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When I was a kid in the ’50s, I learned that health insurance was nonprofit, which my parents explained was the way everybody chipped in money to help pay for the unlucky few who might need expensive medical care at any time.

Ralph Knudson mug

Ralph Knudson | La Crosse

It made sense to me: It was another way that grown-ups worked together to take care of each other. It also helped me feel secure and free of worry. We all took care of each other, like we should. So ... what happened?

Blue Cross and Blue Shield were “community-rated” nonprofit insurance plans in the ’50s. Such insurance companies estimated cost of claims for the next year, and set the premium price to cover costs by simply dividing it evenly among all premium purchasers. Healthy people paid more for the needs of those less healthy when they needed it, and had security and reassurance that they’d be covered if they needed it, too. There were no “high-risk groups.” We were all equally into it together for the long run.

During the late ’50s, for-profit health insurance companies started selling cheaper insurance premiums to only younger, healthy people, whose claims would also be low (at least for a number of years until they got older). By appealing to healthy people’s interest for short-term cost-savings, for-profit insurance pocketed some profit for itself. When healthier people abandoned the community-rated nonprofit plans to buy this for-profit insurance, Blue Cross/Blue Shield was left with fewer healthy people in their pool to help pay claims for older, sicker patients, so they had to raise premiums. Eventually, all insurance plans were forced to charge different rates based on age and health history, just to keep enough healthy people in their plans as well.

What we now have is a system created by the marketplace and defined by for-profit insurance; where patient risk groups and premium charges are decided by insurance to be sure that profits are made at each step by dividing up a selected under-65 population of mostly employed folks. The much more costly older, unemployed and chronically ill population is covered by Medicare and Medicaid tax dollars (which we all pay into and eventually benefit from in different ways).

Private insurance’s main mission is to create profit with each premium sold (and claim denied) to benefit stockholders and the board of directors; not to serve the larger community’s health needs. This is the exact opposite of what made “community-rated” nonprofit insurance work for a diverse population. We’ve gone from taking care of each other in need ... to every man for himself, if he can afford it.

Today’s health insurance adds nothing to quality of care, care provider efficiency, availability or improved communication or advocacy for patients. It has wormed its way into our health system as a parasitic middle-man, which manipulates and profits from the fact that we will all age and eventually need more health care...for which we will then pay a higher premium. Administrative costs are twice as high in as in other nonprofit national health systems. The dysfunction and drain on our resources has become unsustainable.

A national movement to establish Medicare for All is underway, which could lead to restoration of a nonprofit community-rated alternative to the for-profit system.

Here in Wisconsin, we have the option of creating a Badgercare for All (as proposed by Mike McCabe) as a state model, which would offer a lower-cost, nonprofit health insurance to all Badgers. Such health insurance would be a state-sponsored service for many, not a corporate profit industry for a few. Hospitals, doctors and care institutions would remain private and independent, giving patients freedom to choose. Universal, statewide Badgercare expansion would expose the inflated costs, manipulations and inefficiencies that for-profit insurance has inflicted on the public. For-profit insurance would need to compete to provide better service at lower cost. The public knows that affordable health insurance is needed communitywide, and needs a seat at the table through our state government.

Gov. Scott Walker’s recent change to support Obamacare in Wisconsin is evidence that he’s now feeling public pressure to protect health options; not only for-profit insurance. However, Walker’s shell game to finance Obamacare for the middle class by cutting Badgercare funds and generate “Medicaid savings” is clearly designed for short-term political gain. Weakening Badgercare at the expense of our most vulnerable and needy is no solution to the problem of how we best care for each other at times of crisis and need.

Contact your local state representative and senator to oppose Walker’s proposed raid on Badgercare funding, and then ask for support of the Badgercare Public Option Bill that will be introduced soon.

Dr. Ralph Knudson resides in La Crosse.

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(43) comments

johnnybragatti

Pretty good reason that Walker is considered the very worst ,of all governors in the U.S.A.
The writing"s on the wall.

Cassandra

Medicare for all is the cheapest and most effective option. Get the insurance companies out of the picture entirely.

CJ

Any chance you have ever worked on the side that gets paid by Medicare for services provided? There is a reason it is possibly the "cheapest" is because of what they pay out [sad]

tower

CJ, as a seller of HC insurance you should know better. Medicare has 50 yrs of data of what it costs. They figure payment on that + 10% for profit. Since MC is the biggest payer in HC industry where do you think they got the money for all those hospitals that look like resorts? And why all the advertisements for more elderly patients?

