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The furnishing of health care as a collateral benefit of one's employment is largely a matter of historical accident rather than logical choice. Early in the development of the organized labor movement in the U.S. medical insurance was advanced as a benefit for employees.
Initially, management found this a less expensive alternative than an outright wage increase since it was a contingent rather than absolute expense and could be covered by an insurance plan. Over the years this concept became generally accepted in U.S. employment contracts.
Our current economic difficulties, with large numbers of the work force losing their jobs and as a consequence their health insurance demonstrates the illogic of this arrangement. Also, the cost of the insurance makes U.S. companies less competitive in the world market and is a factor in moving business offshore.
A more sweeping and more expensive problem with health care is to regard it as an "insurance program," necessarily tying it to the insurance industry, and creating a universe of unnecessary costs, involving profit taking, managerial expenses and paper processing creating a needless and expensive wall between the patient the care giver. Many other countries less developed and less affluent than the U.S. have provided a more efficient and vastly less expensive alternative by establishing a "single payer" system through taxpayer funded plans.
Resisted in the U.S. for doctrinaire and philosophic reasons rather than issues of practicality, we have inherited an inefficient system, overburdened by excessive and unnecessary costs and vast duplications of administrative functions. Our economic patchwork of co-payment , exclusions and coinsurance does not obscure the fact that we now have one of the most expensive and least efficient health care plans of any developed country and many less developed countries.
It is past time to get the hundreds of large and small insurance companies out of the health care business. By saving the millions of dollars wasted on competing advertising, executive salaries, stockholder dividends and salaries for unnecessary employees performing make-work paper-shuffling services the cost of health care could be immediately reduced to supporting health care function only, rather than the unnecessary appendages which have become the barnacles of the system.
The employees cost of labor would be reduced by no longer being burdened with adding the cost of "health insurance" to wage cost, making us more competitive with foreign companies who are not so burdened. Clearly this would be a win-win scenario for health care, the American public and the U.S. economy.
Randy Ludacer
Lake Placid

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