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Health care reform: congress needs to protect Americans, not insurance companies


opinion1by Mark Dunlea, Green Party of New York State

As Congress negotiates health care reform, Democratic leaders have put the interests of insurance companies ahead of the needs of American citizens.

If Americans want an affordable, quality health care system that enables consumers to choose from whom they receive health care services, private for-profit insurance companies must be eliminated. Michael Mooreís movie SICKO correctly highlighted the problems with insurance companies rather than the problem of the uninsured. While the lack of health insurance is estimated to kill 18,000 Americans annually, for-profit insurance companies kill far more with their unreasonable denial and delay in approving treatment as they seek to maximize their profits.

The proposals being advanced by the White House and congressional Democratic leaders will leave tens of millions without health insurance or care.

mark-dunlea-speakingThe majority of Americans who file for bankruptcy do so due to high medical bills. Incredibly, 77 percent had private health insurance. They are shocked to discover their policy failed to cover the high costs of their medical emergency. Having health insurance is no guarantee you will receive needed health care ñ yet many politicians tend to equate the two.

Despite having some of the best doctors, nurses and hospitals in the world and spending twice as much per capita, the U.S. ìhealth careî system is routinely rated the worst among all the industrial countries. The World Health Organization ranks us 37th. We have higher infant mortality rates, lower life expectancy, fewer doctor visits and longer waiting times than the other industrial countries. The fact that fifty million Americans lack health insurance contributes to the poor performance of our health system. The central role of for-profit health insurance companies and their rules, paperwork and bureaucracy is the other major factor.

Some other industrial countries allow for supplemental insurance to cover options beyond core health care. But they do not allow the insurance companies to be for-profit and the firms are strongly regulated as to how they operate. In America, we allow for-profit insurance companies to dictate if and how health care will be delivered and paid for.

Democrats in Washington understand this, but for a variety of reasons they have decided to protect the insurance companies. A major factor is the large campaign contributions made by insurance companies. Even Congressional members who donít receive huge payments from insurance companies worry about their significant political clout and decide to cut a deal with the insurance industry, supporting incremental changes, figuring half a loaf is better than nothing. Theyíre wrong.

The proposals being advanced by the White House and Congressional Democratic leaders will leave tens of millions without health insurance or care; will mandate expensive and inadequate health insurance to many more (so medical bankruptcies will continue to proliferate); and will actually increase the amount of money spent for health care. If implemented, these shortcomings will undercut future support for real reform.

America does not need to spend more money on health care. Our health care expenditures amount to more than one-sixth of our economy. Just the amount of tax dollars we already spend per capita on Medicare and Medicaid is greater than the health care expenditures of other industrial countries, yet they manage to cover everyone. Health industry defenders argue that we spend more money because we are a rich country and have the discretion to invest in health care and live longer. But the other industrial countries spend less than we do, yet live longer and have better health care systems.

Where does all the extra money for health care go in the U.S.? Certainly some goes to medical specialists, overinvestment in the newest expensive technology (to increase profits), drug companies and for profit medical providers. But much of it goes to insurance companies, which provide virtually nothing of value to our health care services while forcing the rest of the health care system to waste a lot money and time dealing with them. Eliminating for-profit private health insurance could save as much as $400 billion annually.

Instead of cutting health care expenditures, the Democrats want to spend a lot more, in order to protect the insurance companies. They propose expanding subsidies and payments to insurance companies (e.g., enacting various insurance mandates) while making consumers pay more (e.g., taxing health benefits) for less services (e.g., cutting back on Medicare and Medicaid).

Experience also shows us the ìhalf a loafî approach to universal health care doesnít work. A number of states have launched ìuniversal health careî experiments in recent decades. All have failed, largely due to their unwillingness to cut the amount of money going to insurance companies. What happens is the new ìsubsidizedî health insurance plans created are still too expensive for the uninsured, so they donít participate and the number of uninsured does not decrease substantially. But many people presently receiving health insurance through their employer end up being pushed in to the new ìpublicî program, so the costs for taxpayers go up much higher than anticipated even though the number of uninsured remains high. The program collapses due to its failure to control costs.

Democrats often argue ìletís get everyone in the system first, so letís not threaten the insurance and drug companies so theyíll go along. Once everyone is in, it will be so popular ñ just like Medicare and Social Security – that we can then confront costs.î America doesnít work that way. When the costs are so high and the number of uninsured donít come down like promised, the political support for universal health care collapses.

The ìpublic optionî model being fought over by the Democrats as the ìcutting edgeî is just the latest version of the failed state universal health care models. The public option model ñ as weak and flawed as it is ñ is getting weaker during every step of the congressional negotiations. Congressional leaders are bending over backwards to make sure the public option doesnít even ìcompeteî with private health insurance, let alone eliminate it. They appease the insurance companies and Congressional Republicans by promising that the public option will continue all the bad practices of private health insurance so that it doesnít have an ìunfair advantage.î Some models are little more than an ìexchangeî to purchase private health insurance. Even if the public option gets implemented, there is the real risk that it becomes a ìdumping groundî for those with high health care costs (i.e., the chronically ill), defeating the whole concept of ìsocial insurance.î

Democratic leaders, in arguing to preserve insurance companies, claim that Americans want the option to keep what they already have. This is misleading. Americans are not arguing to preserve the roadblocks and costs of private for-profit health insurance. They do want to avoid paying a lot more for health care if they already have it from work and they donít want to have less access to health care. Most want the option to be able to continue to see their present doctor or medical provider. But they certainly donít want HMOs to control their health care decisions ñ or pay higher costs to keep HMOs alive.

Others argue that we have to preserve the jobs in the health insurance industry, especially during this recession. But killing people and wasting money to preserve what are largely data entry jobs isnít the solution. Many of these data entry jobs can be transferred into an expanded health care system. It would be far cheaper and more socially productive to provide job training and job guarantees to the existing workers. Providing a true universal health care system will also create many jobs as more individuals receive health services.

All of the main Democratsí proposals will still leave tens of millions without health care coverage. Without a true universal health care system that covers everyone, there is less incentive to make the public investments needed to focus on keeping everyone healthy (e.g., preventive care) rather than trying to deal with the problem once someone becomes sick. A ìsick careî system such as Americaís is much more expensive.

Democratic leaders from President Obama to Senator Schumer readily admit that a single payer system ñ an expanded ìMedicare for Allî ñ makes the most sense for America if we were willing to take on the insurance companies. Democratic leaders say single payer has no ìpoliticalî support ñ despite having far more sponsors in congress than any other proposal as well as having strong support among doctors, nurses, academics, community groups and voters.

America will not get universal health care until its political leaders forget about the Band-Aids and campaign contributions and do the needed surgery to remove the cancer of for profit private health insurance. Single payer legislation such as HR 676 and S 703 is the clear solution.

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