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As someone who spent four years without any form of health insurance, terrified every time one of the kids fell off a bicycle, I keep thinking that I should praise the national health plan proposed by Democratic presidential candidate Michael Dukakis.
The need seems obvious. In 1960, 68.8 percent of all working Americans had health insurance provided by employers. That rose steadily until peaking in 1980 at 82.5 percent. Since then the percentage has steadily declined. It stood at 75.4 in 1985, the last year that figures are available for. So fewer and fewer Americans have private coverage.
But if you're real poor, you have Medicaid. If you're old, you have Medicare. And even with the decline in employer-provided coverage, most Americans have some sort of health insurance. Of the 235.5 million Americans in 1985, there were only 31.3 million, or 13.3 percent, who had no health coverage whatsoever.
Who are these people? I was one of them; I know a lot of other self-employed people who lack health insurance.
There's a reason. Most health-insurance plans are group policies; when you're self-employed, you're not part of a group. That's understandable, but our tax laws aren't.
If you work for somebody else, your employer can deduct the premiums on your health insurance as a business expense, and the insurance you receive isn't taxed as part of your income. But if you work for yourself, you can't do that. Only recently has the tax law changed, and it's still unfair. Self-employed people can deduct just 25 percent of their health-insurance premiums.
Making the tax code fair would enable many more self-employed people to afford health insurance, but the Dukakis plan appears to ignore the self-employed. It is concerned with the unemployed, and with employed people whose employers do not now provide health insurance.
Employers would be required to provide health insurance, and the unemployed would be covered by a pool, financed by taxes on employers. Since most employers already provide health insurance, that shouldn't change much, should it?
But there would be changes, not necessarily for the better. An employer now has the choice of just getting out if the premiums become too costly. That is a potent incentive to keep health-care costs within reason.
Without such cost-cutting incentives, health-care costs skyrocket. For years, Medicare and Medicaid provided blank checks to doctors and hospitals. Health care went from 7.4 percent of the gross national product in 1970 to 10.9 percent in 1986.
This money doesn't necessarily make anyone healthier. Most industrial nations spend less on health care than we do, and have healthier populations: In West Germany, for example, health care gets but 8.1 percent of the gross national product, and yet Germans enjoy a lower infant mortality rate (8 to our 11) and a longer life-expectancy (76 to our 75).
Putting more money into that system, which is essentially what Dukakis proposes, offers no guarantee of a healthier population.
Further, mandated health insurance will give employers vast new powers over your personal life. As it is, your employer determines when you awake, when you eat, what you wear, where you live, etc. Once the law requires him to worry about your health, he'll quickly tell you what you can eat when you're at home, what you can drink after work, what activities you can indulge in on vacation and during weekends. Any notion of a private life, unconnected with your job, will vanish as Big Brother, in order to keep his costs down, starts watching you all the time.
And yet this proposal comes from a Democrat who is supposedly a friend of the worker.
It is disgusting when the first thing the nurse wants to know is not the nature of your ailment, but the name of your insurance carrier. There has to be a better way than the way we do things now. But making employers into health police is no improvement.
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