Tuesday :: Aug 11, 2009

Why Health Care Reform Now

by Mary

[Here is my argument which I wrote for the Commonweal Institute on why we must have health care insurance reform.]

Today, many of us know someone who has no health insurance and we worry about what would happen if they got seriously sick. Early last year a friend was diagnosed with cancer. Fortunately he had an excellent outcome with treatment. But two months later, he lost his job and -- after he and his wife struggled to keep up with the insurance payments for 8 months while he searched for a new job --they finally stopped paying for insurance. The choice came down to keeping a roof over their heads or paying their COBRA bill. They know they are now playing the lottery with his health. And God forbid his wife or son gets sick. This is the dilemma too many of our families, our friends and our neighbors are facing right now.

Reforming the healthcare insurance market is not only a primary goal of President Obama, but is also a major requirement for the economic health of the United States because it will prevent the bankruptcy of our country and its citizens.

Because of the importance of reform to our future, it behooves us to ask what would happen if this latest attempt at reforming the system failed as it did when President Clinton tried to reform the system in the early 1990s. After all, there are enormous forces that are once again aligned to make healthcare insurance reform fail.

Despite the forces against reform, achieving a credible reordering of the system is more likely this time, which is fortunate because the cost of failure would be so much greater. As Representative Henry Waxman (D-CA) said, "The issue is a lot more severe than it was in the 1990s. Fewer stakeholders — doctors, patients, hospitals or insurance companies — want the present system to continue. It will bankrupt the country."

What happens if we don’t get healthcare insurance reform this time? The trends are very, very bad. In the early 90s, almost 40 million Americans under the age of 65 had no insurance. Today, that number has increased to more than 47 million. Without reform, more Americans will join that group.

Beyond lost jobs, more employers are choosing to no longer provide healthcare coverage or have had to increase the cost to employees so much that employees are opting out. Smaller companies are especially impacted because they have much less ability to negotiate good rates leading to fewer workers getting coverage through their job.

And the costs continue to rise. Today employers are charged on average $12,700 to cover a family of four, with the employee picking up $3,400 of that expense. Businesses fear that the escalating costs will eat all their profits if something is not done.

Americans are increasingly underinsured, which leads to a growing wave of bankruptcies when facing catastrophic illness.

Since the 90s, for-profit insurance companies have been the darlings of Wall Street because they have delivered increased profits to their shareholders. The companies have found innovative ways to increase their profits. As Wendell Potter, a 20 year public relations executive in the health insurance industry who is now strongly advocating for reform, told Bill Moyers, one metric the insurance industry tracks for profitability is the “medical loss ratio,” the money used to pay health care claims. Every year, Wall Street expects that number to decrease and the best way to improve profits is to find reasons to not pay health claims for sick people.

Insurance companies have an awful policy to “make their numbers” known as rescission: the practice of searching for a reason to deny coverage when someone submits a claim that would cost too much. In one case an insurance company dropped coverage for a nurse who submitted a claim when she discovered she had an aggressive breast cancer. The reason given was that she hadn’t noted she had been treated for acne as a teenager on her original application. Worse yet, companies provide bonuses for employees who find reasons to drop people when they are really sick. After all, the seriously sick are the biggest consumers of healthcare and a company saves a lot if they can deny the sick coverage. When CEOs testifying before Congress were asked if they would stop this practice, they all said, “No.”

This is the status quo: when someone gets seriously ill they have a high chance of losing coverage. The status quo will lead to more expense, more bankruptcies and more premature deaths.

We can’t afford to let the status quo win this round. We owe it to our fellow Americans to make sure everyone has affordable and effective health care coverage.

Contact your Representatives and Senators and let them know you expect reform that looks out for our interests. Show up and express your support for real reform when they hold town halls your area.

(x-posted at the Commonweal Institute blog)

Mary :: 10:11 PM :: Comments (17) :: Digg It!