Cassandra

Profiteering by the insurance industry is literally killing people. And they don't care.

Cassandra

Pay out to whom, CJ? The stockholders? The executives? The advertising brokers? Or is it to the fancy golf resorts where they gather?

Redwall

The V.A. is having trouble recruiting doctors to work for the government system.

Snow Cougar Mary Burke

“Badgercare for all” as a state model should rule out Mike McCabe as being competent for the governorship of Wisconsin. Even Bernie Sanders and his state of Vermont recognized it would amount to a total failure and bring harm to its citizens.

In the words of Democrat Governor Peter Shumlin on why he was pulling the plug on imposing single-payer, government-run health care on Vermont residents, “The potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.”

In order to pay for Vermont’s single-payer, government-run health care – known as “Green Mountain Healthcare” (think Badgercare) taxes would need to be raised another 160%. Vermont’s total tax collected revenue for the year was 1.7 Billion. In order to pay for “Green Mountain Healthcare”, Vermont would require an additional 2.6 Billion added to the existing 1.7 Billion in tax revenue.

The Green Mountain plan, like Badgercare would also require hospitals and doctors to accept Medicare-like reimbursement rates for their privately-insured populations. This would require a 16% cut in payments to doctors and hospitals. Wisconsin like Vermont also could not preempt Medicare, or military health care, or large companies that directly pay for their workers’ health care using a process called self-insurance. In addition Wisconsin residents can get private insurance from neighboring states like Minnesota, Iowa, Illinois and Michigan. So one of the false key arguments made of seeing monetary savings by having doctors and hospitals working with one insurer, simplifying paperwork would not be possible.

It shows how Mike McCabe, amongst other Democratic Socialists (communists) are willing to waste our state’s time and resources on something that would attempt to refute the laws of arithmetic.

Scott Walker … America’s Governor!

tower

Problem with Vermont is the population isn't big enough. Even a mental giant like you should know that. Put it on Medicare for All and make it nationwide, you got something. WI could do it but I think it is borderline.

joebadaxxe

Good article, Ralph. Who could argue? Except an insurance company executive or a dupe for the same.

Redwall

So much "free" to be distributed one hardly knows where to start. Free education, free health care, free retirement, free food, free energy, free transportation, free housing, free freedom, and the most basic human right as defined by the Left...freeloading.

Clarification

And yet a lot countries like Norway supply a lot of what you list and are doing a lot better than the always-at-war Trumpified law of the jungle USA.You call it freeloading, I call it caring about people in your country. We have become savages.

Redwall

Norway, like a lot of countries, is particular about who they let immigrate. Norwegians actually work, pay high rates of taxes, and accept the tradeoffs.

America is not particular about who is lets immigrate, provides little incentive to work, and hands out candy (welfare) to the masses in return for votes.

oldhomey

Redwall, how about putting this in your pipe and smoking it? The immigrant population in Norway makes up 16.8 percent of its total population. In the U.S. 13 percent of the population is immigrant.

oldhomey

Redwall? Nothing more to say? Are you in the weeds with Buggs, hiding out?

kingman10

you got him hiding good homey!

Cassandra

Every immigrant I've met, documented or not, is working their butts off to make a decent life for themselves and their families. To assume otherwise is to buy into racist propaganda.

tower

Another fool. Nobody but you said free.

Redwall

What would you call the doctor's idea then, a magic act? Who do you think is paying for it?

tower

Only an idiot would get free out of the article. Is HC free in our system now? We will pay for it through taxes fool.

kingman10

gee no one said anything about free. I don't see free anywhere in the good doctors column. Of course it will cost money, but instead of paying insurance companies you pay into a pool with all the residents of the state or states. Not so hard to figure, for most of us anyway.

Redwall

The country is already broke. Social Security has little more than a decade before it implodes. Yet another entitlement that can only be funded by taxes that already cannot cover the existing entitlements is lunacy. Maybe if Dr Knutsen, all other doctors and nurses agree to work for nothing but altruistic goals this would work.

kingman10

maybe if your right wing nut politicians would quit giving away corporate welfare to the tune of billions at a time, we the middle class could get an even break. Instead we have to subsidies insurance companies, big profitable corporations, and a military that is growing every year. Reagan taught us that deficits don't mean anything, just numbers on a piece of paper is all it is. Social security is not broke, all it needs to to be reimbursed for all the money the gov't borrowed from it and it will be good to go for a long time.

kingman10

hello redwall, are you hiding in the weeds again!!!

