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Dear Rep.

/Senator ,

I am one of your constituents, living overseas but voting in ..I am one of


many Americans living outside the USA who participate in the national
healthcare schemes of our host countries. This puts us in a good position to
compare these schemes with American healthcare insurance. That is why
were providing you with stories about healthcare from Americans living in
many countries around the world. This is our way of encouraging you, as
legislators, to further build and improve upon the ACA in order to enable all
Americans to benefit from affordable, accessible, fair healthcare insurance.

Every one of our contributors has emphasized how happy they are with the
healthcare coverage they receive abroad. They ALL refer to the
extensive coverage and the affordable cost of healthcare in their
host countries.

Healthcare is affordable in our countries of residence (mostly OECD


countries) for three reasons. It is universal, government-regulated
and non-profit. No political party in our host countries questions
the need for national, public healthcare. Some recent OECD statistics
comparing coverage are presented in the table below. This is clearly the
most efficient and economical way to provide healthcare to a countrys
entire population. Weve lived it and we know it works.

Some of the proposals discussed in Congress envisage different coverage


and risk pools (younger/older, healthier, sicker). The only reason for this
differentiation is that American insurance companies need to make a profit
from premiums paid. Hence they prefer to insure healthier people who are
supposedly less likely to need healthcare and charge more for people
supposedly more likely to actually use their insurance. The premiums they
collect are used to pay dividends and bonuses rather than to provide
healthcare. Advocated in the name of competition, this is an ideological
argument, not an economic one. This is the wrong approach for two reasons.

First, it contradicts the whole concept of pooled risk. If you have a single
payer system, such as Medicare for All, or Federal Employees Health
Benefits Program (FEHBP), the problem disappears. If everyone pays into
the system, everyone benefits and the risk is spread as widely as it can
possibly be spread. This is how the healthcare schemes described in our
stories actually operate.

Second, it makes sense to pay for healthcare at a reasonable rate


throughout our lives. We buy our cars and houses over time so that they
are more affordable. The same approach should apply to healthcare
coverage. Moreover, whatever the statistics may say, all of us can have
an accident or fall ill at any time. Probability is not reality.
We urge you to take significant steps towards regulating both the provision
of insurance and the cost of treatment and drugs in order to keep costs
down for our citizens. Whats important is to approach healthcare
reform from the standpoint of benefits to users, not from the
standpoint of profits and competition. This should not be an ideological
debate, but rather a practical exercise to find the best way to serve the
most people at the most reasonable cost. We hope everyone in Congress
will read our stories and take heed as you continue developing healthcare
for all Americans.

Sincerely,

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