The Sorry State of U.S. Health Care "Reform"

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Fri Oct-15-10 09:09 PM
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The Sorry State of U.S. Health Care "Reform"

Universal health care has long been a desire of the American people. Even when the question is phrased in a manner most calculated to elicit negative responses – “Are you willing to pay higher taxes so that all Americans can have health insurance?” – the response has been highly positive – 57 “yes” to 38 “no” in this poll, for example. This kind of response has been generally consistent since 1991.

Prior to the passage earlier this year of the Health Care and Education Reconciliation Act of 2010 and the Patient Protection and Affordable Care Act, the main reason given for the need for health care reform was the tens of millions of uninsured Americans. With 47 million uninsured Americans, studies showed that approximately 23,000 Americans would die every year because of their lack of health care.

But the problem is more complex and deeper than the number of uninsured Americans, and it cannot be adequately addressed without attacking the underlying reason why so many Americans lacked adequate health insurance: the simple fact that it is unaffordable to so many of them.

The above noted legislation partially addressed that problem by providing government subsidies for those Americans who are most unable to afford health insurance or health care. But that solution has been largely countered and negated by virtue of the fact that the health insurance industry was left in control of the system. Indeed, they have already substantially raised their rates to compensate themselves for any losses they have to endure as a result of federal regulation in the health care reform legislation. The problem was again demonstrated recently, when the Obama administration told insurance companies that they may raise premium rates for sick children.

Of course, making the purchase of health insurance mandatory will increase the number of insured Americans. But at what cost to them? We should now ask ourselves whether or not this long-awaited legislation will in fact make health care more affordable for most Americans, or if the rise in premium rates will largely cancel out the government subsidies to the point where it is actually less affordable for many or most Americans. The bottom line is that the underlying problem was not adequately addressed. The health insurance industry remains in charge.

Some things we need to consider about the health insurance industry

The purchase of health insurance is a wager. The health insurance company wagers that you will remain healthy, and the purchaser wagers that he will get sick. There is nothing intrinsically wrong with a wager. But in this case the wager is greatly stacked against the health insurance consumer – much more than is the case for typical casino gambling.

The primary issue is the great amount of non-health care related costs that are involved. Private health insurance companies use the health insurance premiums they receive from their customers to pay for: multi-million dollar salaries for their CEOs; profits for their investors; propaganda campaigns to market their product; campaign contributions for legislators to persuade them to enact favorable legislation; and an army of lobbyists to handle those legislators. Health insurance is also stacked against the consumer because health insurance policies are usually written in a manner that leaves largely unspecified or unclear what the consumer is actually purchasing. Consequently, they are often surprised to learn that, after many years of paying exorbitant premiums, when they get sick enough to get some of their money back their claims are denied.

So why do people put up with this? Because the health insurance industry is the only game in town. They hold all the cards, and they can pretty much structure the game as they see fit. And now, with the recently passed health care legislation, purchase of their product is mandated. Undoubtedly, the health insurance company regulation contained in the recently passed legislation will be of some help. But the large rate increases proclaim who’s still in charge and portend big problems for the future.

Lost opportunity

There was of course a solution to this: Government provided health insurance or health care. Article I, Section 8 of the U.S. Constitution says that Congress may “…provide for the common Defense and general Welfare of the United States…” What constitutes “general welfare” if not our health?

In marked contrast to private health insurance, a government health insurance plan would not have to pay for marketing, lobbying, campaign contributions, or multi-million dollar salaries for anyone. And it would be non-profit. The money that it takes in from premiums would go solely to pay for health care. The savings attendant upon not having to pay for all those other things would be tremendous. In short, government provided health insurance or health care could and would be offered at far less expense and greater quality than what we get from private health insurance companies.

Right wingers show their contempt for most Americans by saying that those of us who favor universal health care coverage want to be “taken care of” rather than provide for ourselves. To the contrary. Our current health care needs are being “taken care of” by the insurance industry – and not very well. Government provided health care would constitute taking care of ourselves. In a democracy, we the people are the government – and we have every right to structure our government to take care of our needs, especially when they are so poorly taken care of by the existing system.