mocha1

Nice hypothetical discussion. Health insurance for all, get evil profiteers out of system. So how much will this universal care cost. And what level of care will you get for that cost. We just had an experiment with Obamacare. We had the same “hypotheticals” when this was being sold to us. Everyone will have great coverage and on average health insurance costs will go down $2500/year. We all know how that turned out. My premiums went from $800/month $2500 deductible to $1800/month $5500 deductible. When I hear talk about Medicare for all it shows me they do not know much about Medicare. This system is already financially unstable, dumping the whole country on a system with fixed payments to healthcare providers which do not cover the actual costs is a disaster in the making.

tower

Another genius. My wife made about $85 k and she had about $30 bucks a month taken out for Medicare. I think she could of had some more deducted without HC taken out. I don't see a rush by other counties to adopt our glorious system of for profit care and insurance.

Redwall

She will have a much higher amount taken out of her retirement check. Just wait.

tower

Probably if the clownservatives get their way.

Redwall

Medicare premiums are at least 10% of your SS check; been that way for several decades.

Smarten up.

tower

Redwall, best just sit there and shut up. Medicare deduction is 1.46% of pay. Not the imaginary 10% you dreamed up.

oldhomey

Well, Mocha, of all the comparable advanced industrial nations in the world, we pay about twice as much on healthcare as any of the others. All of them have single payer systems of one kind or another. And all of them have healthier populations than the U.S. That is not hypothetical.

kingman10

ok moch1, go ahead and tell us how you would fix the system. Instead of criticizing and picking apart every argument come up with a viable solution for comprehensive healthcare for all and a cheaper cost, Just like Trump promised, we will be waiting for your informed response.

kingman10

Well the good doctor makes a lot of sense. He points out the problems with insurance run health care, and offers a viable solution. Now with the republicans running the state gov't it is doubtful anything will be done, but hopefully next november that will change.

A Veteran

kingman--I must have missed where you showed prove on the 130,000 dollars ALLEGEDLY paid by Trump,please show it again so we can all see you are not a liar just repeating lies to see if it will become truth.

kingman10

Oh there is my buddy veteran! What kind of proof do you want. Allegedly Trump paid that money, and allegedly Hillary lost some emails. And Allegedly Trump sexually assaulted women, and allegedly Trump will provide his tax returns for all to see. And allegedly Mexico is going to pay for a border wall. I am just reporting what the Wall street journal and other major news outlets are reporting. Go ahead and google for yourself.

kingman10

here is a little tidbit to get you started veteran. This story came from various sources investigated by the wall street journal. They deemed it true and worthy of reporting, that from a right wing newspaper. So feast your eyes on this: https://www.wsj.com/articles/trump-lawyer-used-private-company-pseudonyms-to-pay-p*rn-star-stormy-daniels-1516315731 My how the mighty have fallen, the strong have become weak, the sins of the flesh overcome. I had to change one word inthe address with a *, so correct that before you search.

A Veteran

kingman--All you have done is spew out an article that their prove is sources told them.Where is your prove,admit it you have non.Like I said like most LOONS you repeat ali enough times people will start thinking it is the truth.Well I am going to drop the subject because you are not man enough to admit you are wrong.SAD!!!!!!

oldhomey

How does that work, A Veteran (of no known military branch)? If I just go around chanting ali, ali, ali, and POVE! ali becomes real? No magic lamps to rub? Now there's a concept anybody could loof!

kingman10

yes veteran is a piece of work. he sure loves his trump, I guess he's upset his dear leader cheats with adult film stars and assaults women. He thinks Trump is some kind of alter boy, pure as the driven snow. Let him be in his fantasy world.

Cassandra

The "vet" wants engraved tablets, handed down by god, at least on any subject that undermines Trump. But he'll accept any evidence, no matter how debunked, that cuts down any Democrat.

kingman10

sorry I don't have the 130,000 dollars Trump gave to his sweety. I imagine she spent a lot of it. Stay tuned, your little choir boy Trump will get cornered again with all his lies. The same happened with Nixon, remember what happened to him?

A Veteran

kingman----The last thing I am doing is defending Trump as I have told you before,what I am doing is defending the truth.But truth is one word that liberal LOONS such as yourself can not spell much less know what it means.I would tell you to look it up but I do not think you could could find it.

kingman10

well I asked you a couple of times what do you want as proof? What would be proof in your mind? You never answered me. If you are looking for an admission of guilt from Trump, aint gonna happen. He lies constantly. If you think a denial from Trump is proof of innocence you are sadly mistaken.

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