On the eve of the American Revolution Thomas Paine provided colonists compelling economic reasons for severing relations with England. In his stirring pamphlet, “Common Sense,” he argued it was foolish to allow a small island 3,000 miles away to rule our continent.

Were he pamphleteering today, he might argue it is equally foolish to permit the medical insurance industry to determine the extent of our nation’s health care and its costs.

Common sense would have the people who need health protection, those who provide it, and those who pay for it to band together as modern patriots to better govern the way we insure our medical “life, liberty, and pursuit of happiness.” We would all benefit from competition in the health care marketplace that a government-sponsored option to private insurance would provide. Competition reduces prices.

Here are just a few arguments a contemporary Tom Paine might use to justify another kind of American Reformation.

1) We spend far too much money on sustaining our current health care system. Nearly everyone complains about their taxes but few, if any, of us know what percentage of it goes toward supporting private health insurance programs. On the local level the cost is enormous.

The bill for two major employers in Allegany County gives us a glimpse at its expense. At. Frostburg State University, it comes to $7 million dollars, $10,000 for each of its full time and retired employees. Cumberland’s city budget earmarks $3.7 million for its employee’s insurance in a variety of venues. These private insurance costs are paid for by our city and state taxes. Our nation’s businesses have suffered even greater pain by what they pay to medical insurance companies to insure their employees.

2) Cost is only one consideration for supporting fundamental change. The comparative efficiency between the administrative arms of private and public medical insurance is another.

Some physicians prefer dealing with Medicare-supported programs, a government insurance model, rather than with private companies because it has more straight forward regulations.

Its rules for governing payments to doctors are clear and the payments they receive are more prompt than those from private companies.

3) Those of us who receive good medical care through private insurance should not have to sacrifice anything. The many who aren’t so fortunate would gain a lot under a new system that they might afford. This would be good for all of us.

Their loss of productivity due to untreated illness hurts the marketplace, their unattended sickness can ultimately take them to a hospital whose high costs are sometimes born by the rest of us, and their coughs can transmit disease. The common good requires our common health care.

4) Doctors, our chief server, also need protection against exorbitant malpractice insurance costs. Without a cap on these costs we’ll lose a new generation of physicians. Our children and grandchildren will need them

We should insist that the forthcoming Congressional legislation provide universal coverage and include some form of governmental option. Those who claim that government programs are bureaucratic monsters refuse to recognize how well Medicare and the veterans’ health care programs have served many of us.

Finally, our President owes us an unadulterated description of what he wants, while our Congressman and Senators owe us a concise description (free of hyperbole) of the components of the final bill that they will vote on, and the reasons for their vote.

The Congressional Budget Office will provide us cost figures. The price of failure to enact a reform program could ultimately be more than the price of success.

John Wiseman

Cumberland

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