Marie Cocco on the Citizens' Working Group report
Jittery about the health system
By Marie Cocco
The Sacramento Bee
October 8, 2006
More than a dozen years after Hillary Rodham Clinton’s grand experiment in reshaping the health insurance system died in a pyre of overheated political argument and hysterical claims, it turns out the public wants pretty much what Clinton tried to deliver: coverage for all Americans in the form of a nationally mandated, guaranteed set of core benefits to replace the current patchwork that leaves even many people who have insurance with inadequate coverage for some illnesses and treatments. In short, it should be a national policy that refuses to let a family be crushed financially if someone becomes very ill.
All this would, naturally, be financed in a way the body politic considers “fair” — without creating an undue burden on sick people and in a way that’s related to a family’s ability to pay. The most popular means of raising additional funds is through “some form of progressive, or ‘sliding scale’ income or payroll tax (like the Medicare payroll tax) specifically dedicated to supporting health care for all.”
No, this isn’t a script for a Democratic candidate’s campaign commercial. And they’re not talking points for an interest group pushing this health care solution or that.
These are the conclusions of an official, nonpartisan government commission set up by Congress as part of the Medicare prescription-drug legislation. What the commission now tells us — after taking soundings in 37 states, collecting tens of thousands of responses to polls and written questionnaires and listening at 98 community meetings — is that Americans see clearly what is wrong with the health care system, and have on their own achieved a remarkable degree of consensus on how to fix it.
More than 90 percent of those who participated in community meetings or responded to the commission’s questions and polls said they believed every American should have affordable coverage. A clear majority wants a mandated, basic benefit for everyone and is “not comfortable with bare-bones benefit packages.” There’s agreement, as well, that if doing things more efficiently and reshuffling current government subsidies don’t generate enough money for expanding coverage then — ahem — people are willing to pay higher taxes.
http://www.sacbee.com/110/story/35162.html
Comment:
By Don McCanne, MD
In a previous Quote-of-the-Day, I condemned the recommendations of the Citizens’ Health Care Working Group as being the product of a partisan hack job. What I did not emphasize in that message (but had stated in previous messages) was the overwhelming consensus of the public participants on what should be done about improving our health care system. Americans want a system that provides reasonably comprehensive coverage for absolutely everyone, that prevents financial hardship and is funded in an equitable manner.
My objection is that there was a disconnect between the findings of the Working Group and the recommendations that were advanced. The recommendations can be summarized as follows: VERY high deductible coverage (reinsurance without coverage of primary benefits); support for integration of systems; contemplating the definition of core benefits; admiring quality; and encouraging humane end-of-life care. These are the recommendations that have been presented to the President and will be forwarded to Congress. No serious person can contend that these recommendations represented the comprehensive reform that Americans seek.
The fact that I condemn the process that resulted in grossly deficient recommendations does not mean that we should discard this report. We should continue to speak up loud and clear on the expressed wishes of the American people. But we should not allow Congress and the President to act on these recommendations and then pretend that they have provided the comprehensive reform we want.
If ever there was a time for citizen activism, it is now.