over paying for health care, however, predates the modern battle for land between the Israelis and the Palestinians by decades. And unfortunately, the solutions for either seem to not be on anyone’s radar.
“If you want to understand today, you have to search yesterday,” author Pearl S. Buck once said.
The Pittsburgh Post Gazette newspaper published a lengthy 3,400-word story in 2014, which posed the question in its headline: “How did America end up with this health care system?”
It’s a piece worth finding, and of course reading. Doing so will help you gain at least a general picture of the origins of how health insurance that comes in all shapes, sizes, coverage — and of course prices —came to be.
Like so much of the late 1800s and early 1900s, workplaces were often not very hospitable places to spend six days a week, 12 hours or however long a day. For instance, it was not uncommon in this era to have in excess of 10 percent of steelworkers for U.S. Steel in Chicago either died or were injured on the job.
But it was coverage of lost wages rather than helping with sickness or injury costs that was deemed more important at the time. Health care was much easier to find with the family doctor, who often would actually travel to offer expertise with the house call. In fact numerous surgeries took place inside the home, not in a hospital setting.
Like most everything else during these times, the world at the beginning of the 20th Century was racing along at a hectic pace of progress. That included finding ways to cover the cost of improved medical practices. Concerns then centered on how to help people avoid medical bankruptcies, the No. 1 cause of financial ruin as it is today.
While origins came in a variety of ways — such as when Dallas, Texas teachers planted the roots for Blue Cross — employer sponsored insurance flourished during World War II as a perk to keep good workers on the job. Between 1940 and 1950 coverage exploded from having just 10 percent of the nation being covered to 50 percent.
After World War II, the notion of health insurance penetrating every corner of the population had become so popular that the push to include the forgotten – retirees and the poor – ultimately hatched Medicare and Medicaid in 1965 that now jointly serve just under a third of the population.
The focus soon shifted to the rest of the country with the desire for “compulsory,” or what we refer to as single-payer coverage, popular across Europe. The Scandinavian nations of Denmark, Finland, Norway and Sweden are singled out for their excellent health coverage for every citizen. But one needs to remember their combined population is not even 10 percent of that of the U.S. — which also lifts a large share of their defense through financial support of NATO.
Starting with President Bill Clinton’s efforts to find a way to provide coast-to-coast coverage during his term, to President Barack Obama’s Affordable Care Act of 2010, efforts have been noble. But they were never the success promised as about 10 percent of the population, the Gazette reported, are still not covered.
And the age-old question of how to deal with preexisting condition coverage still has no answers.
Little has changed in a half-century besides, that is, watching both the cost of healthcare, and insurance skyrocket.
Imagine the shock as reported in Time Magazine’s “Bitter Pill,” special edition, of receiving a $21,000 bill to diagnose a heart attack only to find out it was acute heartburn?
Makes one need a pain reliever. But be wary as that generic Tylenol will set you back $1.50 each inside a clinic, the cost of an entire bottle if bought outside those walls. More meds may be needed when you learn about hospital and insurance company CEOs who earn millions of dollars a year while millions of people go without coverage.
How does that happen?
The answer lies rooted somewhere inside that health care insurance so many of us seek, but is as elusive as getting the Israelis and Palestinians to figure out how to live in harmony with one another.
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