It is useful to the public’s understanding of the health care crisis in our country that the national health care act is before the Supreme Court just as Iola’s health insurance policies also are under fractious review.
The city has a modified self-insurance plan. It contracts with Blue Cross-Blue Shield to cover costs for catastrophic illnesses and injuries that cost more than $50,000 to treat. Smaller bills are paid from the city treasury from funds collected from employees and from the city.
Under its contract with the city, BCBS recommends what Iola should collect from workers and what the city itself should contribute into the fund. As former city administrator Judy Brigham said last week, the city commission elected to keep employee premiums as low as possible as an additional loyalty incentive and set employee premiums below the BCBS recommendations.
As it is now, the city pays $430 a month for single coverage. For those on a family plan, the city asks for $250 for each additional member. Under a new arrangement, employees will pay $509.42 for family plans.
AS WAS REPORTED in Wednesday’s Register, Allen County gives its employees an additional $767.63 each month with which to buy individual health insurance. A family plan — which workers pay for themselves — cost $1,695 a month, or $20,208 a year, as of next week.
It is not surprising not one of the 107 county employees has subscribed to the family plan: they can’t afford to pay as much as half of their income — it would be a larger fraction for some — for health insurance.
It will not be surprising if many of Iola’s city workers make the same choice if the city council decides to charge its workers the full BCBS recommendation for family coverage.
And that’s the point of this piece.
Health care in this country has priced itself out of reach of those who earn $30,000 to $50,000 a year and are not covered, or mostly covered, by their employers.
Barack Obama won the presidency in 2008 partly on his promise to enact health care reform. He was elected and was marginally successful in redeeming that pledge. Marginally, because Obamacare is not the single-payer national health service that it would have to become if costs are to be controlled and coverage is to become universal.
As what is happening right here before our eyes demonstrates so clearly, health care costs must be allocated across the entire economy; care must be available to all and the power to control how much of what kind of care is given to whom, at what price, must be given to neutral administrators who do not benefit personally from those decisions.
These central issues aren’t before the justices. The decisions they will make have mostly to do with the relationship between the states and the nation. Who gets health care isn’t before them. Neither are effective ways to control costs or allocate services.
The justices won’t decide what must be decided because that isn’t their role in our society — and shouldn’t be.
Providing affordable health care to all Americans is the responsibility of the government of all Americans, which is to say, Congress and the president.
As Allen County and the City of Iola can attest, our national government has yet to meet that national responsibility.
