Health reform should give you the freedom to choose

This article is the archived version of a report that appeared in the August 2009 Consumer Reports magazine.

The number of people with generous workplace coverage is dwindling. Out-of-control costs are forcing employers to trim or scrap coverage. And in this recession, millions are confronting a grim side effect of job loss: By 2010, one in five people under age 65 will be uninsured.

That's no worry for Mike and Mary Marks of Huntington, W. Va. Thanks to his 20 years of service, Marks, a retired Air Force captain, and his wife are covered under Tricare, a system for active and retired military personnel. They pay just $460 a year (that's not a misprint) and love its flexibility. "If we lived near a base, we'd get treated there for free," he says. "But we don't, so we use community facilities in the network."

As a result, Mike Marks, now a licensed physical therapist, can choose jobs without health benefits. "Right now, I'm working full time as a replacement for a woman who's on maternity leave," he says. "I didn't have to ask about health care." Compare that with the situation of Marks' brother, "a wizard with wood. He's been a general contractor and a boat collier, but some of his family have medical issues, so he's working at a factory to stay insured."

With truly portable coverage, Marks believes, Americans would feel freer to pursue their talents. "You could start a business without being afraid of not being able to provide health care for yourself or your employees," he says. Economists say job mobility would increase by as much as 25 percent if people didn't have to worry about coverage.

CU recommends

Under health reform, Americans would enjoy not only a wider choice of careers but also a wider array of health plans to choose from, including the public insurance plan. Opponents of reform like to vilify the public plan as "government takeover" of health care. We disagree. It's simply another insurer that uses the same private providers to deliver care. It would bring competition to the many markets now dominated by just one or two private carriers. And though the plan could never be as inexpensive as Tricare (provided in return for military service), programs like it demonstrate that public insurance can work. So we think a public plan would be an important element in comprehensive reform that gives every American the peace of mind of affordable, portable, quality coverage.