State Health Insurance

The mention of governmental health insurance usually evokes loud charges of socialized medicine and many of the other cliches which make discussion of American economics into semi-religious issues. Yet Nelson Rockefeller--not very renowned for his socialistic ideas--advocated in a recent campaign speech that New York extend its workmen's compensation laws to include financial protection against catastrophic medical expenses. Harry Truman, some years ago, also suggested a national health insurance scheme. Such an extension of public welfare activity would be both beneficial and practical.

It is doubtful that a Federal health insurance bill could survive the Washington gauntlet of conservative congressmen and AMA lobbyists. But in some of the wealthier and more liberal states--New York, Pennsylvania, California, Michigan, and others--public health insurance might be initiated. Successful implementation of state insurance programs would provide inspiration and incentive to establish a national health insurance plan.

A good segment of the population, of course, is covered under one plan or another, the best known being Blue Cross and Blue Shield. But policies like these offer only partial coverage to those insured. Even after an insurance corporation has defrayed medical expenses, the remaining costs can very easily be staggering. Doctors' and nurses' fees, extended treatment or psychiatric care will impose expenses that can burden a family with immense debts. In addition, poor risks, like old people, are not covered under private insurance plans, and local or state clinic facilities are necessarily limited. Modern standards of social responsibility, however, seem to indicate that the right of any citizen to needed medical treatment should be guaranteed.

Health insurance does not imply a restriction on the patient's right to choose his own physician, although some control might be needed to discourage any doctors from overcharging insured patients. As a start, it might prove most practical if state insurance covered any medical expenses which exceeded a certain percentage of a patient's income. Any such percentage could be determined according to an individual's income bracket and would allow for dependents.

Financing state insurance would not be excessively expensive. To cover about the same scope as the Social Security System one would probably require an additional payroll tax of about four per cent. Split between employer and employee this is a moderate premium. Present private or factory medical policies, just like current private retirement policies, could continue to exist collaterally.

It is encouraging that a candidate for public office has come up with at least some public health insurance proposals. Hopefully such suggestions will be solidified in legislation on as wide a scale as possible.