The insurance industry and its right wing supporters are fond of saying that they are all in favor of the free run of competition. Yet, they are scared to death of competition from their own government because they know for sure that the U.S. government could and would offer the American people a much better product at a much reduced price – which would of course drive them out of business. That’s why they spent tons of money – money that could have instead been spent on health care – lobbying and propagandizing against Congress’s attempt at health care reform.

These concepts are not new. The Obama campaign and those of other major Democratic candidates for President in 2008 were quite familiar with them. The health care plan that the Obama-Biden team offered during their presidential campaign made this point very well:

It is not right that Americans families are paying skyrocketing premiums while drug and insurance industries are enjoying record profits…. The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. In recent years, for-profit companies have bought up not-for-profit insurers… Premiums have skyrocketed… Insurance administrative overhead has been the fastest-growing component of health spending… And while health care costs continue to rise for families, CEOs of these insurance companies have received multi-million dollar bonuses.

And none of that has changed with the passage of health care “reform” earlier this year.

What Americans want

Most Americans are not demanding destruction of the insurance industry. They merely want a choice – of quality health care at an affordable price. In answer to the question, “In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance?” 77% of people responded that that would be extremely important (58%) or quite important (19%). That response cut across all demographic groups. Even 71% of Republicans said that it was extremely or quite important.

If allowing Americans that choice destroys the insurance industry because they cannot or will not provide a product of comparable quality and cost compared to what our government provides, then so be it. We don’t need them, and we shouldn’t be forced to pay for them.

Political consequences and considerations

With less than a month to go before the 2010 mid-term elections, Congressional Democrats running for Congress are in big trouble. The role of the enacted health “reform” legislation is not clear. Some polls show that most voters (54%) are more likely to vote for a candidate who supported the health reform legislation. But compare that to the 77% of Americans who felt that it is extremely or quite important that we be given a choice between a public federal health insurance plan and a private one. Perhaps if the enacted healthcare reform was designed to provide more tangible benefits to the American people, that would have become evident by now, and disaster for the Democratic Party wouldn’t be looming so closely now.

Instead, the Obama administration and our Democratic Senate succumbed to the demands of the private health insurance industry, and they gave up on the public option without a fight. One could argue that had they bucked the insurance industry they would have been met by a flurry of rabid criticism that would have hurt their political prospects for 2010 – and 2012. Undoubtedly, they would have been met with a flurry of rabid criticism. But that happened anyhow, and it should have been foreseen. How much worse could it have been? And had they fought for and enacted legislation that proved to be of immense benefit to the American people, perhaps that benefit would have over-ridden all propagandizing by the health insurance, health care and pharmaceutical industries.

In my opinion, the fact that Congress didn’t even fight for it means that they don’t truly represent the American people.

The role of Republicans in Congress

Obviously it is not fair to blame only the Congressional Democrats for this fiasco – especially this close to a Congressional election. Most Democrats in both houses of Congress were in favor of a plan that would have provided an option to the American people to purchase government provided health insurance – a plan very similar to our current version of Medicare. Many of us believe that with a little leadership from our Democratic President in that direction, legislation could have been passed that would have given our federal government the responsibility for ensuring universal health care in our country, and taken the system out of the hands of the predatory private for-profit health insurance industry.

Republicans on the other hand were universally against such a plan and did everything in their power to prevent its passage, or even debate on the subject. They sided with the insurance industry all the way, against the welfare of the American people. Many of them exhibited no hesitation whatsoever in lying about the plan for government provided health insurance in order to cast it in the worst possible light. Truth was thrown out the window and replaced by ridiculous talk of such things as federal “death panels”.

And so a great opportunity was lost. For that, the Republican Party is much more culpable than the Democratic Party. But the Democratic Party was in control of both Congress and the Presidency. And because of that they are being held accountable for their failure to enact a more substantive and meaningful health care reform plan.

It’s not too late. Well meaning Democrats who lacked the courage to stand up against the insurance industry can learn from their mistakes and act accordingly in the future. As for those Congresspersons of both parties who were simply co-opted by corporate interests into abandoning the citizens they were elected to serve, hopefully the American people will eventually learn to identify them and vote for better candidates in the future – if not in 2010, then in 2012 or beyond. Or better yet, maybe one day we will make it illegal for private corporations to purchase public legislators for their own private purposes.